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Longitudinal left atrial mechanics and function in children after transcatheter closure of secondary atrial septal defect

[Pediatrics]
Yuri Semenovich Sinelnikov; Ekaterina Nikolaevna Orekhova; Tatyana Vladimirovna Matanovskaya;

In this article we evaluated the dynamics of longitudinal mechanics and phase function of the left atrium (LA) in infants with secondary atrial septal defect (ASD) after transcatheter closure. We examined 38 children of 2.1±0.7 years old, with secondary ASD 10.4±2.5 mm, Qp/Qs 1.86±0.2, with performed transcatheter correction of defect The functional (passive and active emptying fraction, PEF, AEF, expansion index – EI) and mechanical (longitudinal strain – S and strain rate – SR during the contraction phase, time to peak strain in the systolic phase – TTP Spump) LA parameters were evaluated initially, in the first day after surgery and after 6 months. All data were compared with the results obtained in 23 healthy children, comparable in age, gender, weight. In children with ASD, all functional and longitudinal mechanical parameters of LA are reduced in all phases of its activity. After transcatheter correction, the functional and mechanical parameters of the LA in the reservoir and pump phases are improved, but remain reduced by more than two times compared with the group of healthy children. Conduit function of the LA increases compensatory. A relationship was found between LA AEF and stroke index of the left ventricle (LV) 6 months after surgery (RS=0.63, p=0.0001) and LA AEF and LV EF (RS=0.4, p=0.011). An inverse correlation was found between the size of the installed occluder and reservoir longitudinal mechanics of LA after 6 months of observation (S-RS=–0.64, p=0.0001, SR-RS=–0.51, p=0.001), a direct relationship between the parameters of longitudinal mechanics of LA in the systolic phase of the LA and TTP Spump (S-RS=0.86, p=0.0001; SR-RS=0.7, p=0.0001, respectively). Thus, 6 months after transcatheter correction of the ASDs, signs of LA dysfunction persist in the form of inhibition of the pumping and reservoir functional and mechanical components of LA activity and a compensatory increase in conduit functional contribution.

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References:
1. Moore J., Hegde S., El-Said H. Transcatheter device closure of atrial septal defects: a safety review. J. Am. Coll . Cardiol. Intv. 2013;6:433-442.
2. Suchon E., Pieculewicz M., Tracz W. Transcatheter closure as an alternative and equivalent method to the surgical treatment of atrial septal defect in adults: Comparison of early and late results. Med. Sci. Monit. 2009;15(12):612-617.
3. Cakal S., Eroglu E., Baydar O. Two-dimensional strain and strain rate imaging of the left atrium and left ventricle in adult patients with atrial septal defects before and after the later stage of percutaneous device closure. Echocardiography. 2014;00:1-5.
4. Castaldi B., Vida V. L., Agriolas A. Late Electrical and Mechanical Remodeling After Atrial Septal Defect Closure in Children: Surgical Versus Percutaneous Approach. Ann. Thorac. Surg. 2015;100:181-187.
5. Kim J. Y., Yun B.-S., Lee S. Changes in Strain Pattern and Exercise Capacity after Transcatheter Closure of Atrial Septal Defects. Korean Circ. J. 2017;47(2):245-253.
6. Pavlyukova E. N., Kughel D. A., Matyushin G. V. The function of the left atrium: modern methods of assessment and clinical significance. Ratsionalnaya farmakoterapiya v kardiologii. –Rational pharmacotherapy in cardiology. 2017;13(5):675-683. (In Russ.).
7. Cameli M., Lisi M., Focardi M. Left atrial deformation analysis by speckle tracking echocardiography for prediction of cardiovascular outcomes. Am. J. Cardiol. 2012;110(2):264-269.
8. Ghelani S. J., Brown D. W., Kuebler J. D. Left Atrial Volumes and Strain in Healthy Children Measured by Three-Dimensional Echocardiography: Normal Values and Maturational Changes. J. Am. Soc. Echocardiogr. 2018;31(2):187-193.
9. Todaro M. C., Choudhuri I., Belohlavek M. New echocardiographic techniques for evaluation of left atrial mechanics. Eur. Heart J. Cardiovasc. Imaging. 2012;13(12):973-984.
10. Voigt J. U., Pedrizzetti G., Lysyansky P. Definitions for a common standard for 2D speckle tracking echocardiography: consensus document of the EACVI/ASE/Industry Task Force to standardize deformation imaging. Eur. Heart J. Cardiovasc. Imaging. 2015;16:1-11.
11. Di Salvo G., Pacileo G., Castaldi B. Two-dimensional strain and atrial function: a study on patients after percutaneous closure of atrial septal defect. Eur. J. Echocardiogr.2009;10:256-259.
12. Lopes L., Colan S. D., Frommelt P. C. Recommendations for Quantification Methods During the Performance of a Pediatric Echocardiogram: A Report From the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J. Am. Soc. Echocardiogr. 2010;23:465-495.
13. Aslan M., Erturk M., Turen S. Effects of percutaneous closure of atrial septal defect on left atrial mechanical and conduction functions. Eur. Heart J. Cardiovasc. Imaging. 2014;15:1117-1124.
14. Blume G., Mcleod C. J., Barnes M. E. Left atrial function: physiology, assessment, and clinical implications. Eur. J. Echocardiogr. 2011;12(6):421-430.
15. Vieira M. J., Teixeira R., Goncalves L. Left atrial mechanics: echocardiographic assessment and clinical implications. J. Am. Soc. Echocardiogr. 2014;27(5):463-478.
16. Esmaeilzadeh M., Nikparvar M., Maleki M. Assessment of Inter and Intra-atrial Asynchrony in Patients with Systolic Heart Failure Using Velocity Vector Imaging. Res. Cardiovasc. Med. 2013;2(3):114-120.
17. Marcus K. A., Mavinkurve-Groothuis A. M., Barends M. Reference values for myocardial two-dimensional strainechocardiography in a healthy pediatric and young adultcohort. J. Am. Soc. Echocardiogr. 2011;24:625-636.

Keywords: atrial septal defect, left atrial, longitudinal stain


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