Left ventricular rotational deformation changes by speckle tracking imaging before and 24hours after transcatheter closure of large secundum atrial septal defects in children.

Abstract

Large atrial septal defects (ASDs) in children cause increased volume overload of the right side of the heart which in turn lead to impairment of left ventricular (LV) performance. The aim of this study was to evaluate immediate LV rotational deformation changes in children with large ASDs post-device closure and removal of right ventricle (RV) volume overload. Twenty children who underwent transcatheter closure (TCC) of large secundum ASDs were included in the study. LV rotational deformation was assessed pre- and 24hours post-device closure using speckle tracking imaging (STI). 55% were females with mean age 6.1±3.5years. LV peak basal clockwise rotation improved significantly (-6.9±2.6° before vs -10.3±4.1° after TCC, P=.005), and time to peak clockwise rotation (345.1±124.7 milliseconds (ms) before vs 282.2±82.9ms after closure, P=.02). There was no significant difference in apical rotational parameters including peak counterclockwise rotation (P>.05 for both). LV twist (11.3±3.8° before vs 17.5±7.1° after closure, P=.001) and torsion (2.1±0.7°/cm before vs 3.1±1.2°/cm after closure, P=.01) were significantly improved, mainly as the result of improvement of LV basal rotation. LV revealed a significant increase in LV end-diastolic volumes (P=.02) 24hour after TCC with no significant change (P>.05) in end-systolic volumes after closure. Increased peak LV twisting and torsion were attributed to the improved peak systolic clockwise basal rotation after TCC of large ASDs in children.