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Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale
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...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Bohn Stafleu van Loghum
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271075/ https://www.ncbi.nlm.nih.gov/pubmed/33594591 http://dx.doi.org/10.1007/s12471-021-01543-0 |
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author | Jin, X. Hummel, Y. M. Tay, W. T. Nauta, J. F. Bamadhaj, N. S. S. van Melle, J. P. Lam, C. S. P. Voors, A. A. Hoendermis, E. S. |
author_facet | Jin, X. Hummel, Y. M. Tay, W. T. Nauta, J. F. Bamadhaj, N. S. S. van Melle, J. P. Lam, C. S. P. Voors, A. A. Hoendermis, E. S. |
author_sort | Jin, X. |
collection | PubMed |
description | 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 1‑day and 1‑year follow-up who also underwent transcatheter closure between 2013 and 2017 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 (β = 0.31, p = 0.009) and atrial fibrillation (AF; β = 0.24, p = 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. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-021-01543-0) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-8271075 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Bohn Stafleu van Loghum |
record_format | MEDLINE/PubMed |
spelling | pubmed-82710752021-07-20 Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale Jin, X. Hummel, Y. M. Tay, W. T. Nauta, J. F. Bamadhaj, N. S. S. van Melle, J. P. Lam, C. S. P. Voors, A. A. Hoendermis, E. S. Neth Heart J Original Article 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 1‑day and 1‑year follow-up who also underwent transcatheter closure between 2013 and 2017 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 (β = 0.31, p = 0.009) and atrial fibrillation (AF; β = 0.24, p = 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. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-021-01543-0) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2021-02-16 2021-07 /pmc/articles/PMC8271075/ /pubmed/33594591 http://dx.doi.org/10.1007/s12471-021-01543-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Jin, X. Hummel, Y. M. Tay, W. T. Nauta, J. F. Bamadhaj, N. S. S. van Melle, J. P. Lam, C. S. P. Voors, A. A. Hoendermis, E. S. Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title | Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title_full | Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title_fullStr | Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title_full_unstemmed | Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title_short | Short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
title_sort | short- and long-term haemodynamic consequences of transcatheter closure of atrial septal defect and patent foramen ovale |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8271075/ https://www.ncbi.nlm.nih.gov/pubmed/33594591 http://dx.doi.org/10.1007/s12471-021-01543-0 |
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