Akyüz Ali Rıza, Korkmaz Levent, Turan Turhan, Kırış Abdulkadir, Erkan Hakan, Ağaç Mustafa Tarık, Erkuş Muslihittin Emre, Celik Sükrü, Akdemir Ramazan
Clinic of Cardiology, Akçaabat Haçkalı Baba State Hospital; Trabzon-Turkey.
Anadolu Kardiyol Derg. 2014 Aug;14(5):417-21. doi: 10.5152/akd.2014.4828. Epub 2014 Feb 26.
The main purpose of present study was to investigate the impact of percutaneous closure of atrial septal defect (ASD) on right ventricular (RV) systolic function assessed by tricuspid annular isovolumic myocardial acceleration (IVA) that is independent of preload and afterload changes.
A prospective cohort study was designed involving twenty five patients with secundum type ASD whom were successfully closed percutaneously between 2009 and 2011. Standard transthoracic echocardiography and tissue Doppler imaging were performed in all patients 12 to 24 hours before and one month after closure. Paired t test was performed to determine the statistical significance of variables before and after closure.
Significant decreases were observed in RV end-diastolic diameter, RV/left ventricular (LV) end-diastolic diameter ratio, right ventricular systolic myocardial velocity (Sm), right ventricular early myocardial velocity (Em) and right ventricular late myocardial velocity (Am) in the control echocardiography in the first month when compared with pre-procedure values. While significant increase was observed after procedure in right ventricular IVA (3.4 ± 1.3 m/sec2 vs. 4.2 ± 1.8 m/sec2, p=0.001), no significant change was observed in right ventricular global performance index, in right ventricular Em/Am ratio and left ventricular ejection fraction.
Percutaneous closure of ASD resulted in recovery of right ventricular function as early as 1 month after closure.
本研究的主要目的是探讨经皮闭合房间隔缺损（ASD）对右心室（RV）收缩功能的影响，该功能通过三尖瓣环等容心肌加速度（IVA）评估，其独立于前负荷和后负荷变化。
设计了一项前瞻性队列研究，纳入25例继发孔型ASD患者，这些患者在2009年至2011年间成功接受了经皮闭合治疗。在所有患者闭合前12至24小时以及闭合后1个月进行标准经胸超声心动图和组织多普勒成像检查。采用配对t检验来确定闭合前后变量的统计学意义。
与术前值相比，在第一个月的对照超声心动图中，观察到右心室舒张末期直径、右心室/左心室（LV）舒张末期直径比值、右心室收缩期心肌速度（Sm）、右心室早期心肌速度（Em）和右心室晚期心肌速度（Am）显著降低。虽然术后右心室IVA显著增加（3.4±1.3m/sec²对4.2±1.8m/sec²，p = 0.001），但右心室整体功能指数、右心室Em/Am比值和左心室射血分数未见显著变化。
经皮闭合ASD可在闭合后1个月即导致右心室功能恢复。
