title: Evaluation of left ventricular function by tissue Doppler and speckle-derived strain rate echocardiography after percutaneous ductus closure.
abstract: The aim of this study was to evaluate the left ventricular systolic and diastolic function before and after transcatheter percutaneous patent ductus arteriosus (PDA) closure. 21 children (age >6 months old) diagnosed with hemodynamically significant PDA underwent percutaneous PDA closure. Conventional, Doppler and tissue Doppler imaging and speckled-derived strain rate echocardiography were done at pre-closure, 1 day (early) and 1 month (late) post-closure. Mean age of the patients (female/male: 1.3) was 17.54 ± 24.7 months with the mean PDA diameter of 3.6 ± 0.8 mm. Systolic measures (ejection fraction, shortening fraction) reduced significantly early after PDA closure (P < 0.05). After 1 month, both improved significantly; ultimately, after 1 month no change was observed in systolic function measures compared with the pre-closure status. Early and late diastolic flow velocities of mitral (E M and A M) reduced considerably in early and late post-closure time (P < 0.05). Both early tissue Doppler early velocity of lateral mitral annulus (E'M) and early to late velocity ratio (E'M/A'M) of lateral mitral annulus decreased significantly (P = 0.02) in early post-closure. After 1 month, E'M increased considerably. (P = 0.01) but E'M/A'M had an insignificant rise (P > 0.05). E M/E'M ratio did not change in early post-closure but it had a considerable reduction in the subsequent month compared with the pre- and early post-closure (P < 0.001 for both occasions). Global and segmental longitudinal strain measures reduced significantly early after PDA closure (P < 0.05) but it improved remarkably in the subsequent month. Transcatheter PDA closure causes a significant decrease in left ventricular performance early after PDA closure which recovers completely within 1 month. Also PDA size can affect post-closure left ventricular function.
authors.affiliation: Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Amoogzar
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Shakiba
authors.forename: Dorna
authors.initials: D
authors.lastname: Derakhshan
authors.forename: Gholamhossein
authors.initials: G
authors.lastname: Ajami
authors.forename: Sirous
authors.initials: S
authors.lastname: Cheriki
authors.forename: Mohammad
authors.initials: M
authors.lastname: Borzouee
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Edraki
authors.forename: Nima
authors.initials: N
authors.lastname: Mehdizadegan
mesh_terms: D002648:Child; D002675:Child, Preschool; D003971:Diastole; D004374:Ductus Arteriosus, Patent / Q000000981:diagnostic imaging / Q000601:surgery*; D004452:Echocardiography / Q000379:methods*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D062645:Percutaneous Coronary Intervention; D015203:Reproducibility of Results; D013599:Systole; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging*
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