Velocity Vector Imaging Assessment of Functional Change in the Right Ventricle during Transcatheter Closure of Atrial Septal Defect by Intracardiac Echocardiography

Jung SY, Shin JI, Choi JY, Park SJ, Kim NK.

J Clin Med. 2020 Apr 15;9(4). pii: E1132. doi: 10.3390/jcm9041132.

PMID: 32326588 Free Article

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Abstract

The functional change of the right ventricle (RV) after atrial septal defect (ASD) via transcatheter closure is well known. We assessed the immediate RV functional change using velocity vector imaging (VVI) with intracardiac echocardiography (ICE). Seventy-four patients who underwent transcatheter closure of an ASD were enrolled. VVI in the “home view” of ICE showing the RV was obtained before and after the procedure. Velocity, strain, strain rate (SR), and longitudinal displacement were analyzed from VVI data, and the changes of these parameters before and after the procedure were compared. The velocity of the RV decreased after ASD transcatheter closure (3.97 ± 1.48 to 3.56 ± 1.4, p = 0.024), especially in the RV inlet and outlet. The average strain decreased (-19.21 ± 5.79 to -16.87 ± 5.03, p = 0.002), as did the average SR (-2.28 ± 0.64 to -2.03 ± 0.61, p = 0.006). The average longitudinal displacement did not differ. With the VVI technique, we could clearly observe RV functional change immediately after transcatheter closure of the ASD. RV functional change with regional difference may reflect the heterogeneity of volume reduction and suggest subclinical RV dysfunction. These findings can enhance our understanding of the physiologic changes in the RV during reverse remodeling.

 

Figure 1 “Home view” of intracardiac echocardiography. RA: right atrium, RV: right ventricle. “Home view” was obtained to analyze the vector velocity image of the right ventricle, before and after the transcatheter closure.

Figure 2 Vector velocity image of the right ventricle in “home view”. RA: right atrium, RV: right ventricle. The right ventricle was divided into six segments, and the velocity, strain, strain rate, and longitudinal displacement of each part was analyzed from the vector velocity image obtained in “home view”.

 

source:https://pubmed.ncbi.nlm.nih.gov/32326588/

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