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Favorable changes of left ventricular function in the circumferential direction following transcatheter atrial septal defect closure: a strain imaging study

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To clarify the impact on left ventricular (LV) function of percutaneous atrial septal defect (ASD) closure in adult patients. Echocardiograms of 46 patients (52 ± 18 years) who underwent ASD closure with a significant left-to-right shunt obtained before and 1 month after the procedure were retrospectively analyzed. Functional parameters were obtained by 2-dimensional speckle-tracking imaging. Global longitudinal strain and strain rate at early diastole (SRe) was calculated from the three standard apical views, while circumferential and radial parameters were calculated from basal, middle, and apical LV short-axis views. Along with a diminished right ventricular (RV) volume, the LV volume and ejection fraction increased (end-diastolic volume: 61 ± 12 to 76 ± 15 mL, p < 0.001; and 63% ± 4 to 64% ± 4% p = 0.03; respectively). Both global strain and SRe was augmented only in the circumferential direction (− 16.2% ± 2.9% to − 19.8% ± 2.8%; and 1.07 ± 0.29 to 1.34 ± 0.28 s−1, both p < 0.001). Augmentation of circumferential SRe correlated with both the changes in and the pre-procedural value of diastolic LV eccentricity index (r = − 0.57, p < 0.001; and r = 0.37, p = 0.01; respectively), a morphological parameter of RV volume overload. Following ASD closure in adults, both LV systolic and diastolic function could favorably change in the circumferential direction, and the degree of diastolic functional change is associated with RV volume overload, i.e., severity of ventricular interdependence.

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Atrial septal defect


Early diastolic transmitral flow velocity


Early diastolic mitral annular velocity


Left ventricular


Right ventricular


Strain rate at early diastole


Speckle-tracking echocardiography






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This research was not supported by grants from any funding agencies in the public, commercial, or not-for-profit sectors.

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All authors contributed to study conception and design. Methodology: TM, TY, MY; Data collection and analysis: TM, TY, MY; Writing—original draft preparation: TM, TY; Writing—reviewing and editing: TY, SM; All authors read and approved the final version.

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Correspondence to Tetsuhiro Yamano.

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Miki, T., Yamano, T., Yamano, M. et al. Favorable changes of left ventricular function in the circumferential direction following transcatheter atrial septal defect closure: a strain imaging study. Int J Cardiovasc Imaging 37, 903–912 (2021).

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