Can a simple echocardiographic Doppler VTI based flow comparison between the RVOT and LVOT assist in identifying patients with a significant atrial septal defect?

Abstract Background Detection of haemodynamically significant shunting from atrial septal defect (ASD) can be identified by using the pulmonary-systemic flow ratio (Qp/Qs). However, calculation Qp/Qs echocardiography relies on geometric assumptions that outflow tracts are circular, suffers squared linear measures, and accurate measurement right ventricular tract (RVOT) diameter is challenging. Whilst adults with ASD should have overt dilatation, RV sizing often subjective underappreciated. We evaluated whether a dimensionless index (VTI) differences between RVOT left (LVOT) could assist in identifying patients ASD, compared it relative (RAI), parameter previously assessed shunting. Methods Data 64 consecutive who underwent closure had no concomitant lesions, were 63 normal controls. VTI, LVOT diameter, areas measured. Results Between controls patients, there was difference VTI or forward stroke volume, but significantly higher VTI. The RVOT-LVOT 1:1 1.5:1 patients. Area under ROC curve analysis 0.83, 1.1:1 predicted 86% sensitivity 73% specificity. In comparison, area RAI 0.70, an 1.05:1 77% 44% Conclusion Calculation simple, may useful additional semi-quantitative tool to cardiologists sonographers detecting shunting, particularly borderline heart identify undergo further evaluation. Funding Acknowledgement Type funding sources: None.