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Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults
Author(s) -
Wu EnTing,
Akagi Teiji,
Taniguchi Manabu,
Maruo Takeshi,
Sakuragi Satoru,
Otsuki Shinichi,
Okamoto Yoshio,
Sano Shunji
Publication year - 2007
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21075
Subject(s) - medicine , cardiology , volume overload , ventricular remodeling , cardiac catheterization , brain natriuretic peptide , cohort , heart failure
Abstract Objectives : To evaluate acute cardiac remodeling after transcatheter closure of atrial septal defect (ASD) in adult patients. Background : In adult patients with ASD, longer periods of cardiac adaptation should be expected after the procedure due to long‐standing RV volume overload and subsequent changes in the pulmonary vasculature. There are limited reports about this remodeling in adult patients. Methods : We prospectively enrolled 17 adults (mean age 58.4 ± 17.3 years) who underwent successful transcatheter closure of their ASDs from August 2005 to July 2006. We performed routine transthoracic echocardiographic studies, including LV and RV myocardial performance indices, or Tei indices, and plasma brain natriuretic peptide (BNP) sampling before closure of the ASD, and 1 day, 1 month, and 3 months after closure. Results : We found (1) LV end diastolic diameter increased, and RVEDD decreased markedly after the closure; (2) differences existed in LV and RV adaptation. While LV Tei index improved soon after the procedure, RV Tei index worsened until 1 month after the procedure, then recovered by the 3 month follow‐up visit; and (3) BNP elevated 1 day after closure of the ASD and declined by the 1‐month follow‐up visit. Conclusion : “Shrinkage” of the RV and “expansion” of the LV occurred soon after the procedure, even in elderly patients. Device closure of ASDs caused rapid improvement of LV function, but RV function underwent transient deterioration, probably due to delayed changes in RV ventricular mass in the face of acute volume reduction in this aged cohort. © 2007 Wiley‐Liss, Inc.