Echocardiographic Doppler Evaluation of Ventricular Function in Children With an Atrial Septal Defect

Abstract

To evaluate ventricular function using Doppler echocardiography in patients with an atrial septal defect (ASD). The study involved 158 children, who were divided into two groups: Group 1 comprised 111 children with an ASD, and Group 2, 47 healthy children. Left ventricular systolic function was evaluated by measuring the ejection fraction, the shortening fraction, and the systolic mitral annular velocity (by tissue Doppler), and right ventricular systolic function, by measuring the systolic tricuspid annular velocity. Left ventricular diastolic function was evaluated by measuring standard transmitral Doppler indices, the color M-mode Doppler flow propagation velocity (Vp), the E/Vp ratio, and early and late diastolic mitral annular velocities at the lateral and septal areas of the mitral annulus (EML, EMS and AML, AML waves, respectively), and right ventricular diastolic function, by using pulsed tissue Doppler to measure early and late diastolic tricuspid annular velocities (ET and AT waves, respectively). There was no significant difference between the two groups in any left ventricular systolic or diastolic function parameter, except that the EML and EMS velocities were smaller in Group 1. Right ventricular systolic function was significantly increased in children with an ASD. The peak ET wave velocity was similar in the two groups but the peak AT wave velocity was significantly greater in children with an ASD. Systolic and diastolic left ventricular function (i.e., preload-independent indices) were similar in the two groups. Children with an ASD demonstrated an increase in right ventricular systolic function, though diastolic function was unchanged.