A STUDY OF ASSESSMENT OF RIGHT VENTRICULAR STRAIN BY SPECKLE TRACKING ECHOCARDIOGRAPHY IN PATIENTS WITH OSTIUM SECUNDUM ATRIAL SEPTAL DEFECT (OS-ASD) BEFORE AND AFTER DEFECT CLOSURE AT A TERTIARY CARE HOSPITAL.

Background: Ostium secundum atrial septal defect (OS-ASD) is a signicant cause of right-sided volume overload, often requiring closure for large defects. Assessment of right ventricle (RV) strain via speckle tracking echocardiography (STE) help assess RV function, a key prognostic factor. Limited data is available on the immediate impact of ASD closure on RV strain. Objective: To quantify RV function in patients of OS-ASD via echocardiography and strain imaging via STE and to assess improvement in RV function after correction of defect. This prospective cross-sectional study conducted at SMS Medical Methods: College, Jaipur, evaluated RV strain and function in 30 patients of OS-ASD patients before and 48 hours after defect closure either surgical or by device. Patients over 2 years with OS-ASD were included, except those with other cardiac comorbidities, atrial brillation, eisenmengerisation or poor windows. RV strain, pulmonary artery systolic pressure (PASP), RV fractional area change (FAC), RV myocardial performance index (MPI), peak systolic velocity at lateral tricuspid annulus (RV S'), tricuspid annular plane systolic excursion (TAPSE) were recorded before and after 48 hours of defect closure. Results: RV global longitudinal strain decreased signicantly after 48 h of correction (−21.61 ±2.88 to -20.11 ±2.54, p < 0.001, mean diff: -1.50) which was statistically signicant. RV free wall strain also decreased signicantly after 48 hours of closure (-24.59 ±3.78 to -21.74 ±3.08, p <0.001, mean difference: -2.84). PASP also decreased signicantly post closure (33.27 ±7.36 to 27.87 ±6.95, p value <0.001). No signicant difference was observed in RV septal segmental strain values, TAPSE, RV S', FAC and RV MPI. Closing Conclusion: an atrial septal defect improves right ventricular function, regardless of defect size or technique. Two-dimensional strain imaging effectively assesses RV myocardial function, predicts early dysfunction, and aids timely therapeutic interventions for conditions involving right sided volume overload.