Assessment of right ventricular function by isovolumic contraction acceleration before and after percutaneous closure of atrial septal defects: a preliminary study.

Abstract

The main purpose of present study was to investigate the impact of percutaneous closure of atrial septal defect (ASD) on right ventricular (RV) systolic function assessed by tricuspid annular isovolumic myocardial acceleration (IVA) that is independent of preload and afterload changes. A prospective cohort study was designed involving twenty five patients with secundum type ASD whom were successfully closed percutaneously between 2009 and 2011. Standard transthoracic echocardiography and tissue Doppler imaging were performed in all patients 12 to 24 hours before and one month after closure. Paired t test was performed to determine the statistical significance of variables before and after closure. Significant decreases were observed in RV end-diastolic diameter, RV/left ventricular (LV) end-diastolic diameter ratio, right ventricular systolic myocardial velocity (Sm), right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am) in the control echocardiography in the first month when compared with pre-procedure values. While significant increase was observed after procedure in right ventricular IVA (3.4 ± 1.3 m/sec2 vs. 4.2 ± 1.8 m/sec2, p=0.001), no significant change was observed in right ventricular global performance index, in right ventricular Em/Am ratio and left ventricular ejection fraction. Percutaneous closure of ASD resulted in recovery of right ventricular function as early as 1 month after closure.