P870Early right ventricular remodeling after percutaneous atrial septal defect closure: assessment of regional deformation properties and its correlates with global right ventricular systolic function

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Background: Right ventricular (RV) function is an important prognostic factor in patients with left to right shunt. We aimed to quantify regional RV systolic function in atrial septal defect (ASD) pts before and early after percutaneous closure (PC) and to assess the relations with global RV systolic function indices.Methods: Study group included 20 ASD pts before and within 24 hrs of PC. Twenty age-matched healthy subjects were served as controls. RV function assessment included tricuspid annular systolic excursion (TAPSE), RV ejection fraction (RVEF) by Simpson, RV to LV end-diastolic area ratio (R/L). Peak systolic longitudinal strain (S) and strain rate (SR) were measured in the RV free wall (basal, mid, apical; apical 4-chamber) with 2-dimensional SR imaging (2D-SRI).Results: Basal-mid RV S and SR were significantly higher in ASD patients and apical S was slightly lower. Following PC, basal-mid S and SR decreased and apical S increased to near normal values (Table 1). RV apical S in ASD patients showed significant correlations with R/L(r=0.60; p=0.007), TAPSE (r=0.52; p=0.02), and RVEF (r=0.48; p=0.05).Conclusion: Chronic volume overload causes higher RV basal-mid S and lower apical S in ASD pts. PC results in rapid normalization of RV longitudinal deformation. 2D-SRI allows us to monitor the regional differences in early remodeling following PC.

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