Evaluation of Left Ventricular Function by Tissue Doppler and Speckle-Derived Strain Rate Echocardiography after Percutaneous Ductus Closure

Abstract

The aim of this study was to evaluate the left ventricular systolic and diastolic function before and after transcatheter percutaneous patent ductus arteriosus (PDA) closure. 21 children (age >6 months old) diagnosed with hemodynamically significant PDA underwent percutaneous PDA closure. Conventional, Doppler and tissue Doppler imaging and speckled-derived strain rate echocardiography were done at pre-closure, 1 day (early) and 1 month (late) post-closure. Mean age of the patients (female/male: 1.3) was 17.54 ± 24.7 months with the mean PDA diameter of 3.6 ± 0.8 mm. Systolic measures (ejection fraction, shortening fraction) reduced significantly early after PDA closure (P < 0.05). After 1 month, both improved significantly; ultimately, after 1 month no change was observed in systolic function measures compared with the pre-closure status. Early and late diastolic flow velocities of mitral (E M and A M) reduced considerably in early and late post-closure time (P < 0.05). Both early tissue Doppler early velocity of lateral mitral annulus (E'M) and early to late velocity ratio (E'M/A'M) of lateral mitral annulus decreased significantly (P = 0.02) in early post-closure. After 1 month, E'M increased considerably. (P = 0.01) but E'M/A'M had an insignificant rise (P > 0.05). E M/E'M ratio did not change in early post-closure but it had a considerable reduction in the subsequent month compared with the pre- and early post-closure (P < 0.001 for both occasions). Global and segmental longitudinal strain measures reduced significantly early after PDA closure (P < 0.05) but it improved remarkably in the subsequent month. Transcatheter PDA closure causes a significant decrease in left ventricular performance early after PDA closure which recovers completely within 1 month. Also PDA size can affect post-closure left ventricular function.

Predictors of transient left ventricular dysfunction following transcatheter patent ductus arteriosus closure in pediatric age

“…By TDI, there was a significant decline of all tissue Doppler velocities as well as E′ / A ′ ratio immediately after PDA closure, which was reverted at 1 month, denoting improvement of myocardial function. These results partially agreed with that of Amoogzar et al [16] who reported a significant decrease in E ′ and E ′/ A ′ ratio, but not in A ′ or S ′ wave, at 48 hours and improvement in these parameters at 1-month follow-up. Moreover, MPI became significantly prolonged at 48 hours but started to normalize at 1 month.…”

Left ventricular dysfunction postsurgical patent ductus arteriosus ligation in children: predictor factors analysis

“…Because in the early post ligation period, we identified that the bigger PDA size, the more decrease in LVEDd, FS and EF. These findings were steady with perceptions made by Amoogzar et al [23], and El sheddony et al [15]…”

Speckle‐Tracking Echocardiography in Dogs With Patent Ductus Arteriosus: Effect of Percutaneous Closure on Cardiac Mechanics

“…Afterload plays a relative role in the preclosure hemodynamics but gains importance in the postclosure phase, because preload is decreased and afterload is increased by shunt closure. [6][7][8][29][30][31] These hemodynamic changes were investigated by standard transthoracic echocardiography in previous studies in humans and animals. [11][12][13][14][15][29][30][31][32][33][34] As a consequence of PDA closure and decreased preload, end-diastolic dimensions (EDVI M-B , AlloD) as well as end-systolic dimensions (ESVI M-B , AlloS) decrease, although they rarely normalize in the short term.…”

“…[6][7][8][29][30][31] These hemodynamic changes were investigated by standard transthoracic echocardiography in previous studies in humans and animals. [11][12][13][14][15][29][30][31][32][33][34] As a consequence of PDA closure and decreased preload, end-diastolic dimensions (EDVI M-B , AlloD) as well as end-systolic dimensions (ESVI M-B , AlloS) decrease, although they rarely normalize in the short term. [6][7][8][11][12][13][14][15][29][30][31][32][33][34] A more pronounced decrease in diastolic dimensions generally is appreciated, whereas systolic dimensions appear to decrease but to a lesser extent as compared to diastolic dimensions after PDA closure.…”