Di Salvo Giovanni, Drago Manuela, Pacileo Giuseppe, Rea Alessandra, Carrozza Marianna, Santoro Giuseppe, Bigazzi Maurizio Cappelli, Caso Pio, Russo Maria Giovanna, Carminati Mario, Calabro' Raffaele
Physiopathology of the Cardio-Respiratory System and Associated Biotechnologies, Second University of Naples, Naples, Italy.
J Am Soc Echocardiogr. 2005 Sep;18(9):930-3. doi: 10.1016/j.echo.2005.01.029.
The effect of operation and the effect of the imposition of an occluding device on atrial function for patients with an atrial septal defect (ASD) has never been studied. Thus, the aim of this study was to evaluate for the first time both left atrial (LA) and right atrial (RA) function of children after transcatheter ASD closure with that of sex- and age-matched patients with surgically treated ASD, and sex- and age-matched control subjects using strain (epsilon) and epsilon rate imaging (SR). In all, 45 participants formed our studied sample: 15 patients after successful ASD device closure (ASD-D [atrial septal defect device closure] group, mean age: 9 +/- 3 years) and 15 age- and sex-matched patients after successful ASD surgical closure (ASD-S [atrial septal defect surgical closure] group, mean age: 9 +/- 3 years). All patients underwent ASD correction at least 6 months before the study. As a control group we selected 15 age- and sex-matched control subjects. In the ASD-S group the peak systolic epsilon and SR values were significantly reduced in both RA and LA when compared with control and ASD-D groups (P < .01). In the ASD-D group there was no significant difference in both LA and RA deformation properties when compared with control subjects. SR imaging indexes could provide new, noninvasive, clinically relevant insight on regional changes in atrial function for patients with ASD. ASD percutaneous closure is useful not only because it is less expensive and invasive than open-heart operation but also for its conservation of both LA and RA regional myocardial properties.
对于房间隔缺损(ASD)患者,手术及应用封堵装置对心房功能的影响从未被研究过。因此,本研究的目的是首次使用应变(ε)和应变率成像(SR),评估经导管封堵ASD术后儿童的左心房(LA)和右心房(RA)功能,并与年龄和性别匹配的手术治疗ASD患者以及年龄和性别匹配的对照受试者进行比较。本研究样本共45名参与者:15例成功进行ASD封堵装置置入术后的患者(ASD-D[房间隔缺损封堵装置置入]组,平均年龄:9±3岁)和15例年龄和性别匹配的成功进行ASD手术闭合术后的患者(ASD-S[房间隔缺损手术闭合]组,平均年龄:9±3岁)。所有患者在研究前至少6个月接受了ASD矫正。作为对照组,我们选择了15名年龄和性别匹配的对照受试者。与对照组和ASD-D组相比,ASD-S组的RA和LA的收缩期峰值ε和SR值均显著降低(P<.01)。与对照受试者相比,ASD-D组的LA和RA变形特性均无显著差异。SR成像指标可为ASD患者心房功能的区域变化提供新的、非侵入性的、与临床相关的见解。ASD经皮封堵术不仅因其比开胸手术成本更低、侵入性更小而有用,而且还因其能保留LA和RA的区域心肌特性。