Di Salvo Giovanni, Drago Manuela, Pacileo Giuseppe, Carrozza Marianna, Santoro Giuseppe, Bigazzi Maurizio Cappelli, Caso Pio, Russo Maria Giovanna, Carminati Mario, Calabró Raffaele
Physiopathology of the Cardio-Respiratory System and Associated Biotechnologies, Second University of Naples, Naples, Italy.
Am J Cardiol. 2005 Jul 15;96(2):299-302. doi: 10.1016/j.amjcard.2005.02.060.
For the first time, peak systolic strain and strain rate (SR) were used to assess right ventricular (RV) and left ventricular (LV) regional function in children after transcatheter and surgical atrial septal defect (ASD) closure. Fifteen patients with successful ASD device closure (the ASD-D group, mean age 9 +/- 3 years), 15 age- and gender-matched patients with successful ASD surgical closure (the ASD-S group, mean age 9 +/- 3 years), and 15 age- and gender-matched controls were enrolled. Regional RV and LV longitudinal function was significantly reduced in the ASD-S group compared with controls in all the studied segments. The ASD-D group presented significantly (p <0.001) reduced strain and SR values only on the basal and mid segments of the septal wall compared with controls. In the ASD-D group, only the RV basal segment showed significantly (p <0.001) reduced strain and SR values compared with controls but significantly greater values than those measured in the ASD-S group. SR imaging indexes could provide new, noninvasive, clinically relevant insight into regional changes in RV function and support the transcatheter approach to ASD for its less negative impact on RV and LV function.
首次使用收缩期峰值应变和应变率(SR)来评估经导管和外科房间隔缺损(ASD)封堵术后儿童右心室(RV)和左心室(LV)的局部功能。纳入了15例成功进行ASD封堵器封堵的患者(ASD-D组,平均年龄9±3岁)、15例年龄和性别匹配且成功进行ASD外科手术封堵的患者(ASD-S组,平均年龄9±3岁)以及15例年龄和性别匹配的对照组。与对照组相比,ASD-S组所有研究节段的右心室和左心室纵向局部功能均显著降低。与对照组相比,ASD-D组仅在室间隔壁的基底段和中间段出现应变和SR值显著降低(p<0.001)。在ASD-D组中,仅右心室基底段与对照组相比出现应变和SR值显著降低(p<0.001),但显著高于ASD-S组测量值。SR成像指标可为右心室功能的局部变化提供新的、非侵入性的、与临床相关的见解,并支持采用经导管方法治疗ASD,因为其对右心室和左心室功能的负面影响较小。