Seo Jeong Sook, Park Young Ah, Wi Jin Hong, Jin Han Young, Han Il Yong, Jang Jae Sik, Yang Tae Hyun, Kim Dae Kyeong, Kim Dong Soo
Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Busan, Korea.
J Cardiovasc Imaging. 2021 Apr;29(2):123-132. doi: 10.4250/jcvi.2020.0142. Epub 2020 Nov 26.
Studies comparing left atrial (LA) function after surgical closure or percutaneous closure in patients with an atrial septal defect (ASD) are lacking.
Between 1 and 3 years after ASD treatment, we retrospectively analyzed the medical records and transthoracic echocardiographic images of patients who had been diagnosed with an ASD after 20 years of age and who had undergone surgical closure (ASD-S) or percutaneous device closure (ASD-D). We measured LA peak systolic, early diastolic, and late diastolic strain values using 2-dimensional (2D) speckle tracking echocardiography (STE) and calculated reservoir, conduit, and contraction strain.
The reservoir strain value of the ASD-D groups was 25.2% ± 7.4%, which was lower compared to the control group (33.6% ± 5.5%) (p = 0.004). The LA conduit strain and the LA contraction values of the ASD-D group were also lower compared to the control group (-13.8% ± 5.8% vs. -20.4% ± 4.7%, p = 0.034; -11.3% ± 4.2% vs. -13.2% ± 2.5%, p = 0.037, respectively). The reservoir, conduit, and contraction strains of the ASD-S group were 27.8% ± 8.8%, -15.3% ± 6.4%, and -12.5% ± 5.8%, respectively, and were not different from those of the control group or the ASD-D group.
The 2D STE is a suitable method for evaluating LA function after ASD closure. Our results demonstrate that 1 year after device closure, the LA reservoir, conduit and contraction function were reduced in ASD-D group compared to healthy controls, while there was no difference between the ASD-S and ASD-D groups.
缺乏关于房间隔缺损（ASD）患者手术闭合或经皮闭合后左心房（LA）功能的比较研究。
在ASD治疗后1至3年，我们回顾性分析了20岁以后被诊断为ASD且接受了手术闭合（ASD-S）或经皮器械闭合（ASD-D）的患者的病历和经胸超声心动图图像。我们使用二维（2D）斑点追踪超声心动图（STE）测量LA的收缩期峰值、舒张早期和舒张晚期应变值，并计算储存、管道和收缩应变。
ASD-D组的储存应变值为25.2%±7.4%，与对照组（33.6%±5.5%）相比更低（p = 0.004）。ASD-D组的LA管道应变和LA收缩值也低于对照组（分别为-13.8%±5.8%对-20.4%±4.7%，p = 0.034；-11.3%±4.2%对-13.2%±2.5%，p = 0.037）。ASD-S组的储存、管道和收缩应变分别为27.8%±8.8%、-15.3%±6.4%和-12.5%±5.8%，与对照组或ASD-D组无差异。
二维STE是评估ASD闭合后LA功能的合适方法。我们的结果表明，器械闭合1年后，与健康对照组相比，ASD-D组的LA储存、管道和收缩功能降低，而ASD-S组和ASD-D组之间无差异。
