Echocardiographic assesment of the right ventricular systolic and diastolic function in children with atrial septal defect before and after surgery
Bożena Werner, Marek Pleskot, Andrzej Walawski
Med Sci Monit 1996; 2(4): CR437-440
We assessed systolic and diastolic performance of the right ventricle in 34 children with atrial septal defect before and at 7-10 days, 6 months and 1 year following the surgery. The evaluation of the right ventricular systolic function was carried out by the measurements of the ejection fraction based on TAPSE measurement. In order to evaluate diastolic performance we analysed the following parameters of tricuspid valve flow: velocity of early diastole (E wave) and velocity in late diastole (A wave), the E and A velocity ratio, acceleration and deceleration time of maximal E wave velocity. The mean values of the ejection fraction in all the studied groups did not reveal statistically significant differences as compared to the control group. It suggests normal systolic performance in children before and after the surgery. In children with ASD II we found increased velocities of E wave and A wave with the maintained vE/vA ratio. It may be indicative of increased preload. In children assessed a few days and six months following the surgery we found normal E wave velocity, higher A wave velocity than in healthy children with subsequent reduction in the vE/vA ratio. E wave velocity normalisation may be related with elimination of the shunt while higher A wave velocity may be due to increased contractility of the atrium persistent after the surgery. In children assessed one year after the surgery the mean E and A velocities did not differ from those in healthy children. Measurements of E wave ascent and descent times did not reveal statistically significant differences between the patient group and the control group which, along with the velocity measurements, suggest normal right ventricular performance in all the studied groups.
Keywords: right ventricular performance, atrial septal defect, Echocardiography