Cargando…

Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure

Pulmonary hypertension (PH) is an established risk factor in patients with atrial septal defect (ASD), and its persistence after ASD closure is associated with increased mortality. Therefore, predictors for PH normalization after defect closure are needed. Multiple hemodynamic types of PH exist, but...

Descripción completa

Detalles Bibliográficos
Autores principales: Rubáčková Popelová, Jana, Tomek, Jakub, Tomková, Markéta, Živná, Renata
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226374/
https://www.ncbi.nlm.nih.gov/pubmed/35757340
http://dx.doi.org/10.3389/fcvm.2022.876755
_version_ 1784733856549568512
author Rubáčková Popelová, Jana
Tomek, Jakub
Tomková, Markéta
Živná, Renata
author_facet Rubáčková Popelová, Jana
Tomek, Jakub
Tomková, Markéta
Živná, Renata
author_sort Rubáčková Popelová, Jana
collection PubMed
description Pulmonary hypertension (PH) is an established risk factor in patients with atrial septal defect (ASD), and its persistence after ASD closure is associated with increased mortality. Therefore, predictors for PH normalization after defect closure are needed. Multiple hemodynamic types of PH exist, but little is known about their prevalence and prognostic value for PH normalization after ASD closure. We carried out a retrospective study on 97 patients (76% female, median age at ASD closure 58 years) with four types of PH determined predominantly by right heart catheterization: hyperkinetic, pulmonary arterial hypertension, isolated post-capillary, and combined pre- and post-capillary. We investigated the frequency of the PH types and their prognostic significance for PH normalization after ASD closure. Frequency of PH types before ASD closure in our study was: hyperkinetic 55%, pulmonary arterial hypertension 10%, isolated post-capillary PH 24%, and combined PH 11%. Hyperkinetic PH type was positively associated with PH normalization after ASD closure (78% patients normalized), remaining a significant independent predictor when adjusted for age at closure, sex, heart failure, and NYHA. Hyperkinetic PH patients also had significantly better survival prognosis versus patients with other PH types (p = 0.04). Combined PH was negatively associated with PH normalization, with no patients normalizing. Pulmonary arterial hypertension and isolated post-capillary PH had intermediate rates of normalization (60 and 52%, respectively). In summary, all four hemodynamic types of PH are found in adult patients with ASD, and they can be used to stratify patients by their likelihood of PH normalization and survival after ASD closure.
format Online
Article
Text
id pubmed-9226374
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-92263742022-06-25 Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure Rubáčková Popelová, Jana Tomek, Jakub Tomková, Markéta Živná, Renata Front Cardiovasc Med Cardiovascular Medicine Pulmonary hypertension (PH) is an established risk factor in patients with atrial septal defect (ASD), and its persistence after ASD closure is associated with increased mortality. Therefore, predictors for PH normalization after defect closure are needed. Multiple hemodynamic types of PH exist, but little is known about their prevalence and prognostic value for PH normalization after ASD closure. We carried out a retrospective study on 97 patients (76% female, median age at ASD closure 58 years) with four types of PH determined predominantly by right heart catheterization: hyperkinetic, pulmonary arterial hypertension, isolated post-capillary, and combined pre- and post-capillary. We investigated the frequency of the PH types and their prognostic significance for PH normalization after ASD closure. Frequency of PH types before ASD closure in our study was: hyperkinetic 55%, pulmonary arterial hypertension 10%, isolated post-capillary PH 24%, and combined PH 11%. Hyperkinetic PH type was positively associated with PH normalization after ASD closure (78% patients normalized), remaining a significant independent predictor when adjusted for age at closure, sex, heart failure, and NYHA. Hyperkinetic PH patients also had significantly better survival prognosis versus patients with other PH types (p = 0.04). Combined PH was negatively associated with PH normalization, with no patients normalizing. Pulmonary arterial hypertension and isolated post-capillary PH had intermediate rates of normalization (60 and 52%, respectively). In summary, all four hemodynamic types of PH are found in adult patients with ASD, and they can be used to stratify patients by their likelihood of PH normalization and survival after ASD closure. Frontiers Media S.A. 2022-06-10 /pmc/articles/PMC9226374/ /pubmed/35757340 http://dx.doi.org/10.3389/fcvm.2022.876755 Text en Copyright © 2022 Rubáčková Popelová, Tomek, Tomková and Živná. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Rubáčková Popelová, Jana
Tomek, Jakub
Tomková, Markéta
Živná, Renata
Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title_full Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title_fullStr Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title_full_unstemmed Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title_short Normalization of Four Different Types of Pulmonary Hypertension After Atrial Septal Defect Closure
title_sort normalization of four different types of pulmonary hypertension after atrial septal defect closure
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9226374/
https://www.ncbi.nlm.nih.gov/pubmed/35757340
http://dx.doi.org/10.3389/fcvm.2022.876755
work_keys_str_mv AT rubackovapopelovajana normalizationoffourdifferenttypesofpulmonaryhypertensionafteratrialseptaldefectclosure
AT tomekjakub normalizationoffourdifferenttypesofpulmonaryhypertensionafteratrialseptaldefectclosure
AT tomkovamarketa normalizationoffourdifferenttypesofpulmonaryhypertensionafteratrialseptaldefectclosure
AT zivnarenata normalizationoffourdifferenttypesofpulmonaryhypertensionafteratrialseptaldefectclosure