Department of Echocardiography, Cardiovascular Institute, Fu Wai Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100037, China.
Int J Cardiovasc Imaging. 2014 Apr;30(4):721-7. doi: 10.1007/s10554-014-0385-0. Epub 2014 Feb 7.
Previous studies using speckle-tracking echocardiography (STE) for quantifying the functions of the right and left ventricles (RV and LV, respectively) in the presence of percutaneous atrial septal defect (ASD) closure have focused on the peak systolic strain (PSS). This study investigated changes in the mechanical dyssynchrony of ventricular contraction before and after ASD closure, issues that have been little addressed in the literature. Thirty-one adults with ASD were studied using two-dimensional STE before and 24 h after ASD closure. Thirty-one healthy age- and sex-matched subjects were recruited as controls. Global and segmental PSS values from the longitudinal, circumferential, and radial directions were analyzed. The time to peak systolic strain (PSST) and the standard deviation of the time to peak strain (SDT) among segments in each direction were calculated, to investigate the inter- and intra-ventricular mechanical dyssynchrony in these patients and improvements after closure. Compared to the control group, patients with ASD had higher RV free-wall longitudinal systolic strain, with increased PSST and SDT. The SDT values of the LV longitudinal and circumferential strains were also increased. By 24 h after ASD closure, the RV free-wall longitudinal strain and its PSST and SDT had reverted to normal levels. The LV circumferential strain was increased, and its SDT was decreased. The contraction period of the RV and myocardial contraction dyssynchrony in the RV and LV were increased in ASD patients. The inter- and intra-ventricular mechanical utilities were improved after percutaneous closure of the ASD.
先前使用斑点追踪超声心动图（STE）来量化存在经皮房间隔缺损（ASD）关闭时右心室（RV）和左心室（LV）功能的研究主要集中在收缩期峰值应变（PSS）上。本研究探讨了 ASD 关闭前后心室收缩机械不同步的变化，这在文献中很少涉及。31 例 ASD 成人患者在 ASD 关闭前后使用二维 STE 进行研究。招募了 31 名年龄和性别匹配的健康对照者。分析了纵向、环向和径向方向的整体和节段 PSS 值。计算了各向同性的收缩期峰值应变时间（PSST）和应变时间标准差（SDT），以研究这些患者的室内和室内机械不同步性以及关闭后的改善情况。与对照组相比，ASD 患者的 RV 游离壁纵向收缩应变较高，PSST 和 SDT 增加。LV 纵向和环向应变的 SDT 值也增加。ASD 关闭后 24 小时，RV 游离壁纵向应变及其 PSST 和 SDT 恢复正常水平。LV 环向应变增加，SDT 降低。ASD 患者 RV 和 LV 的收缩期和心肌收缩不同步性增加。经皮 ASD 关闭后，RV 和 LV 的室内和室内机械功能得到改善。
