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Effect of chronic volume overload on echocardiographic parameters of the right ventricular function in adults with atrial septal defect before and after endovascular closure

Authors: Dontsova V.I., Mironenko M.Yu., Golukhova E.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2024-18S-S112–S128

For citation: Dontsova V.I., Mironenko M.Yu., Golukhova E.Z. Effect of chronic volume overload on echocardiographic parameters of the right ventricular function in adults with atrial septal defect before and after endovascular closure. Creative Cardiology. 2024; 18 (Special Issue): S112–S128 (in Russ.). DOI: 10.24022/1997-3187-2024-18S-S112–S128

Received / Accepted:  28.10.2024 / 19.11.2024

Keywords: atrial septal defect right ventricle systolic function speckle tracking analysis

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Abstract

Objective. This study examined the influence of increased the right ventricle (RV) preload caused by persisted atrial septal defect (ASD) on functional RV properties.

Material and methods. 34 patients (age 39 (34,0; 52,5)) with isolated ASD secundum underwent echocardiography assessment, both before and after 4–6 weeks after percutaneous closure of the defect, which included 3D-examination and speckle tracking analysis for longitudinal RV strain, as well as 19 normal adults were enrolled.

Results. After successful transcatheter closure of the ASD we observed a significant reduction of fractional area change (FAC) and RV ejection fraction (EF): from 39.5 (29.5–44.3) to 36.5 (30.1–37.3) % and from 51.8 (50.0–54.4) to 41.1 (38.6–45.0) % respectively, as well as RV free-wall longitudinal strain from –26.9 (–19.5; –29.2) to –20.1 (–16.3; –21.5) %. Negative association was found between initial indices of RV free-wall longitudinal strain and delta FAC (Rho = –0.58, р < 0.001) as well as delta RV EF (Rho = –0.64, р < 0.001) revealed 4–6 weeks after the procedure. According linear regression analysis, RV free-wall longitudinal strain was independently associated with its contractile function (р < 0.001).

Conclusion. Signs of RV myocardial hyperkinesis according to a comprehensive echocardiographic examination in patients with chronic volume overload due to secondary ASD, are mainly caused by its passive stretching and accompanied by a decreased RV systolic function, they are accompanied by a decrease in the global contractile function of the pancreas. Elimination of the defect leads to an even greater decrease in the contractile function of the pancreas in the nearest long- term period, and initially higher values of deformation of its free wall can be regarded as a marker of its damage in patients with prolonged volume overload. Defect closure leads to a following reduction of contractile RV function within 4–6 weeks after the procedure. Initial increased indices of the free-wall longitudinal strain should be considered as a marker of altered myocardium due to a chronically persistent volume overload in patients with ASD secundum.

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About Authors

  • Vera I. Dontsova, Cand. Med. Sci., Ultrasound Diagnostics Doctor; ORCID
  • Marina Yu. Mironenko, Cand. Med. Sci., Head of the Ultrasound Diagnostics Department; ORCID
  • Elena Z. Golukhova, Dr. Med. Sci., Professor, Academician of the Russian Academy of Sciences, Director; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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