Left and Right Atrial Myocardial Deformation Properties in Patients with an Atrial Septal Defect

Clinic of Cardiology, Ankara Yuksek Ihtisas Hospital, Ankara, Turkey.
Echocardiography (Impact Factor: 1.25). 05/2008; 25(4):401-7. DOI: 10.1111/j.1540-8175.2007.00614.x
Source: PubMed


Atrial septal defect (ASD) is a common form of congenital heart defect in adults, which affects all cardiac chambers. Atrial myocardial function in patients with ASD has not yet been clearly elucidated. The aim of this study was to investigate atrial myocardial deformation properties in patients with ASDs.
The study involved 24 patients with a secundum type ASD, and 22 healthy subjects. Color Doppler myocardial imaging was used to measure left and right atrial myocardial systolic strain and strain rate values, together with peak systolic velocity, early velocity, and late diastolic velocity.
There was no significant difference between the two groups with regard to age, gender, body mass index, heart rate, blood pressure, left atrial diameter, and ventricular function. The peak systolic atrial myocardial strain and strain rate values in each of the atrial walls studied were lower in the ASD group compared to those of the control group, but the difference reached statistical significance only in the case of the right atrial wall (right atrial strain: 48.0 +/- 32.7% vs 100.2 +/- 46.6%, P = 0.006; right atrial strain rate: 2.6 +/- 1.2/sec vs 3.8 +/- 1.2/sec, P = 0.024).
The left to right cardiac shunt that results from ASD leads to a reduction in the right atrial myocardial longitudinal lengthening that occurs during ventricular ejection. These findings demonstrate that the reservoir function of the atrium is impaired and atrial stiffness increases in patients with ASDs.

1 Follower
10 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: Two-dimensional (2D) speckle imaging has shown that it could evaluate not only regional but also global strain (epsilon) and strain rate (SR) of the left and right ventricles. There are no data for global epsilon/SR imaging for left atrial (LA) function evaluation. A total of 54 subjects (37 men; mean age, 44 +/- 10 years) with normal treadmill exercise stress echocardiography and no coronary risk factors were enrolled. Global longitudinal LA epsilon/SR data obtained by 2D speckle imaging with automated software (EchoPAC, GE Medical) were compared with LA volumetric parameters. LA epsilon/SR imaging was acceptable in all patients. Bland-Altman analysis for these parameters showed no evidence of any systematic difference regarding inter- and intraobserver variabilities. Global longitudinal LA strain during systole and peak systolic global longitudinal LA SR were correlated with LA total emptying fraction (EF) (r = 0.399, P = 0.004; r = 0.366, P = 0.008). Global longitudinal LA strain during early diastole and peak early diastolic global longitudinal LA SR were correlated significantly with LA passive EF (r = 0.476, P < 0.001; r = 0.507, P < 0.001). Global longitudinal LA strain during late diastole and peak late diastolic global longitudinal LA SR were not correlated with LA active EF (r = 0.198, P = 0.163; r = 0.265, P = 0.060). Global longitudinal LA epsilon/SR parameters determined by 2D speckle tracking echocardiography are feasible and reproducible indices for the evaluation of LA function.
    Echocardiography 08/2009; 26(10):1179-87. DOI:10.1111/j.1540-8175.2009.00955.x · 1.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: We hypothesized that contraction of the LA wall could be documented by speckle tracking and could be applied for assessment of LA function. This study tried to identify the association between LA longitudinal strain (LAS) and strain rate (LASR) measured by speckle tracking with paroxysmal atrial fibrillation (PAF). Methods: Fifty-two patients (61 ± 17 years old, 23 men) with sinus rhythm at baseline referred for the evaluation of episodic palpitation were included. Standard four-chamber and two-chamber views were acquired and analyzed off-line. Peak LAS and LASR were carefully identified as the peak negative inflection of speckle tracking waves after P-wave gated by electrocardiography. Results: Ten patients (19%) had PAF. LAS, LASR, age, left ventricular end-diastolic dimension, left ventricular mass, LA volume, and mitral early filling-to-annulus early velocity ratio were different between patients with and without PAF. After multivariate analysis, LASR was significantly independently associated with PAF (OR 8.56, 95% CI 1.14–64.02, P = 0.036). Conclusion: Speckle tracking echocardiography could be used in measurements of LAS and LASR. Decreased negative LASR was independently associated with PAF. (ECHOCARDIOGRAPHY, Volume 26, November 2009)
    Echocardiography 10/2009; 26(10):1188 - 1194. DOI:10.1111/j.1540-8175.2009.00954.x · 1.25 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The left atrium modulates left ventricular filling with its reservoir, conduit, and contractile functions. There is growing literature on the importance of a detailed assessment of left atrial function. This review article discusses the echocardiographic assessment of left atrial function by conventional parameters such as atrial size measurements, transmitral and pulmonary Doppler flow, mitral annular tissue velocities, as well as newer techniques such as regional strain and strain rate imaging by color tissue Doppler imaging and two-dimensional speckle tracking techniques. The clinical applications of these techniques in various conditions are discussed. KeywordsSpeckle tracking-Color tissue Doppler-Atrial fibrillation-Left atrial function-Left atrial volume-Doppler echocardiography
    Current Cardiovascular Imaging Reports 10/2010; 3(5):276-285. DOI:10.1007/s12410-010-9041-9
Show more