Objective The current study was the first in China to investigate the value of single-beat real-time three-dimensional echocardiography (sRt-3DE) in assessing the shape and function of right ventricle in Patients with Atrial Septal Defect (ASD).
Methods 33 healthy volunteers (11 male, mean age (41.15±17.49 years)) and 18 ASD patients (six male, mean age (34.67±19.50 years)) were enrolled. All the participants received routine echocardiography. sRt-3DE by SIEMENS SC2000 was performed in all to evaluate parameters concerning morphology and systolic function of participants’ right ventricle. All the parameters were indexed by body surface area. Further correlative analysis was calculated between right ventricular parameters and right heart pressures by cardiac catheter as well as right ventricular parameters and body surface area-indexed maximum diameter of ASD (IASD). 21 participants (15 controls and six ASD patients) were randomly selected to explore the inter-observer agreement of this novel technique.
Results Rt-3DE was successful in all participants, even in patients with large right ventricle volume up to 250 ml. Statistic analysis showed the technology has good inter-observer correlation, (EDVRV: ICC 0.891 (95% CI 0.731 to 0.956); ESVRV: ICC 0.737 (95% CI 0.731 to 0.893)) Indexed right ventricular end diastolic volume (IEDVRV) and end systolic volume (IESVRV), indexed right ventricular systolic volume (ISVRV) and right ventricular ejection fraction (RVEF) were greater in the ASD group than in controls (p<0.001, p<0.01, p<0.001, p<0.05). IEDVRV, IESVRV and ISVRV had positive relations with pulmonary artery pressures, especially pulmonary artery diastolic pressure measured by cardiac catheter (r=0.61, r=0.79, r=0.83, all p<0.05) and IASD (r=0.57, p<0.05; r=0.6, p<0.01; r=0.55, p<0.05 respectively). At the same time, they had negative relations with LVEF (r=−0.47, r=−0.5, r=−0.52; all p<0.05).
Conclusions Left-to-right shunt in ASD patients may lead to an aggressive increase of pulmonary artery pressure and right ventricular volume. The enlargement of right ventricle increases right ventricular contraction and affects the morphology and function of left ventricle. sRt-3DE is a unique new modality to precisely and stably evaluate right ventricular changes in ASD patients.
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