Noninvasive assessment of right ventricular systolic pressure in atrial septal defect: analysis of the end-systolic configuration of the ventricular septum by two-dimensional echocardiography.

This study was performed to determine if 2-dimensional echocardiography (2-D echo) can be used to predict right ventricular (RV) systolic pressure. Ninety-one patients with atrial septal defect were studied prospectively. Analysis of the end-systolic configuration of the ventricular septum (VS) in the short-axis 2-D echocardiogram allowed classification of patients into 4 groups: type A (67 patients)--the VS was more circular at end-systole than at end-diastole; type B (9 patients)--the VS curvature at end-systole was same as or further flattened compared with that at end-diastole; type C (9 patients)--the VS was straight at end-systole; type D (6 patients)--the VS curvature at end-systole was reversed so that it was convex toward the left ventricle. Between these types, the RV pressure was different. The RV systolic pressure ranged from 18 to 55 mm Hg (mean 34 +/- 1) in type A, 46 to 55 mm Hg (50 +/- 1) in type B, 60 to 76 mm Hg (66 +/- 2) in type C, and 72 to 118 mm Hg (93 +/- 7) in type D. The RV systolic pressure was statistically different between types except for types C and D. These data indicate that the end-systolic configuration of the VS in the short-axis 2-D echocardiogram may be useful for the semiquantitative assessment of the RV systolic pressure in patients with atrial septal defect.