Advertisement

Left ventricular torsional deformation in patients undergoing transcatheter closure of secundum atrial septal defect

  • Lili Dong
  • Feng Zhang
  • Xianhong Shu
  • Daxin Zhou
  • Lihua Guan
  • Cuizhen Pan
  • Haozhu Chen
Original Paper

Abstract

Left ventricular (LV) torsional deformation plays an important role with respect to LV ejection and filling. However, no data are available on the impact of overload relief on LV torsional deformation after transcatheter ASD closure. This study sought to evaluate LV twist and untwisting before and early after device closure of ASD using the speckle tracking imaging (STI). We acquired basal and apical LV short-axis ultrasound images in 30 asymptomatic patients (29 ± 9 years, 9 males) scheduled for percutaneous closure of an ASD before and 1-day after transcatheter ASD closure. All data were offline analyzed with Echopac 7.0 software. After transcatheter ASD closure, there was no significant difference in peak apical rotation and time to the peak (P > 0.05 for both). However, a significantly improved basal rotation was recorded, including significantly increased peak clockwise rotation (−7.1 ± 3.2° vs. −5.4 ± 2.9°, P = 0.014), decreased initial counterclockwise rotation (2.0 ± 1.8° vs. 5.1 ± 3.2°, P < 0.001) and shortened time to peak clockwise rotation (105.5 ± 16.5% vs. 118.0 ± 18.5% of systolic period, P = 0.001). LV twist was significantly improved in patients with ASD after the device closure (16.1 ± 6.7° vs. 12.2 ± 6.3°, P = 0.001), whereas there was no significant difference in peak untwisting rate, time to the peak and untwisting during IVRT (P > 0.05 for all). In conclusion, LV systolic twist could be significantly improved but diastolic untwisting remained unchanged after transcatheter ASD closure. This improvement was mainly attributed to the improved LV basal rotation rather than the unchanged apical rotation.

Keywords

Atrial septal defect Transcatheter closure Speckle tracking imaging Torsion 

References

  1. 1.
    Masura J, Gavora P, Formanek A, Hijazi ZM (1997) Transcatheter closure of secundum atrial septal defects using the new self-centering amplatzer septal occluder: initial human experience. Cathet Cardiovasc Diagn 42:388–393. doi: 10.1002/(SICI)1097-0304(199712)42:4<388::AID-CCD7>3.0.CO;2-7 PubMedCrossRefGoogle Scholar
  2. 2.
    Hijazi ZM, Cao Q, Patel HT, Rhodes J, Hanlon KM (2000) Transesophageal echocardiographic results of catheter closure of atrial septal defect in children and adults using the amplatzer device. Am J Cardiol 85:1387–1390. doi: 10.1016/S0002-9149(00)00779-7 PubMedCrossRefGoogle Scholar
  3. 3.
    Formigari R, Di Donato RM, Mazzera E, Carotti A, Rinelli G, Parisi F, Pasquini L, Ballerini L (2001) Minimally invasive or interventional repair of atrial septal defects in children: experience in 171 cases and comparison with conventional strategies. J Am Coll Cardiol 37:1707–1712. doi: 10.1016/S0735-1097(01)01213-X PubMedCrossRefGoogle Scholar
  4. 4.
    Gade CL, Bergman G, Naidu S, Weinsaft JW, Callister TQ, Min JK (2007) Comprehensive evaluation of atrial septal defects in individuals undergoing percutaneous repair by 64-detector row computed tomography. Int J Cardiovasc Imaging 23:397–404. doi: 10.1007/s10554-006-9149-9 PubMedCrossRefGoogle Scholar
  5. 5.
    Walker RE, Moran AM, Gauvreau K, Colan SD (2004) Evidence of adverse ventricular interdependence in patients with atrial septal defect. Am J Cardiol 93:1374–1377. doi: 10.1016/j.amjcard.2004.02.033 PubMedCrossRefGoogle Scholar
  6. 6.
    Pascotto M, Santoro G, Caso P, Cerrato F, Caso I, Caputo S, Bigazzi MC, D’Andrea A, Russo MG, Calabrò R (2005) Global and regional left ventricular function in patients undergoing transcatheter closure of secundum atrial septal defect. Am J Cardiol 96:439–442. doi: 10.1016/j.amjcard.2005.03.096 PubMedCrossRefGoogle Scholar
  7. 7.
    Brochu MC, Baril JF, Dore A, Juneau M, De Guise P, Mercier LA (2002) Improvement in exercise capacity in asymptomatic and mildly symptomatic adults after atrial septal defect percutaneous closure. Circulation 106:1821–1826. doi: 10.1161/01.CIR.0000029924.90823.E0 PubMedCrossRefGoogle Scholar
  8. 8.
    Giardini A, Donti A, Formigari M, Specchia S, Prandstraller D, Bronzetti G, Bonvicini M, Picchio FM (2004) Determinants of cardiopulmonary functional improvement after transcatheter atrial septal defect closure in asymptomatic adults. J Am Coll Cardiol 43:1886–1891. doi: 10.1016/j.jacc.2003.10.067 PubMedCrossRefGoogle Scholar
  9. 9.
    Salehian O, Horlick E, Schwerzmann M, Haberer K, McLaughlin P, Siu SC, Webb G, Therrien J (2005) Improvements in cardiac form and function after transcatheter closure of secundum atrial septal defects. J Am Coll Cardiol 45:499–504. doi: 10.1016/j.jacc.2004.10.052 PubMedCrossRefGoogle Scholar
  10. 10.
    Tuncer M, Ekim H, Günes Y, Güntekin U (2008) Atrial septal defect presenting with Brucella endocarditis. Circ J 72:2096–2097. doi: 10.1253/circj.CJ-07-0980 PubMedCrossRefGoogle Scholar
  11. 11.
    Buckberg GD, Weisfeldt ML, Ballester M, Beyar R, Burkhoff D, Coghlan HC, Doyle M, Epstein ND, Gharib M, Ideker RE, Ingels NB, LeWinter MM, McCulloch AD, Pohost GM, Reinlib LJ, Sahn DJ, Sopko G, Spinale FG, Spotnitz HM, Torrent-Guasp F, Shapiro EP (2004) Left ventricular form and functionscientific priorities and strategic planning for development of new views of disease. Circulation 110:e333–e336. doi: 10.1161/01.CIR.0000143625.56882.5C PubMedCrossRefGoogle Scholar
  12. 12.
    Rademakers FE, Buchalter MB, Rogers WJ, Zerhouni EA, Weisfeldt ML, Weiss JL, Shapiro EP (1992) Dissociation between left ventricular untwisting and filling: accentuation by catecholamines. Circulation 85:1572–1581PubMedGoogle Scholar
  13. 13.
    Gibbons Kroeker CA, Ter Keurs HE, Knudtson ML, Tyberg JV, Beyar R (1993) An optical device to measure the dynamics of apex rotation of the left ventricle. Am J Physiol 265:H1444–H1449PubMedGoogle Scholar
  14. 14.
    Moon MR, Ingels NB Jr, Daughters GT, Stinson EB, Hansen DE, Miller DC (1994) Alterations in left ventricular twist mechanics with inotropic stimulation and volume loading in human subjects. Circulation 89:142–150PubMedGoogle Scholar
  15. 15.
    Dong L, Shu X, Guan L, Chen H, Pan C, Chen H (2008) Assessment of left ventricular twist in patients with secundum atrial septal defect using speckle tracking imaging. Eur J Echocardiogr 9:S156 abstractGoogle Scholar
  16. 16.
    Dong L, Zhang F, Shu X, Guan L, Chen H (2009) Left ventricular torsion in patients with secundum atrial septal defect. Circ J 73 (in press)Google Scholar
  17. 17.
    Wang J, Khoury DS, Yue Y, Torre-Amione G, Nagueh SF (2007) Left ventricular untwisting rate by speckle tracking echocardiography. Circulation 116:2580–2586. doi: 10.1161/CIRCULATIONAHA.107.706770 PubMedCrossRefGoogle Scholar
  18. 18.
    Pavlopoulos H, Nihoyannopoulos P (2008) Strain and strain rate deformation parameters: from tissue Doppler to 2D speckle tracking. Int J Cardiovasc Imaging 24:479–491. doi: 10.1007/s10554-007-9286-9 PubMedCrossRefGoogle Scholar
  19. 19.
    Akagawa E, Murata K, Tanaka N, Yamada H, Miura T, Kunichika H, Wada Y, Hadano Y, Tanaka T, Nose Y, Yasumoto K, Kono M, Matsuzaki M (2007) Augmentation of left ventricular apical endocardial rotation with inotropic stimulation contributes to increased left ventricular torsion and radial strain in normal subjects: quantitative assessment utilizing a novel automated tissue tracking technique. Circ J 71:661–668. doi: 10.1253/circj.71.661 PubMedCrossRefGoogle Scholar
  20. 20.
    Baur LH (2008) Strain and strain rate imaging: a promising tool for evaluation of ventricular function. Int J Cardiovasc Imaging 24:493–494. doi: 10.1007/s10554-008-9301-9 PubMedCrossRefGoogle Scholar
  21. 21.
    Lai WW, Gauvreau K, Rivera ES, Saleeb S, Powell AJ, Geva T (2008) Accuracy of guideline recommendations for two-dimensional quantification of the right ventricle by echocardiography. Int J Cardiovasc Imaging 24:691–698. doi: 10.1007/s10554-008-9314-4 PubMedCrossRefGoogle Scholar
  22. 22.
    Ashraf M, Li XK, Young MT, Jensen AJ, Pemberton J, Hui L, Lysyansky P, Friedman Z, Park B, Sahn DJ (2006) Delineation of cardiac twist by a sonographically based 2-dimensional strain analysis method: an in vitro validation study. J Ultrasound Med 25:1193–1198PubMedGoogle Scholar
  23. 23.
    Nakai H, Takeuchi M, Nishikage T, Kokumai M, Otani S, Lang RM (2006) Effect of aging on twist-displacement loop by 2-dimensional speckle tracking imaging. J Am Soc Echocardiogr 19:880–885. doi: 10.1016/j.echo.2006.02.007 PubMedCrossRefGoogle Scholar
  24. 24.
    Helle-Valle T, Crosby J, Edvardsen T, Lyseggen E, Amundsen BH, Smith HJ, Rosen BD, Lima JA, Torp H, Ihlen H, Smiseth OA (2005) New noninvasive method for assessment of left ventricular rotation: speckle tracking echocardiography. Circulation 112:3149–3156. doi: 10.1161/CIRCULATIONAHA.104.531558 PubMedCrossRefGoogle Scholar
  25. 25.
    Notomi Y, Lysyansky P, Setser RM, Shiota T, Popovic ZB, Martin-Miklovic MG, Weaver JA, Oryszak SJ, Greenberg NL, White RD, Thomas JD (2005) Measurement of ventricular torsion by two-dimensional ultrasound speckle tracking imaging. J Am Coll Cardiol 45:2034–2041. doi: 10.1016/j.jacc.2005.02.082 PubMedCrossRefGoogle Scholar
  26. 26.
    Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, Solomon SD, Spencer KT, Sutton MS, Stewart WJ, Chamber Quantification Writing Group American Society of Echocardiography’s Guidelines and Standards Committee, European Association of Echocardiography (2005) Recommendations for chamber quantification: a report from the American society of echocardiography’s guidelines and standards committee and the chamber quantification writing group, developed in conjunction with the European association of echocardiography, a branch of the European society of cardiology. J Am Soc Echocardiogr 18:1440–1463. doi: 10.1016/j.echo.2005.10.005 PubMedCrossRefGoogle Scholar
  27. 27.
    Flamm MD, Cohn KE, Hancock EW (1970) Ventricular function in atrial septal defect. Am J Med 48:286–294. doi: 10.1016/0002-9343(70)90058-6 PubMedCrossRefGoogle Scholar
  28. 28.
    Popio KA, Gorlin R, Teichholz LE, Cohn PF, Bechtel D, Herman MV (1975) Abnormalities of left ventricular, geometry in adults with an atrial septal defect Ventriculographic, hemodynamic and echocardiographic studies. Am J Cardiol 36:302–308. doi: 10.1016/0002-9149(75)90480-4 PubMedCrossRefGoogle Scholar
  29. 29.
    Ingels NB, Hansen DE, Daughters GT, Stinson EB, Alderman EL, Miller DC (1989) Relation between longitudinal, circumferential, and oblique shortening and torsional deformation in the left ventricle of the transplanted human heart. Circ Res 64:915–927PubMedGoogle Scholar
  30. 30.
    Nikolic S, Yellin EL, Tamura K, Vetter H, Tamura T, Meisner JS, Frater RW (1988) Passive properties of canine left ventricle: diastolic stiffness and restoring forces. Circ Res 62:1210–1222PubMedGoogle Scholar
  31. 31.
    Yellin EL, Hori M, Yoran C, Sonnenblick EH, Gabbay S, Frater RW (1986) Left ventricular relaxation in the filling and nonfilling intact canine heart. Am J Physiol 250:H620–H629PubMedGoogle Scholar
  32. 32.
    Louie EK, Rich S, Levitsky S, Brundage BH (1992) Doppler echocardiographic demonstration of the differential effects of right ventricular pressure and volume overload on left ventricular geometry and filling. J Am Coll Cardiol 19:84–90PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2009

Authors and Affiliations

  • Lili Dong
    • 1
    • 2
  • Feng Zhang
    • 2
    • 3
  • Xianhong Shu
    • 1
    • 2
    • 3
  • Daxin Zhou
    • 2
    • 3
  • Lihua Guan
    • 2
    • 3
  • Cuizhen Pan
    • 1
    • 2
  • Haozhu Chen
    • 2
    • 3
  1. 1.Department of Echocardiography, Zhongshan HospitalFudan UniversityShanghaiChina
  2. 2.Shanghai Institute of Cardiovascular DiseasesShanghaiChina
  3. 3.Department of Cardiology, Zhongshan HospitalFudan UniversityShanghaiChina

Personalised recommendations