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Interventricular septal motion and left ventricular function in patients with atrial septal defect
R N Vincent1, R H Saurette, A N Pelech
1Section of Pediatric Cardiology, Health Sciences Centre, Winnipeg, Manitoba, Canada.
Pediatric Cardiology
|January 1, 1988
Summary
In atrial septal defect (ASD) patients, the interventricular septum moves normally. Apparent paradoxical motion is caused by left ventricular displacement, not abnormal septal contraction, in echocardiography studies.
Area of Science:
- Cardiology
- Echocardiography
- Pediatric Cardiology
Background:
- Patients with atrial septal defect (ASD) often exhibit paradoxical interventricular septal motion.
- The underlying cause of this motion, whether intrinsic septal abnormality or secondary effect, requires clarification.
Purpose of the Study:
- To determine if the interventricular septum contracts abnormally in patients with ASD.
- To investigate the mechanism behind the observed paradoxical septal motion using advanced echocardiographic analysis.
Main Methods:
- Studied eight pediatric patients with ASD and eight age-matched controls.
- Utilized qualitative and quantitative two-dimensional (2D) and M-mode echocardiography.
- Performed comprehensive left ventricular (LV) wall motion analysis with fixed and floating reference models.
Main Results:
- Interventricular septal wall motion and function were found to be normal in ASD patients.
- The apparent paradoxical motion occurred due to excessive anterior LV motion, visible only with a fixed reference system.
- No significant differences in LV function (e.g., shortening fraction, wall thickening) were observed between ASD patients and controls.
Conclusions:
- The paradoxical interventricular septal motion in ASD is not due to abnormal septal contraction.
- This motion is an artifact of the assessment method, specifically the use of a fixed reference system.
- Standard M-mode echocardiography remains reliable for assessing LV function in ASD patients.