title: Analysis of atrial and ventricular performance by tissue Doppler imaging in patients with atrial septal defects before and after surgical and catheter closure.
abstract: OBJECTIVE
  To compare the effects of surgical and device closure of atrial septal defects on atrial and ventricular performance assessed by the novel tissue Doppler derived strain rate.
  
  
  BACKGROUND
  Despite the increasing number of transcatheter closures, there is no information comparing the effect of the transcatheter closure technique on atrial performance with that of conventional surgery. Tissue Doppler derived strain rate can effectively quantify local myocardial function independent of the overall heart motion.
  
  
  METHODS
  Twenty-four patients [aged 21.5 (6-70) years] with isolated atrial septal defect of the secondum type before and 1 week after surgical (n = 12) or Amplatzer Septal Occluder closure (n = 12) and 30 healthy controls [aged 26.0 (2-58) years] were studied. Atrial and ventricular strain rate curves were assessed in the middle of their corresponding lateral walls in an apical four-chamber view. The systolic, early diastolic, and late diastolic strain rates peaks were measured.
  
  
  RESULTS
  Compared to preclosure condition, the right atrial late diastolic (P < 0.01), right ventricular systolic (P < 0.01), right ventricular early diastolic (P < 0.01), and left atrial late diastolic peak (P < 0.01) strain rates were reduced after surgery but not after Amplatzer Septal Occluder closure. The LV parameters did not significantly differ before and after atrial septal defect closure by either technique.
  
  
  CONCLUSIONS
  In contrast to surgery, transcatheter closure of atrial septal defect preserves atrial and right ventricular function. Tissue Doppler derived strain rate can be applied to provide quantitative analysis of regional atrial and ventricular performance.
authors.affiliation: Department of Congenital Heart Disease and Thoracic, Augustenburger Platz 1, Berlin, Germany.
authors.forename: M Y
authors.initials: MY
authors.lastname: Abd El Rahman
authors.forename: W
authors.initials: W
authors.lastname: Hui
authors.forename: J
authors.initials: J
authors.lastname: Timme
authors.forename: P
authors.initials: P
authors.lastname: Ewert
authors.forename: F
authors.initials: F
authors.lastname: Berger
authors.forename: F
authors.initials: F
authors.lastname: Dsebissowa
authors.forename: R
authors.initials: R
authors.lastname: Hetzer
authors.forename: P E
authors.initials: PE
authors.lastname: Lange
authors.forename: H
authors.initials: H
authors.lastname: Abdul-Khaliq
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization; D002648:Child; D015150:Echocardiography, Doppler; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D016277:Ventricular Function, Left; D016278:Ventricular Function, Right