ASSESSMENT OF RIGHT & LEFT VENTRICLES BY 4D SPECKLE  TRACKING BEFORE & AFTER TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECTS IN CHILDREN

Ibrahim Mohammed, Islam Saad; Hassan, Hassan Ali; Abu Saif, Hassan Saad; Agha, Hala Mounir; Abu Farag, Ibrahim Mohamed

doi:10.21608/azjp.2019.70224

ASSESSMENT OF RIGHT & LEFT VENTRICLES BY 4D SPECKLE TRACKING BEFORE & AFTER TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECTS IN CHILDREN

Document Type : Original Article

Authors

10.21608/azjp.2019.70224

Abstract

Introduction: Myocardial strain and strain rate are more accurate than velocities as indices of ventricular contractility, perhaps by eliminating translational artifact, Strain rate values appeared to be dependent on pressure overload but less dependent on volume overload compared to strain.
Aim of the Work: The goal of this study was to analyze the acute changes in longitudinal strain and strain rate for both RV & LV walls& for early detection of Ventricular dysfunction through regular follow up,also to measure children mental health symptoms before &after transcatheter closure of Atrial septal defect.
Methodology: prospective analytical study for 32 patients in the Pediatric Cardiology Division of Specialized Pediatric Hospital, Cairo University with haemodynamically significant Atrial septal defect (ASD) before & 6 months after transcatheter closure of ASD from September 2016 to September 2018, & using Spence Children Anxeity Scale (SCAS) to measure children mental health.
Results: the mean age was 6.01 ± 3.19 (range 3 to 9 ys), was BSA 0.73 ± 0.22 m2 (range 0.5 to 0.94m2) with female to male ratio 1.3/1. There was improvement of RVMPI(Myocardial Performance Index) and LVMPI after 6-month post ASD closure, RVMPI (0.46±0.069 before vs 0.38±0.053 after P <0.0001) LVMPI (0.49±0.12 before vs 0.38±0.08 after P <0.0001) .There was a significant improvement of LV End Diastolic Volume ( EDV), LV End systolic Volume (ESV) using 4D TomTec measures after device closure , LV EDV (32.96 ±10.99 ml before vs 44.024±14.9017 ml after P <0.0001) , LV ESV (15.16±6.08 ml before vs 21.76±8.34 ml after P <0.0001). There also was significant improvement of the LV Global Circumferential Strain( GCS) after device occlusion (-20.76 ±11.17 before vs -26.36±6.59) , & LV Global Longitudinal Strain(GLS) (-19.17± 3.67 before vs -22.36 ± 4.72) after device occlusion using 4D TomTec .4D RV volumes and strains are better predictors of the hemodynamic indices of RV dysfunction compared to conventional RV parameters . There was a significant decrease of the RV EDV (ml), 54.65±10.05 before vs 15.73 ± 8.67 after) & RV SV (25.15 ±6.36 before vs 20.06±7.2, after device occlusion) using 4D TomTec.

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