Related Experiment Video
Updated: Dec 2, 2025
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Left and right ventricular speckle tracking study before and after percutaneous atrial septal defect closure in
Hala M Agha1, Islam S Mohammed2, Hassan A Hassan2
1Department of Pediatrics, Pediatric Cardiology Division, Specialized Pediatric Hospital, Cairo University, Cairo, Egypt.
Insights
Transcatheter closure of atrial septal defect (ASD) in children significantly improves right and left ventricular function and strain. Speckle tracking echocardiography (STE) effectively evaluates these improvements, showing enhanced myocardial performance post-procedure.
Area of Science:
- Pediatric Cardiology
- Echocardiography
- Congenital Heart Disease
Background:
- Atrial septal defect (ASD) secundum can lead to right and left ventricular volume overload and dysfunction.
- Transcatheter closure is a common treatment for hemodynamically significant ASDs in children.
- Assessing ventricular deformation changes post-closure is crucial for understanding treatment efficacy.
Purpose of the Study:
- To analyze acute and short-term deformation changes in the right ventricle (RV) and left ventricle (LV) walls before and after transcatheter ASD secundum closure in children.
- To evaluate the feasibility of tissue Doppler and myocardial deformation imaging for assessing RV and LV functions post-procedure.
Main Methods:
- A prospective study involving 32 children with significant ASD secundum.
- Two-dimensional (2D) and four-dimensional (4D) speckle tracking echocardiography (STE) were used to assess global longitudinal strain (GLS) and myocardial performance index (MPI) of both ventricles before and 6 months after percutaneous ASD closure.
Main Results:
- Significant improvement in RV and LV myocardial performance index (MPI) 6 months post-closure (p < 0.0001).
- Significant improvement in RV global longitudinal strain (GLS) by 2D STE (p < 0.0001).
- Significant increase in LV end-diastolic volume (EDV) and LV end-systolic volume (ESV) by 4D STE (p < 0.0001), with improved LV GLS (p = 0.009).
Conclusions:
- Transcatheter ASD closure leads to significant short-term improvements in RV and LV myocardial deformation and function in children.
- 4D STE demonstrated improved LV GLS, while 2D STE showed decreased RV volume overload and improved RV GLS.
- Myocardial deformation imaging is a feasible and valuable tool for evaluating ventricular function after transcatheter ASD closure.
Objectives:
To analyze the acute and short-term deformation changes of both right (RV) and left (LV) ventricular wall before and after transcatheter closure of atrial septal defect (ASD) secundum in children.
Outcome Measures:
To determine the feasibility of tissue Doppler and myocardial deformation imaging for evaluating RV and LV functions in children undergoing transcatheter ASD closure.
Patients And Methods:
A prospective study was performed for 32 children with hemodynamic significant ASD secundum before and 6 months after percutaneous ASD closure in the Pediatric Cardiology Division of Specialized Pediatric Hospital, Cairo University. Speckle tracking echocardiography (STE) of LV and RV global analysis (longitudinal and circumferential strain) before and after ASD transcatheter closure was performed.
Results:
The mean age of the patients was 6.01 ± 3.19 (range: 3-9) years with a female to male ratio of 1.3:1. There was an improvement in the RV and LV myocardial performance index (MPI) 6 months post-ASD closure (RVMPI = 0.46 ± 0.069 vs. 0.38 ± 0.05, p < 0.0001; LVMPI = 0.49 ± 0.12 vs. 0.38 ± 0.08, p < 0.0001, respectively). By 2D STE, there was a significant improvement in the RV global longitudinal strain (GLS) 6 months post-ASD closure (-20.17 ± 3.14% vs. -25.86 ± 5.02%, p < 0.0001). There was a significant increase in the LV end-diastolic volume (EDV) and LV end-systolic volume (ESV) using 4D STE after device closure (LVEDV = 32.96 ± 10.99 mL vs. 44.024 ± 14.9017 mL, p < 0.0001; LVESV = 15.16 ± 6.08 mL vs. 21.76 ± 8.34 mL, p < 0.0001, respectively). Additionally, there was a significant improvement in the LV GLS after device occlusion (-19.17 ± 3.67% vs. -22.36 ± 4.72%, p = 0.009) using 4D TomTec software. There was a significant decrease in the RVEDV (54.65 ± 10.05 mL vs. 15.73 ± 8.67 mL) and RV stroke volume (25.15 ± 6.36 vs. 20.06 ± 7.2) after device occlusion using 4D TomTec software.
Conclusion:
By using 4D STE, the LV GLS was significantly improved; in contrast, by 2D STE, the RV volume overload decreased and the RV GLS was improved on short term after transcatheter ASD secundum closure in children.
