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Association between the Use of Diuretics and Size Reduction in Pediatric Atrial Septal Defect

BACKGROUND AND OBJECTIVES: While diuretics are sometimes used in atrial septal defect (ASD) treatment, their effect on ASD size reduction remains unclear. We aimed to evaluate the efficacy of diuretics in ASD size reduction in pediatric patients. METHODS: We retrospectively reviewed the medical reco...

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Detalles Bibliográficos
Autores principales: Lee, Jue Seong, Kim, Gi Beom, Lee, Won Jung, Song, Seok Hyun, An, Hyo Soon, Lee, Sang Yun, Song, Mi Kyoung, Kwon, Hye Won, Bae, Eun Jung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636757/
https://www.ncbi.nlm.nih.gov/pubmed/34595884
http://dx.doi.org/10.4070/kcj.2021.0076
Descripción
Sumario:BACKGROUND AND OBJECTIVES: While diuretics are sometimes used in atrial septal defect (ASD) treatment, their effect on ASD size reduction remains unclear. We aimed to evaluate the efficacy of diuretics in ASD size reduction in pediatric patients. METHODS: We retrospectively reviewed the medical records of patients with secundum ASD (size ≥10 mm), between 2005 and 2019. Patients were divided into two groups based on the diuretic administration. RESULTS: Of the 73 enrolled patients, 40 received diuretics. The initial age at ASD diagnosis (2.8±1.7 vs. 2.5±2.0 years, p=0.526) and follow-up duration (22.3±11.4 vs. 18.7±13.2 months, p=0.224) were not significantly different between the groups. The ASD diameter at the initial diagnosis (13.7±2.0 vs. 13.5±3.4 mm, p=0.761) and the indexed ASD diameter (25.5±5.9 vs. 26.9±10.3 mm/m(2), p=0.493) were also not significantly different between two groups. The ASD diameter significantly increased in the non-diuretic group during follow-up (0.0±2.9 vs. +2.6±2.0 mm, p<0.001). The indexed ASD diameter significantly decreased in the diuretic group during follow-up (−5.7±6.5 vs. +0.2±3.9 mm/m(2), p<0.001). In the linear mixed model analysis, diuretic use was associated with ASD diameter decrease (p<0.001) and indexed ASD diameter reduction (p<0.001) over time. Device closure was more frequently performed in the diuretic (75.0%) than in the non-diuretic group (39.4%). CONCLUSIONS: Patients receiving diuretics are less likely to undergo surgery. The diuretics administration may be associated with the use of smaller ASD devices for transcatheter treatment through ASD size reduction.