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Diastolic ventricular septal motion in atrial septal defect: analysis of M-mode echocardiograms in 31 patients
Insights
Early diastolic posterior ventricular septal motion (DPSM) in atrial septal defect patients reflects relative ventricular filling. A DPSM over 5 mm specifically indicates a large left-to-right shunt, aiding diagnosis.
Area of Science:
- Cardiology
- Medical Imaging
- Physiology
Background:
- Echocardiography is crucial for assessing cardiac function.
- Ventricular septal motion during diastole is theorized to reflect relative ventricular filling.
- Atrial septal defects (ASDs) alter intracardiac blood flow dynamics.
Purpose of the Study:
- To investigate the relationship between early diastolic posterior ventricular septal motion (DPSM) and pulmonary to systemic flow ratios (Qp:Qs) in patients with ASD.
- To determine the diagnostic utility of DPSM in identifying large left-to-right shunts in ASD.
Main Methods:
- M-mode echocardiography was performed on 31 patients diagnosed with atrial septal defect.
- Early diastolic posterior ventricular septal motion (DPSM) was measured.
- DPSM measurements were correlated with pulmonary to systemic flow ratios (Qp:Qs).
Main Results:
- All 31 patients exhibited early diastolic posterior ventricular septal motion (DPSM).
- DPSM measurements showed a significant correlation with pulmonary to systemic flow ratios (Qp:Qs) (r = 0.64, p < 0.001).
- A DPSM greater than 5 mm was observed in all 15 patients with a Qp:Qs > 2.5:1, while only 8 of 16 patients with DPSM < 5 mm had such a shunt (p < 0.003).
Conclusions:
- Early diastolic posterior ventricular septal motion (DPSM) in atrial septal defect patients reflects relative ventricular filling.
- DPSM exceeding 5 mm is a specific, though not sensitive, echocardiographic indicator of a large left-to-right shunt in ASD.
- The findings support the hypothesis that ventricular septal diastolic motion correlates with relative ventricular filling patterns.
Abstract:
Previous echocardiographic studies suggest that diastolic motion of the ventricular septum reflects relative filling of the right and left ventricles. We studied 31 patients with atrial septal defect by M-mode echocardiography. Early diastolic posterior ventricular septal motion (DPSM) occurred in all patients. Measurement of DPSM correlated with pulmonary to systemic flow ratios (Qp:Qs) (r = 0.64, p less than 0.001). All 15 patients with DPSM greater than 5 mm had a Qp:Qs greater than 2.5:1, whereas only 8 of 16 patients with DPSM less than 5 mm had a shunt this large (p less than 0.003). DPSM greater than 5 mm in patients with atrial septal defect is a specific but not sensitive echocardiographic sign of a large left-to-right shunt. Our findings substantiate the hypothesis that diastolic motion of the ventricular septum reflects relative filling of the ventricles.