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Updated: Jan 5, 2026
Transthoracic Speckle Tracking Echocardiography for the Quantitative Assessment of Left Ventricular Myocardial Deformation
Published on: October 20, 2016
Assessment of left ventricular systolic function after VSD transcatheter device closure using speckle tracking
Yasmin Abdelrazek Ali1, Maryam Araby Hassan2, Azza Abdallah El Fiky2
1Ain Shams University, Cairo, 11528, Egypt. yasminabdelrazek@med.asu.edu.eg.
Insights
Transcatheter closure of ventricular septal defect (VSD) in children improves left ventricular (LV) systolic function. Post-procedure, LV circumferential strain decreases and radial strain increases, indicating reduced volume overload and enhanced contractility.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Imaging
- Congenital Heart Disease
Background:
- Ventricular septal defect (VSD) is a common congenital heart anomaly.
- Transcatheter device closure is a minimally invasive treatment option for VSD.
- Assessing global left ventricular (LV) systolic function post-VSD closure is crucial.
Purpose of the Study:
- To evaluate global LV systolic function using 2D speckle tracking before and after transcatheter VSD closure.
- To compare LV function in children with VSD to healthy controls.
- To assess changes in LV strain parameters after VSD device closure.
Main Methods:
- Case-control study of 30 children (15 VSD, 15 controls).
- 2D speckle tracking echocardiography to assess LV circumferential and radial strain.
- Transthoracic echocardiography performed pre-procedure and 3 months post-procedure.
- VSD characteristics (size, site) and LV dimensions/volumes were analyzed.
Main Results:
- Children with VSD showed higher LV end-diastolic and end-systolic dimensions and volumes pre-procedure compared to controls.
- Pre- and post-procedure, LV circumferential strain was significantly higher (more negative) in the VSD group.
- Post-procedure, LV circumferential strain decreased (less negative), and LV radial strain increased (more positive).
Conclusions:
- Transcatheter VSD closure leads to significant changes in LV strain patterns.
- A decrease in LV circumferential strain and an increase in LV radial strain suggest improved LV contractility.
- These findings indicate a reduction in LV volume overload following VSD transcatheter device closure.
Background:
This is a case-control study conducted on 30 children, 15 with VSD who performed VSD transcatheter device closure (group A) and 15 controls of matching age and gender (group B), in the period between September 2015 and February 2018. We aimed to assess the global left ventricular (LV) systolic function by 2D speckle tracking before and after ventricular septal defect (VSD) transcatheter closure, in comparison to normal controls. All patients were subjected to full history taking; general and cardiac examination; ECG; CXR; full transthoracic echocardiographic examination, including VSD number, size, and site; LV dimensions and volumes; estimated pulmonary artery pressure; right ventricular size and function; left ventricular circumferential; and radial strain imaging by 2D speckle tracking. Patients who had ventricular septal defect closed were reassessed by transthoracic echocardiography after 3 months.
Results:
The study included 15 children with VSD: 3 males and 12 females; their age ranged from 2 to 13 years; all had subaortic VSD except for 1 who had apical muscular VSD: VSD size ranged from 3 to 8 mm; PFM coil was used to close defect in all patients except for 2 patients who had an Amplatzer duct occlude I (ADOI) device, and 1 patient needed an additional vascular plug after significant hemolysis. Pre-procedurally, group A had a significantly higher LVEDD, LVESD, and LVEDV than group B. Mean circumferential strain was significantly higher (more negative) in group A than that in group B either pre- or post-procedure. Post-procedurally, there was a significant decrease in circumferential strain (less negative) and a significant increase in radial strain (more positive).
Conclusion:
Following transcatheter VSD closure, there is a significant decrease in LV circumferential strain and a significant increase in LV radial strain, which conclude a decrease in LV volume overload with the improvement of its contractility.
