Background: Pulmonary arterial hypertension in congenital heart disease is reversed by early shunt closure, but this potential is lost beyond a certain point of no return. this study was conducted to evaluate the results of simple cardiac shunt closure regarding right ventricular function using speckle tracking and reversibility of pulmonary hypertension, testing its ability to provide information with minimal risk,we detected right ventricular function in simple cardiac shunt patients before closure using longitudinal strain and to investigate its role in predicting reversibility of pulmonary hypertension after closure
Methods: a prospective randomized comparative study,simple shunt patients from age 25-48 years presented to Zagazig University hospitals, cardiology department from September 2018 to July 2019 were divided into two groups Group I: ten patients having irreversible pulmonary hypertension. Group II: Twenty patients having reversible pulmonary hypertension.
Results: There was statistically significant increase in Group II post closure regarding LVEF, RVFAC,TAPSE,SRV, RVLS (P< 0.05). While PASP showed significant decrease in Group II post closure (P < 0.05). On the other hand, RVLS was negatively correlated with the defect size (r = -0.65; p = <0.001), Qp/Qs (r = -0.53, p = <0.001), PASP (r = -0.8, p = <0.001). And significant positive correlation with SRV(r = 0.37; p = <0.001),RVFAC (r =0.30, p < 0.001),TAPSE(r =0.34, p < 0.001).ROC curve analysis revealed that RVLS value of ≥ -20 could predict reversibility of PASP (P< 0.001).
Conclusion: The RVLS value of ≥-20 could predict reversibility of PASP (P< 0.001). RVLS correctly identify simple shunt patients with increased PASP.