Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale.
Neth Heart J
; 29(7-8): 402-408, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-33594591
ABSTRACT
BACKGROUND:
Transcatheter atrial septal defect (ASD) and patent foramen ovale (PFO) closure might have opposite short- and long-term haemodynamic consequences compared with restricted interatrial shunt creation, which recently emerged as a potential treatment modality for patients with heart failure with preserved ejection fraction (HFpEF). Given the opposing approaches of ASD and PFO closure versus shunt creation, we investigated the early and sustained cardiac structural and functional changes following transcatheter ASD or PFO closure.METHODS:
In this retrospective study, adult secundum-type ASD and PFO patients with complete echocardiography examinations at baseline and at 1day and 1year follow-up who also underwent transcatheter closure between 2013 and 2017â¯at the University Medical Centre Groningen, the Netherlands were included.RESULTS:
Thirty-nine patients (mean age 48⯱ standard deviation 16 years, 61.5% women) were included. Transcatheter ASD/PFO closure resulted in an early and persistent decrease in right ventricular systolic and diastolic function. Additionally, transcatheter ASD/PFO closure resulted in an early and sustained favourable response of left ventricular (LV) systolic function, but also in deterioration of LV diastolic function with an increase in LV filling pressure (LVFP), as assessed by echocardiography. Age (ßâ¯= 0.31, pâ¯= 0.009) and atrial fibrillation (AF; ßâ¯= 0.24, pâ¯= 0.03) were associated with a sustained increase in LVFP after transcatheter ASD/PFO closure estimated by mean E/e' ratio (i.e. ratio of mitral peak velocity of early filling to diastolic mitral annular velocity). In subgroup analysis, this was similar for ASD and PFO closure.CONCLUSION:
Older patients and patients with AF were predisposed to sustained increases in left-sided filling pressures resembling HFpEF following ASD or PFO closure. Consequently, these findings support the current concept that creating a restricted interatrial shunt might be beneficial, particularly in elderly HFpEF patients with AF.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Neth Heart J
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Singapura