Int J Arrhythm.  2022 Sep;23(3):23. 10.1186/s42444-022-00074-y.

Assessment of left atrial remodeling using speckle tracking echocardiography after percutaneous atrial septal defect closure in adult patients

• Choi J
• Kim J
• Hwang J
• Kim H
• Chung T
• Kim J
• Park S
• Kang I
• Song J
• Park S
• Park K
• On Y
• Kim J
• Huh J

• KMID: 2534097
• DOI: http://doi.org/10.1186/s42444-022-00074-y

Abstract

Background
Atrial fibrillation (AF) is a well-known, long-term complication of atrial septal defect (ASD) in adults, even after device closure. Left atrial (LA) strain rate applied to the analysis of chamber function has been demon‑ strated to be an important predictor of LA reverse remodeling. This study aimed to determine the changes in cham‑ ber function after device closure of ASD.
Methods
This prospective study enrolled adults with secundum ASD undergoing transcatheter device closure from December 2016 to August 2017. We analyzed the clinical characteristics and LA strain rate before and six months after ASD closure.
Results
A total of 11 patients were enrolled. The mean age was 42.6 ± 9.9 years, and six (54.5%) were females. There was no significant change of conventional echocardiographic parameters after ASD closure. The mean global LA res‑ ervoir strain rate before ASD closure was 1.17 ± 0.34 and 0.85 ± 0.30 after ASD closure (p = 0.030). The median global LA conduit strain rate was 0.68 (0.42–1.16) and 0.41 (0.16–0.79) before and after ASD closure (p = 0.213), respectively. The mean global LA contractile strain rate at the six-month follow-up showed significant improvement compared with pre-procedural strain rate (0.33 ± 0.65 vs. − 0.43 ± 0.38, p = 0.006).
Conclusions
LA functional changes occurred during the six-month follow-up, while LA and right atrial (RA) geo‑ metric changes were not significant. LA reverse remodeling was proved by restoration of LA late diastolic contractile function.

Keyword

Atrial septal defect; Percutaneous; Closure; Strain rate; Remodeling; Left atrium