Immediate- and Short-Term Effect of Percutaneous Patent Ductus Arteriosus Closure on Left Ventricular Function: A Speckle Tracking Echocardiographic Study

Abstract

Background: Patent ductus arteriosus (PDA) closure results in a sudden drop in left ventricular (LV) preload, and this may affect the LV functions. Aim: The aim was to evaluate the immediate- and short-term changes in LV functions by speckle tracking echocardiography (STE) post percutaneous PDA closure. Materials and Methods: The study included 45 patients with PDA who were referred for PDA trans-catheter closure. All the patients included in the study underwent full echocardiographic examination and speckle tracking analysis before PDA closure, immediately after closure, and 1 month after the PDA closure. Results: There was no statistically significant change in LV functions by two-dimensional transthoracic echocardiography; the LV end-diastolic volume (EDV) decreased significantly in the immediate follow-up from 41.608 ± 25.8846 ml before duct closure to 36.317 ± 21.6945 ml. The drop in the LV EDV continued in the 1-month follow-up. The LV end-systolic volume decreased as well, however it took 1 month for this drop to be statistically significant. The LV end-diastolic dimension also decreased significantly after duct closure. Regarding STE results, the global LV strain and strain rate values did not significantly change. The global strain values had a mean of −22.944% ± 3.5128% before duct closure and decreased to a mean −22.028% ± 2.8932% immediately after duct closure. Conclusion: The study concluded that STE could be used to detect subtle changes in LV deformation. Time to peak systolic strain is an understudied parameter that needs further evaluation to provide a better understanding regarding its role in myocardial function assessment.