title: Is right ventricular myocardial deformation affected by degree of interatrial shunt in adults?
abstract: OBJECTIVE
  Data on right ventricle (RV) regional function in adults with interatrial shunt are scarce. The aim of the study was to assess the regional RV deformation in the population of adults with uncorrected atrial left-to-right shunt and to establish a potential relationship between its magnitude and RV regional deformation.
  
  
  RESULTS
  We studied 40 adults (30F/10M; mean age 39.2 years) with atrial septal defect (ASD) [average pulmonary-to-systemic blood flow ratio (Qp/Qs) 2.1 ± 0.7]. Standard echocardiographic evaluation was completed with right ventricular dimensions, parameters of its global [tricuspid annular plane systolic excursion (TAPSE), fractional area change, myocardial performance index], and regional [strain/strain rate (ε/SR)] function. Among echocardiographic indices describing RV global function, only TAPSE was increased when compared with healthy subjects. No differences in RV deformation data (ε/SR) between ASD patients and control group were found. Non-linear relationship between the differing Qp/Qs and maximal ε in the mid-segments of the RV free wall was observed. In patients with moderate shunt, maximal ε values were higher when compared with the values obtained in mild and large shunts.
  
  
  CONCLUSIONS
  Regional RV deformation (ε/SR) does not differ significantly in the group of patients with various degrees of the left-to-right shunts when compared with healthy subjects. However, a non-linear correlation between Qp/Qs and ε could be observed. The affected region of the RV wall is the mid-segment and the highest values of ε were recorded in patients with moderate left-to-right shunts.
authors.affiliation: Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, 04-628 Warsaw, Poland. ewa.kowalik@gmail.com
authors.forename: Ewa
authors.initials: E
authors.lastname: Kowalik
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Kowalski
authors.forename: Piotr
authors.initials: P
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D018618:Echocardiography, Doppler, Color; D005260:Female; D006305:Health Status Indicators; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000473:pathology; D006344:Heart Septal Defects, Atrial / Q000000981:diagnostic imaging* / Q000473:pathology; D006352:Heart Ventricles / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D013223:Statistics as Topic; D016278:Ventricular Function, Right / Q000502:physiology*; D055815:Young Adult