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Time course of the changes in right and left ventricle function and associated factors after transcatheter closure of atrial septal defects

 Byung W Yoo  ;  Jung O Kim  ;  Lucy Y Eun  ;  Jae Y Choi  ;  Dong S Kim 
 CONGENITAL HEART DISEASE, Vol.13(1) : 131-139, 2018 
Journal Title
Issue Date
Adult ; Cardiac Catheterization/*methods ; Cardiac Surgical Procedures/*methods ; Doppler Echocardiography ; Female ; Atrial/diagnosis/*physiopathology/surgery Heart Septal Defects ; Heart Ventricles/diagnostic imaging/*physiopathology ; Humans ; Male ; Postoperative Period ; Retrospective Studies ; Treatment Outcome ; Left/*physiology Ventricular Function ; Right/*physiology Ventricular Function ; *Ventricular Remodeling
atrial septal defect ; isovolumic acceleration ; myocardial performance index ; tissue Doppler imaging ; ventricular function
OBJECTIVE: The purpose of this study was to evaluate the changes in right ventricle (RV) and left ventricle (LV) function after transcatheter atrial septal defect (ASD) closure and to assess the influence of the age and the amount of shunt. DESIGN: Retrospective study PATIENTS: Fifty-three adult patients who underwent transcatheter closure were enrolled, then divided into subgroups according to the age (< 40 years vs >/= 40 years), and the amount of shunt flow (QpQs < 2.5 vs QpQs >/= 2.5). OUTCOME MEASURES: Two-dimensional tissue Doppler imaging was performed in a four-chamber view at the basal ventricular septum (VS) and tricuspid valve annulus (TVA) before and at 1 month and 6 months after closure. Myocardial velocities, the myocardial performance index (MPI), and isovolumic acceleration (IVA) were assessed. RESULTS: At the TVA, the MPI decreased slightly and then greatly increased at 6 months after closure (P = .002). The IVA improved in all patients (P < .001), and the E'/A' ratio decreased, especially in the old age group (P = .031) and larger shunt group (P = .035). At the VS, S' and the IVA decreased and had not recovered until 6 months in the old age (P = .02) and larger shunt (P = .02). The Qp/Qs showed a significant reverse correlation with a decrease in the E'/A' at the TVA (r = -0.37, P = .008), and age of patient was correlated with a decrease in the IVA at the VS (r = -0.32, P = .019). The age at closure (beta = -0.36, P = .002), the Qp/Qs ratio (beta = -0.45, P = .01), and RV MPI changes (beta = -7.64, P < .001) were found to be associated factors with IVA decrease at the VS. CONCLUSIONS: After ASD closure, RV global function might be impaired. In elderly patients and patients with a large shunt, impairment of LV contractility developed until 6 months after closure. Close long-term observation is required after closure, especially in old-age patients with a large shunt.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Soo(김동수)
Yoo, Byung Won(류병원) ORCID logo https://orcid.org/0000-0001-6895-1484
Eun, Lucy Youngmin(은영민) ORCID logo https://orcid.org/0000-0002-4577-3168
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0002-1247-6669
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