Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults

En Ting Wu, Teiji Akagi, Manabu Taniguchi, Takeshi Maruo, Satoru Sakuragi, Shinichi Otsuki, Yoshio Okamoto, Shunji Sano

Research output: Contribution to journalArticle

41 Citations (Scopus)

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 ere limited reports about this remodeling in edult patients. Methods: We prospectively enrolled 17 adults (mean ege 58.4 ± 17.3 years) who underwent successful transcatheter closure of their ASDs from August 2005 to July 2006. We performed routine transthoracic echocardlographic studies, including LV and RV myocardial performance indices, or Tei indices, and plasma brain natriuretic peptide (BNP) sampling before closure of the ASD, end 1 day, 1 month, and 3 months after closure. Results: We round (1) LV end diastolic diameter increased, and RVEDD decreased markedly after the cloaure; (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 end 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.

Original languageEnglish
Pages (from-to)866-871
Number of pages6
JournalCatheterization and Cardiovascular Interventions
Volume69
Issue number6
DOIs
Publication statusPublished - May 1 2007

Keywords

  • Atrial septal defect
  • Echocardiography
  • Myocardial performance index
  • Tel index

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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