Quantitative evaluation of right ventricular myocardial function changes in patients with atrial septal defect before and after occlusion by noninvasive right ventricular pressure‐strain loop

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 41; no. 6; pp. e15868 - n/a
• Main Authors: Jiang, Huanhuan, Ran, Hongling, Xu, Pan, Hu, Jia, Xiahou, Yu, Zhou, Xiling, Liu, Ming, Yuan, Xinchun
• Format: Journal Article
• Language: English
• Published: United States 01.06.2024
• Subjects: Adult; aimed; atrial septal defect; Echocardiography - methods; Female; Heart Septal Defects, Atrial - complications; Heart Septal Defects, Atrial - physiopathology; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; interventional occlusion; Male; Reproducibility of Results; right ventricular function; right ventricular myocardial work; right ventricular pressure‐strain loop; Ventricular Dysfunction, Right - diagnostic imaging; Ventricular Dysfunction, Right - etiology; Ventricular Dysfunction, Right - physiopathology; Ventricular Function, Right - physiology; Ventricular Pressure - physiology; right ventricular pressure‐strain loop; interventional occlusion; aimed; right ventricular myocardial work; atrial septal defect; right ventricular function
• ISSN: 0742-2822; 1540-8175; 1540-8175
• DOI: 10.1111/echo.15868

Objective The noninvasive right ventricular pressure‐strain loop (PSL) represents a novel method for the quantitative assessment of right ventricular myocardial function. Given that atrial septal defect (ASD) is a prevalent congenital heart anomaly associated with right ventricular volume overload, this study aimed to quantitatively assess the myocardial function of the right ventricle in ASD patients pre‐ and post‐occlusion by noninvasive right ventricular PSL. Methods This study included 36 patients diagnosed with secundum ASD group and 30 healthy adults (control group). We compared conventional right ventricular echocardiographic parameters, right ventricular strain, and myocardial work in the ASD group before occlusion, two days post‐occlusion, and three months post‐occlusion, with those in the control group. Results Prior to and two days following occlusion, the ASD group exhibited higher right ventricular global work index (RVGWI), right ventricular global wasted work (RVGWW), and right ventricular global constructive work (RVGCW) compared to the control group (P < .05). Within the ASD group, post‐occlusion, RVGWI, RVGCW, and RVGWW values were significantly reduced compared to pre‐occlusion values (P < .001). Furthermore, RVGWI and RVGCW showed a significant decrease three months after occlusion compared to two days post‐occlusion (P < .05). Multivariate regression analysis identified ASD diameter and pulmonary artery systolic pressure (PASP) as independent predictors of RVGWI (β = .405, P < .001; β = 2.307, P = .037) and RVGCW(β = .350, P<.001; β = 1.967, P = .023). Conclusions The noninvasive right ventricular PSL effectively demonstrates the alterations in right ventricular myocardial function in ASD patients, pre‐ and post‐occlusion. The metrics of right ventricular myocardial work (RVMW) offer a novel indicator for evaluating right ventricular myocardial function in these patients. Moreover, ASD diameter and PASP emerge as independent determinants of RVGWI and RVGCW. Noninvasive right ventricular pressure‐strain loop (PSL) enables quantitative assessment of right ventricular myocardial function changes in atrial septal defect (ASD) patients pre‐ and post‐occlusion. These right ventricular myocardial work (RVMW) parameters can serve as novel indicators for the follow‐up evaluation of right ventricular function in ASD patients, offering vital insights for the clinical postoperative follow‐up of these patients. Moreover, ASD diameter and PASP emerge as independent factors of right ventricular global work index (RVGWI) and right ventricular global constructive work (RVGCW).