Assessment of Right Ventricular Function by 2D Speckle Tracking Echocardiography Pre and Post the Trans Catheter Closure of Atrial Septal Defect

Background: dysfunction is associated with adverse outcomes in patients with congenital heart disease. RV adaptation to disease is complex and depends on many factors. 2D Speckle tracking echocardiography is an angle-independent technique that may allow an accurate assessment of segmental myocardial deformation.

Aims: The aim of the work is to assess right ventricular function in patients with congenital left to right shunt (ASD) pre and 3 month post device closure using.

Patients and Methods: 31 patients were enrolled in the study, comparison was held between the group and itself before and 3 month after device closure. ESPAP measurement via TR jet also Tricuspid annular. Global longitudinal Strain of RV free wall and septum were measured by 2D STE.

Results: Volume overload on RV and according to Frank Starling law leads to increased contractility provided that function is preserved, so volume load in ASD cases leads to increased deformation and deformation rate values as evidenced in significant reduction of strain and strain rate values after volume load elimination. Strain and strain rate values gained via 2D speckle tracking echocardiography are load dependent parameter of contractility as evidenced in this study testing RV performance under both pressure and volume load. The value of these parameters of contractility assessment comes from their ability to detect subtle changes in mechanics and deformation that are not easily detected by conventional measures.

Conclusion: Myocardial deformation imaging is a novel echocardiographic tool for evaluation of global and regional myocardial function that can be applied to the RV for assessment of its longitudinal deformation by 2DE. 2D-STE derived strain and strain rate is a good method to exclude the effect of tethering and translational motions. RV responds to volume load by increasing its deformation and deformation rate provided that contractile function is preserved.