Ağaç Mustafa Tarık, Akyüz Ali Rıza, Acar Zeydin, Akdemir Ramazan, Korkmaz Levent, Kırış Abdülkadir, Erkuş Emre, Erkan Hakan, Celik Sükrü
Cardiology Department, Ahi Evren Heart and Vascular Surgery Training and Research Hospital, Trabzon, Turkey.
Echocardiography. 2012 Mar;29(3):358-62. doi: 10.1111/j.1540-8175.2011.01558.x. Epub 2011 Nov 8.
There is limited data on alterations in novel right ventricular (RV) function indices like tricuspid annular plane systolic excursion (TAPSE) and tricuspid annular systolic velocity (TASV) after transcatheter atrial septal defect (ASD) closure. We aimed to evaluate RV function by echocardiography (ECG) with these novel indices in early period in patients with secundum-type ASD that was closed percutaneously.
Patients were enrolled to study if they had secundum-type ASD that was suitable for percutaneous closure. Patient population consisted of 4 men and 16 women. Echocardiography was performed before and 1 month after closure.
Mean age was 37 ± 16. Mean diameter of ASD and total atrial septum length measured by ECG were 19 ± 6 mm and 49 ± 7 mm, respectively. Mean diameter of defect in transesophageal echocardiography was 20 ± 6 mm. Stretched mean diameter in catheterization was 23 ± 6 mm. One month after closure, there were statistically significant decreases in RV end-diastolic diameters (43.3 ± 10.7 mm vs. 34.9 ± 5.5 mm; P < 0.001), RV/left ventricular (LV) end-diastolic diameter ratio (1.1 ± 0.3 vs. 0.87 ± 0.1; P < 0.001), TASV (16.9 ± 3.2 cm/sec vs. 14.3 ± 3.3 cm/sec; P < 0.05), early diastolic tricuspid annular velocity (15.3 ± 3.1 cm/sec vs. 13.4 ± 2.4 cm/sec P <0.05), late diastolic tricuspid annular velocity (16.2 ± 5.4 cm/sec vs. 14.3 ± 6.3 cm/sec; P < 0.05), and TAPSE (29.9 ± 6.2 mm vs. 22.4 ± 7.4 mm; P < 0.001). LV end-diastolic diameter (38.0 ± 6.9 mm and 40.0 ± 4.5 P < 0.05) was increased, whereas there was no change in LV ejection fraction.
Closure of ASD by using Amplatzer devices led to decrease in right heart chamber size, tissue Doppler-derived tricuspid annular velocities and TAPSE in early period.
关于经导管房间隔缺损（ASD）封堵术后新型右心室（RV）功能指标（如三尖瓣环平面收缩期位移（TAPSE）和三尖瓣环收缩期速度（TASV））变化的数据有限。我们旨在通过超声心动图（ECG）利用这些新型指标评估继发孔型ASD患者经皮封堵术后早期的右心室功能。
纳入适合经皮封堵的继发孔型ASD患者进行研究。患者群体包括4名男性和16名女性。在封堵术前及术后1个月进行超声心动图检查。
平均年龄为37±16岁。经超声心动图测量的ASD平均直径和房间隔总长度分别为19±6mm和49±7mm。经食管超声心动图测量的缺损平均直径为20±6mm。心导管检查时的伸展平均直径为23±6mm。封堵术后1个月，右心室舒张末期直径（43.3±10.7mm对34.9±5.5mm；P<0.001）、右心室/左心室（LV）舒张末期直径比值（1.1±0.3对0.87±0.1；P<0.001）、TASV（16.9±3.2cm/秒对14.3±3.3cm/秒；P<0.05）、舒张早期三尖瓣环速度（15.3±3.1cm/秒对13.4±2.4cm/秒，P<0.05）、舒张晚期三尖瓣环速度（16.2±5.4cm/秒对14.3±6.3cm/秒；P<0.05）和TAPSE（29.9±6.2mm对22.4±7.4mm；P<0.001）均有统计学意义的下降。左心室舒张末期直径（38.0±6.9mm和40.0±4.5，P<0.05）增加，而左心室射血分数无变化。
使用Amplatzer装置封堵ASD可导致早期右心腔大小、组织多普勒衍生的三尖瓣环速度和TAPSE降低。
