Supervisors info:
Τούτουζας Κωνσταντίνος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Τούσουλης Δημήτριος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Κυρίτση Ελένη, Ομότιμος Καθηγήτρια, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Summary:
Patent foramen ovale in adults is a very common pathology, which can even lead to devastating consequences for their quality of life through paradoxical embolism that causes a stroke. This pathology is relatively easily treated these days with the transcatheter implantation of a PFO closure device. However, since implantation, there are now many methods to visualize its hemodynamic effects on left atrial function. One of them is the measurement of the distortion of the left atrium through the Speckle tracking technique, a relatively new method for identifying possible changes in this recently identified myocardial function indicator, called Strain. The aim of the present study was achieved, and it was to record the change in left atrial strain before and immediately after the operation through the measurement of LASr, LAScd, LASct and LAVi. The patient sample was satisfactory in size with a young mean age as expected from the incidence of stroke and divided by gender into approximately equal numbers of men and women. The intervention caused a statistically significant decrease in the nominal value of LASr (p<0,001), and in the absolute values of LAScd (p= 0,004) and LASct (p=0,003), immediately after the intervention for the 27 subjects enrolled. Additionally, one month post-intervention no difference was detected in the measurements from the levels achieved post-intervention, demonstrating that the effects of the intervention were maintained one month later. Also, the measurements at one month and three months follow up were compared and it was found that there are no statistically significant differences. Therefore, three months after the intervention the effects of the intervention were maintained. The results of Friedman's ANOVA tests, for the comparison of measurements at all four time points (pre, post, 1 month, 3 months) showed a statistically significant decrease in the absolute values of LASr(p<0,001), LAScd(p=0,004) and LASct(p=0,003), while no change observed in LAVi(p=0,501). The above results confirm the value of the present study for the investigation of patients undergoing PFO closure and lead us to the conclusion/proposal that it should be extended with the aim of strengthening the sample and continuing the follow up.
Keywords:
Left atrium, Left atrium strain, LAS, PFO, PFO CLOSURE, Patent foramen ovale
