The impacts of transcatheter occlusion for congenital atrial septal defect on left ventricular systolic synchronicity: a three-dimensional echocardiography study.

摘要

OBJECTIVES: To investigate the impacts of transcatheter occlusion for congenital atrial septal defect (ASD) on left ventricular (LV) systolic synchronicity using a real time three-dimensional echocardiography (RT3DE). METHODS: Thirty patients with ASD closure were recruited for the study. Realtime three-dimensional echocardiographic data sets were acquired for the measurement of LV volumes LV ejection fractions and LV three-dimensional systolic synchronicity before and at 6 months after transcatheter occlusion for ASD. M-mode echocardiography and RT3DE were performed to characterize interventricular septal (IVS) motion. RESULTS: There were no differences in LV systolic synchronicity between before and after transcatheter closure of ASD (Tmsv-16SD%: 5.6%+/- 1.4% vs 5.8%+/- 1.8%, P > 0.05; Tmsv-12SD%: 5.2 +/- 1.1% vs 5.4 +/- 1.2%, P > 0.05). But the abnormal IVS motion was found before device closure and normalized after transcatheter occlusion for ASD using M-mode echocardiography and the excursion-time figure (bull's-eye derived from RT3DE); At the same time, LV ejection fraction (59.8 +/- 2.6 vs 66.7 +/- 5.9, P < 0.05) stroke volume (49 +/- 14 vs 63 +/- 11, P < 0.05) was improved significantly as well as normalization of IVS motion after transcatheter occlusion for ASD. The correlation between ASD diameter and change of LVEF is significant (r = 0.85, P < 0.001). CONCLUSION: Although transcatheter occlusion did not significantly impact on intrinsic LV systolic synchronicity in patients with ASD, LV systolic function can be improved through normalization of IVS abnormal motion after transcatheter ASD occlusion.