Left ventricular dispersion as a parameter for augmented left ventricular stroke volume in patients with atrial septal defect following transcatheter closure

Hatani, Yutaka; Tanaka, Hidekazu; Mochizuki, Yasuhide; Hatazawa, Keiko; Matsuzoe, Hiroki; Shimoura, Hiroyuki; Ooka, Junichi; Sano, Hiroyuki; Sawa, Takuma; Motoji, Yoshiki; Ryo-Koriyama, Keiko; Matsumoto, Kensuke; Otake, Hiromasa; Shinke, Toshiro; Hirata, Ken‐ichi

doi:10.1111/echo.13757

Cited by 2 publications

(7 citation statements)

References 29 publications

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“…This has largely been attributed to altered left ventricular geometry with a reduction of left ventricular dimensions and an impairment of left ventricular filling . Various imaging modalities have been used in the past to study the left ventricular function . More recently, MRI, considered as the gold standard for ventricular volume quantification, has been used to derive left ventricular volumes and EF in ASD patients .…”

Section: Discussionmentioning

confidence: 99%

“…Recently, Hatani et al used speckle tracking in ASD patients to demonstrate that global longitudinal strain and right ventricular free wall strain were similar for ASD and controls, but LV dispersion, reflecting the heterogeneity of timing of regional LV myocardial contraction, was significantly larger in ASD patients, suggesting that intraventricular LV dyssynchrony was greater. Our study yielded a similar observation of LV dyssynchrony in ASD patients, which appeared to be age‐dependent (Figure ).…”

Section: Discussionmentioning

confidence: 99%

“…A probable explanation, in keeping with the Frank–Starling mechanism, is that decreased LV filling leads to decreased muscle fiber tension and decreased velocity of fiber shortening, translating into a delay in segmental contraction. However, as many studies have shown that an improvement in LV function parameters is seen after a delay of months rather than immediately after ASD closure, segmental dyssynchrony may not entirely be a volume‐dependent phenomenon but may be an enduring functional abnormality of a chronically underfilled LV, which takes time to resolve.…”

Section: Discussionmentioning

confidence: 99%

“…Atrial septal defect (ASD) is one of the commonest congenital heart defects . As patients are mostly asymptomatic, there is often a delay in closure of the defects .…”

Section: Background and Objectivesmentioning

confidence: 99%

“…Left ventricular wall motion in ASD patients has previously been studied with two‐dimensional echocardiogram (2DE), tissue Doppler imaging, and speckle tracking echocardiogram . Few studies have utilized real time three‐dimensional echocardiogram (RT3DE) for left ventricular wall‐motion analysis in ASD patients.…”

Section: Background and Objectivesmentioning

confidence: 99%

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The left ventricle in atrial septal defect: Looking through 3D glasses

Mohanty¹,

Solomon²

2019

Echocardiography

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Objectives To identify left ventricular (LV) dyssynchrony and associated factors in atrial septal defect (ASD) patients, using real time three‐dimensional echocardiogram (RT3DE). Background Left ventricular dysfunction has been observed in ASD. Few studies have utilized RT3DE to assess LV wall‐motion abnormality in ASD. Methods Patients aged ≥1 year with ASD, with or without partial anomalous pulmonary venous drainage (PAPVD), were included over 1 year. Additional cardiac defects or abnormalities independently affecting LV function were excluded. 2DE and RT3DE‐derived LV function data were recorded. Student's t test and Pearson's correlation were used for analysis. Results Of 104 patients (69 females) aged 1–57 years, ostium secundum ASD was present in 97 and sinus venosus ASD in 7. Maximum excursion increased significantly with age, weight, and body surface area (P < 0.001). Majority of children (58%) aged 3–5 years showed no delay in segmental excursion. Lateral wall excursional delay was greater beyond 5 years or with weight > 15 kg (42% as compared to 20% in <15 kg). In patients weighing < 15 kg, time to minimum systolic volume (Tmsv 16‐SD) was higher with PAPVD and with indexed defect size > 40 mm/m2, though not statistically significant. As compared to EF estimation by 2DE, EF derived using RT3DE was significantly lower (P < 0.001). Conclusion Left ventricular dyssynchrony is least between 3 and 5 years. Beyond 5 years, delayed lateral wall excursion is seen. With an indexed defect size exceeding 40 mm/m2, and in the presence of PAPVD, time to minimum systolic volume is higher.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Atrial septal defect (ASD) is one of the commonest congenital heart defects . As patients are mostly asymptomatic, there is often a delay in closure of the defects .…”

Section: Background and Objectivesmentioning

confidence: 99%

Section: Background and Objectivesmentioning

confidence: 99%

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The left ventricle in atrial septal defect: Looking through 3D glasses

Mohanty¹,

Solomon²

2019

Echocardiography

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Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial

Du,

Li,

Wang

et al. 2024

BMC Med

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Background New “noncardiac” problems in children with congenital heart disease (CHD), such as developmental delay or long-term neurodevelopmental impairments, have attracted considerable attention in recent years. It is hypothesized that exercise might attenuate CHD-associated neurodevelopmental impairments; however, this has not been thoroughly investigated. The objective of this prospective, single-blinded, randomized controlled experiment was to evaluate the impact of customized home-based exercise for children with CHD. Methods Children aged 0–5 years with echocardiography-confirmed simple CHD subtypes who were scheduled to undergo cardiac catheterization were screened for enrolment. Among 420 screened CHD children, 192 were enrolled and randomly assigned at a 1:1 ratio to receive a 6-month intervention (30 min daily customized home-based exercise program with supervision for no less than 5 days per week, combined with home-based exercise education) or control treatment (home-based education). The primary outcome was motor development (gross motor quotient (GMQ), fine motor quotient (FMQ), and total motor quotient (TMQ)). The secondary outcomes were cardiac function and structure, bone quality, physical development, parental anxiety, caregiver burden, and quality of life. Children and their families were assessed before and 1, 3, and 6 months after catheterization; 183 (95.3%) children were included in the primary analysis. Results After 6-month treatment, the intervention group significantly increased their motor quotient, which was consistently higher than that of the control group (GMQ p < 0.0001, FMQ p = 0.02, TMQ p < 0.001). The physical developments in height, weight, and circumferences of the upper-arm, chest, and head were also significantly improved by exercise (all p < 0.017). No significant improvements in the bone strength or the cardiac structure and function were found among patients in the intervention group (all p > 0.017). For parents, higher quality of life level (total score p = 0.016) was observed in the intervention group; while effects of exercise on the anxiety (rude score p = 0.159, standard score p = 0.159) or the Zarit caregiver burden scale score (p = 0.404) were non-significant. No adverse events occurred during the study period. Conclusions Customized home-based exercise improved motor development in children with CHD. While the long-term effects of parent training in home-based exercise are unknown, the study results suggest positive outcomes. Trial registration A home-based exercise program in congenital heart disease children with cardiac catheterization: a randomized controlled trial. (http://www.chictr.org.cn/, ChiCTR-IOR-16007762, January 14, 2016).

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Left ventricular dispersion as a parameter for augmented left ventricular stroke volume in patients with atrial septal defect following transcatheter closure

Abstract: The assessment of LV dispersion may well have clinical implications for better management of ASD patients after transcatheter closure.

Cited by 2 publications

References 29 publications

The left ventricle in atrial septal defect: Looking through 3D glasses

The left ventricle in atrial septal defect: Looking through 3D glasses

Effects of 6-month customized home-based exercise on motor development, bone strength, and parental stress in children with simple congenital heart disease: a single-blinded randomized clinical trial

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