Ventricular function in atrial septal defect

Flamm, M.; Cohn, Keith; Hancock, E. William

doi:10.1016/0002-9343(70)90058-6

Cited by 70 publications

(14 citation statements)

References 23 publications

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“…34,35 Thus, it has been demonstrated that torsional deformation is a sensitive indicator of LV function. Global LV systolic function has been shown to be impaired in ASD [8][9][10]36,37 and we also found that the LVEF in patients with ASD was lower than that of normal controls. Moreover, our results showed that a lower EF in patients with ASD was associated with reduced LV torsion values.…”

Section: Discussionsupporting

confidence: 66%

“…In the present study, LVESV did not change in patients with ASD, despite the significantly decreased EDV and prolonged IVRT. The reduction in LVEDV in patients with ASD is thought to be mostly caused by decreased left atrial systolic contribution to late diastolic ventricular filling and decreased LV distensibility as a result of compression by the dilated RV, 36,41 rather than to impairment of LV untwisting.…”

Section: Discussionmentioning

confidence: 99%

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Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Dong

Zhang

Shu

et al. 2009

Circ J

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he secundum atrial septal defect (ASD) is a common form of congenital heart disease accounting for approximately 10% of children and 30% of adult patients with congenital cardiac defects. [1][2][3][4][5][6][7] Previous studies have demonstrated that right ventricular (RV) volume overload is associated with adverse left ventricular (LV) function in patients with ASD. [8][9][10] Recently, assessment of LV rotation has become an important approach for quantifying LV function. [11][12][13][14][15][16][17][18][19][20][21][22][23][24] However, to the best of our knowledge there are no data available to date on the impact of RV volume overload on LV twist in patients with ASD. The recent development of 2-dimensional (D) ultrasound speckle tracking imaging (STI) has allowed LV torsional deformation to be evaluated noninvasively with validation against sonomicrometry and tagged magnetic resonance imaging (MRI). 25,26 In the present study, we sought to analyze LV twisting and untwisting using the novel STI method in adult patients with ASD. Methods Study SampleWe enrolled 45 asymptomatic adults (28±9 years, 13 males) with ASD. Inclusion criteria included age ≥18 years, isolated secundum ASD, evidence of RV volume overload and evidence of shunt on transthoracic echocardiogram. Patients were excluded if they were clinically unstable, were not in sinus rhythm at the time of echocardiographic examination, or had inadequate echocardiographic assessment. The ASD group was compared with an age-and sex-matched control group of normal subjects (n=45, 27±10 years, 13 males). The Institutional Review Board of the hospital approved the study, and all study participants provided informed consent before participation. Echocardiographic StudiesPatients were imaged in a supine position using a GE Vivid 7 ultrasound system with a M3S probe (1.7-3.4 MHz). The 2D grayscale images were acquired in the standard parasternal and apical views at a frame rate of 80-100 frames/s, and 3 cardiac cycles were recorded. Care was taken to obtain parasternal circular short-axis tomograms at basal (identified by the mitral valve) and apical (no papillary muscles noted) levels. All images were stored digitally for subsequent offline analysis. Conventional Echocardiographic AnalysisThe analysis was performed offline by a single observer without knowledge of hemodynamic data, using commercially available 2D strain software (Echopac PC, version 7.0, GE Vingmed Ultrasound, Horten, Norway). LV volumes (end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF)) were measured according to the recent guidelines of the American Society of Echocardiography. 27 Analysis of Twist MechanicsThe time interval from the R wave on the ECG to aortic

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Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Dong

Zhang

Shu

et al. 2009

Circ J

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“…All of them were asymptomatic. Their findings did not correlate with age in patients operated on after 11 years of age, contrary to the findings of Petersson [26], The causes of the impairment in cardiac performance after closure of ASD II are presumably sequelae to the longstanding hemo dynamic stress upon the right ventricle, and in some cases an additional impaired left ventricular function [11,13,16,37]. The basic abnormality might be due to a defective contractile response, and abnormal compli ance characteristics of the ventricular myocardium or a combination of the two.…”

Section: Discussionmentioning

confidence: 60%

Hemodynamic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

Forfang¹

1978

Cardiology

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84 patients without concomitant pulmonary or cardiac disease, underwent surgery for atrial septal defect of the secundum type (ASD II) at the age of 40 years or more. Hemodynamics were studied preoperatively at rest, and postoperatively at rest and during exercise during a follow-up investigation which took place 74 months (range 22–174) after surgery. Preoperatively, the pulmonary artery mean pressure (PAMP) exceeded 20 mm Hg in 24 patients (30%). In the patients aged 50 years or more PAMP was significantly higher than in the younger patients, whereas the shunt ratio did not show any increase with age. After surgery, the pressures in right atrium, right ventricle and PA showed significant changes towards normalization. During exercise, a considerable increase of the PA pressures appeared, and this increase correlated significantly with the PA pressures obtained preoperatively at rest.

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“…Furthermore, important additional information about the functional state of the heart is gained (e.g., ejection fraction, end-diastolic volume) (Geffers et al, 1977) which is of special value, particularly in the elderly pa-tient, to evaluate the risk of operative closure of the shunt (Flamm et al, 1970).…”

Section: Discussionmentioning

confidence: 99%

Untitled

1982

Clinical Cardiology

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Summary: The present investigation was undertaken to assess a new scintigraphic method for the diagnosis of left-ta-right shunts due to atrial septal defect based on the differing stroke volumes of left and right ventricles and to compare it with oxymetric data. Radionuclide ventriculography was carried out after idjection. of 20 mCi 99mtechnetium-labeled red blood cells. TiI:ne-activity curves were obtained from the left and right ventricular regions, and the ratio (A) of end-diastolicend-systolic count rate differences for the left and right ventricles was calculated. The left-to-right shunt (in percent ofthe-pulmonary flow rate) is then giveri as 100 X (I -A/1.43); 1.43 being the previously deterrrlined mean value of A in 66 normal patients. In 16 pafients with an atrial septal defect and/or partial anomalous pulmonary venous connection a correlation of r = 0.81 was found between those shunts determined by the scintigraphic method and those calculated by oxymetric data. The specificity of the method and the sensitivity in detecting left-to-right shunts exceeding 30% are high. The method is practical and already widely used for determination of ejection fraction, end-diastolic volufne and other factors. The combination of this tec~nique

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Ventricular function in atrial septal defect

Cited by 70 publications

References 23 publications

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Left Ventricular Torsion in Patients With Secundum Atrial Septal Defect

Hemodynamic Findings before and after Surgery for Atrial Septal Defect of the Secundum Type in Middle-Aged Patients

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