Percutaneous closure of atrial septal defects leads to normalisation of atrial and ventricular volumes

Journal of Cardiovascular Magnetic Resonance - Tập 10 Số 1 - Trang 1-8 - 2008
Teo, Karen SL1,2, Dundon, Benjamin K1,2, Molaee, Payman1,2, Williams, Kerry F1, Carbone, Angelo1, Brown, Michael A1, Worthley, Matthew I1,2, Disney, Patrick J1, Sanders, Prashanthan1,2, Worthley, Stephen G1,2
1Cardiovascular Research Centre, Royal Adelaide Hospital and The University of Adelaide, Adelaide, Australia
2The University of Adelaide, Adelaide, Australia

Tóm tắt

Percutaneous closure of atrial septal defects (ASDs) should potentially reduce right heart volumes by removing left-to-right shunting. Due to ventricular interdependence, this may be associated with impaired left ventricular filling and potentially function. Furthermore, atrial changes post-ASD closure have been poorly understood and may be important for understanding risk of atrial arrhythmia post-ASD closure. Cardiovascular magnetic resonance (CMR) is an accurate and reproducible imaging modality for the assessment of cardiac function and volumes. We assessed cardiac volumes pre- and post-percutaneous ASD closure using CMR. Consecutive patients (n = 23) underwent CMR pre- and 6 months post-ASD closure. Steady state free precession cine CMR was performed using contiguous slices in both short and long axis views through the ASD. Data was collected for assessment of left and right atrial, ventricular end diastolic volumes (EDV) and end systolic volumes (ESV). Data is presented as mean ± SD, volumes as mL, and paired t-testing performed between groups. Statistical significance was taken as p < 0.05. There was a significant reduction in right ventricular volumes at 6 months post-ASD closure (RVEDV: 208.7 ± 76.7 vs. 140.6 ± 60.4 mL, p < 0.0001) and RVEF was significantly increased (RVEF 35.5 ± 15.5 vs. 42.0 ± 15.2%, p = 0.025). There was a significant increase in the left ventricular volumes (LVEDV 84.8 ± 32.3 vs. 106.3 ± 38.1 mL, p = 0.003 and LVESV 37.4 ± 20.9 vs. 46.8 ± 18.5 mL, p = 0.016). However, there was no significant difference in LVEF and LV mass post-ASD closure. There was a significant reduction in right atrial volumes at 6 months post-ASD closure (pre-closure 110.5 ± 55.7 vs. post-closure 90.7 ± 69.3 mL, p = 0.019). Although there was a trend to a decrease in left atrial volumes post-ASD closure, this was not statistically significant (84.5 ± 34.8 mL to 81.8 ± 44.2 mL, p = NS). ASD closure leads to normalisation of ventricular volumes and also a reduction in right atrial volume. Further follow-up is required to assess how this predicts outcomes such as risk of atrial arrhythmias after such procedures.

Tài liệu tham khảo

citation_journal_title=J Am Coll Cardiol; citation_title=The incidence of congenital heart disease; citation_author=JI Hoffman, S Kaplan; citation_volume=39; citation_issue=12; citation_publication_date=2002; citation_pages=1890-900; citation_id=CR1

citation_journal_title=Am Heart J; citation_title=Prevalence of congenital heart disease; citation_author=JI Hoffman, S Kaplan, RR Liberthson; citation_volume=147; citation_issue=3; citation_publication_date=2004; citation_pages=425-39; citation_id=CR2

citation_journal_title=Br Heart J; citation_title=Natural history of atrial septal defect; citation_author=M Campbell; citation_volume=32; citation_issue=6; citation_publication_date=1970; citation_pages=820-6; citation_id=CR3

citation_journal_title=Circulation; citation_title=Isolated atrial septal defect with pulmonary vascular obstructive disease – long-term follow-up and prediction of outcome after surgical correction; citation_author=PM Steele, V Fuster, M Cohen, DG Ritter, DC McGoon; citation_volume=76; citation_issue=5; citation_publication_date=1987; citation_pages=1037-42; citation_id=CR4

citation_journal_title=Ann Neurol; citation_title=Cerebral emboli of paradoxical origin; citation_author=HR Jones, LR Caplan, PC Come, NW Swinton, DJ Breslin; citation_volume=13; citation_issue=3; citation_publication_date=1983; citation_pages=314-9; citation_id=CR5

citation_journal_title=N Engl J Med; citation_title=Long-term outcome after surgical repair of isolated atrial septal defect. Follow-up at 27 to 32 years; citation_author=JG Murphy, BJ Gersh, MD McGoon, DD Mair, CJ Porter, DM Ilstrup, DC McGoon, FJ Puga, JW Kirklin, GK Danielson; citation_volume=323; citation_issue=24; citation_publication_date=1990; citation_pages=1645-50; citation_id=CR6

citation_journal_title=Ann Thorac Surg; citation_title=Incidence of atrial flutter/fibrillation in adults with atrial septal defect before and after surgery; citation_author=F Berger, M Vogel, A Kramer, V Alexi-Meskishvili, Y Weng, PE Lange, R Hetzer; citation_volume=68; citation_issue=1; citation_publication_date=1999; citation_pages=75-8; citation_id=CR7

citation_journal_title=Circulation; citation_title=Effect of chronic right atrial stretch on atrial electrical remodeling in patients with an atrial septal defect; citation_author=JB Morton, P Sanders, JK Vohra, PB Sparks, JG Morgan, SJ Spence, LE Grigg, JM Kalman; citation_volume=107; citation_issue=13; citation_publication_date=2003; citation_pages=1775-82; citation_id=CR8

citation_journal_title=Eur Heart J; citation_title=Excellent survival and low incidence of arrhythmias, stroke and heart failure long-term after surgical ASD closure at young age. A prospective follow-up study of 21–33 years; citation_author=JW Roos-Hesselink, FJ Meijboom, SE Spitaels, R van Domburg, EH van Rijen, EM Utens, AJ Bogers, ML Simoons; citation_volume=24; citation_issue=2; citation_publication_date=2003; citation_pages=190-7; citation_id=CR9

citation_journal_title=N Engl J Med; citation_title=A comparison of surgical and medical therapy for atrial septal defect in adults; citation_author=S Konstantinides, A Geibel, M Olschewski, L Görnandt, H Roskamm, G Spillner, H Just, W Kasper; citation_volume=333; citation_issue=8; citation_publication_date=1995; citation_pages=469-73; citation_id=CR10

citation_journal_title=Eur Heart J; citation_title=Peri-operative complications following surgical closure of atrial septal defect type II in 232 patients – a baseline study; citation_author=MO Galal, A Wobst, Z Halees, L Hatle, AA Schmaltz, F Khougeer, E De Vol, ME Fawzy, F Abbag, F Fadley; citation_volume=15; citation_issue=10; citation_publication_date=1994; citation_pages=1381-4; citation_id=CR11

citation_journal_title=J Am Coll Cardiol; citation_title=Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial; citation_author=ZD Du, ZM Hijazi, CS Kleinman, NH Silverman, K Larntz; citation_volume=39; citation_issue=11; citation_publication_date=2002; citation_pages=1836-44; citation_id=CR12

citation_journal_title=Circulation; citation_title=Improvement in exercise capacity in asymptomatic and mildly symptomatic adults after atrial septal defect percutaneous closure; citation_author=MC Brochu, JF Baril, A Dore, M Juneau, P De Guise, LA Mercier; citation_volume=106; citation_issue=14; citation_publication_date=2002; citation_pages=1821-6; citation_id=CR13

citation_journal_title=Int J Cardiol; citation_title=Long-term impact of transcatheter atrial septal defect closure in adults on cardiac function and exercise capacity; citation_author=A Giardini, A Donti, S Specchia, R Formigari, G Oppido, FM Picchio; citation_volume=124; citation_issue=2; citation_publication_date=2007; citation_pages=179-182; citation_id=CR14

citation_journal_title=J Cardiovasc Magn Reson; citation_title=Normal human right and left ventricular mass, systolic function, and gender differences by cine magnetic resonance imaging; citation_author=CH Lorenz, ES Walker, VL Morgan, SS Klein, TP Graham; citation_volume=1; citation_issue=1; citation_publication_date=1999; citation_pages=7-21; citation_id=CR15

citation_journal_title=J Magn Reson Imaging; citation_title=Normal human left and right ventricular dimensions for MRI as assessed by turbo gradient echo and steady-state free precession imaging sequences; citation_author=K Alfakih, S Plein, H Thiele, T Jones, JP Ridgway, MU Sivananthan; citation_volume=17; citation_issue=3; citation_publication_date=2003; citation_pages=323-9; citation_id=CR16

citation_journal_title=J Cardiovasc Magn Reson; citation_title=Assessment of left atrial volume by contrast enhanced magnetic resonance angiography; citation_author=TH Hauser, S McClennen, G Katsimaglis, ME Josephson, WJ Manning, SB Yeon; citation_volume=6; citation_issue=2; citation_publication_date=2004; citation_pages=491-7; citation_id=CR17

citation_journal_title=Catheter Cardiovasc Interv; citation_title=Closure of secundum atrial septal defects with the Amplatzer septal occluder device: techniques and problems; citation_author=RW Harper, PM Mottram, DJ McGaw; citation_volume=57; citation_issue=4; citation_publication_date=2002; citation_pages=508-24; citation_id=CR18

citation_journal_title=Lancet; citation_title=Statistical methods for assessing agreement between two methods of clinical measurement; citation_author=JM Bland, DG Altman; citation_volume=1; citation_issue=8476; citation_publication_date=1986; citation_pages=307-10; citation_id=CR19

citation_journal_title=Heart; citation_title=Safety of cardiovascular magnetic resonance in patients with cardiovascular implants and devices; citation_author=SK Prasad, DJ Pennell; citation_volume=90; citation_issue=11; citation_publication_date=2004; citation_pages=1241-4; citation_id=CR20

citation_journal_title=Am J Cardiol; citation_title=Comparison of interstudy reproducibility of cardiovascular magnetic resonance with two-dimensional echocardiography in normal subjects and in patients with heart failure or left ventricular hypertrophy; citation_author=F Grothues, GC Smith, JC Moon, NG Bellenger, P Collins, HU Klein, DJ Pennell; citation_volume=90; citation_issue=1; citation_publication_date=2002; citation_pages=29-34; citation_id=CR21

citation_journal_title=Am Heart J; citation_title=Interstudy reproducibility of right ventricular volumes, function, and mass with cardiovascular magnetic resonance; citation_author=F Grothues, JC Moon, NG Bellenger, GS Smith, HU Klein, DJ Pennell; citation_volume=147; citation_issue=2; citation_publication_date=2004; citation_pages=218-23; citation_id=CR22

citation_journal_title=J Magn Reson Imaging; citation_title=Magnetic resonance imaging to assess acute changes in atrial and ventricular parameters after transcatheter closure of atrial septal defects; citation_author=C Burgstahler, J Wöhrle, M Kochs, T Nusser, C Löffler, M Kunze, M Höher, MP Gawaz, V Hombach, N Merkle; citation_volume=25; citation_issue=6; citation_publication_date=2007; citation_pages=1136-40; citation_id=CR23

citation_journal_title=Heart; citation_title=Transcatheter closure of atrial septal defects improves right ventricular volume, mass, function, pulmonary pressure, and functional class: a magnetic resonance imaging study; citation_author=SP Schoen, T Kittner, S Bohl, MU Braun, G Simonis, A Schmeisser, RH Strasser; citation_volume=92; citation_issue=6; citation_publication_date=2006; citation_pages=821-6; citation_id=CR24

citation_journal_title=Am Heart J; citation_title=Left atrial volume determination by biplane two-dimensional echocardiography: validation by cine computed tomography; citation_author=B Kircher, JA Abbott, S Pau, RG Gould, RB Himelman, CB Higgins, MJ Lipton, NB Schiller; citation_volume=121; citation_issue=3 Pt 1; citation_publication_date=1991; citation_pages=864-71; citation_id=CR25

citation_title=Three methods for evaluation of left atrial volume; citation_inbook_title=Eur J Echocardiogr; citation_publication_date=2007; citation_id=CR26; citation_author=P Jiamsripong; citation_author=T Honda; citation_author=CS Reuss; citation_author=RT Hurst; citation_author=HP Chaliki; citation_author=DE Grill; citation_author=SL Schneck; citation_author=R Tyler; citation_author=BK Khandheria; citation_author=SJ Lester

citation_journal_title=Radiology; citation_title=Right atrial MR imaging studies of cadaveric atrial casts and comparison with right and left atrial volumes and function in healthy subjects; citation_author=VM Jarvinen, MM Kupari, PE Hekali, VP Poutanen; citation_volume=191; citation_issue=1; citation_publication_date=1994; citation_pages=137-42; citation_id=CR27

citation_journal_title=Radiology; citation_title=Right and left atrial phasic volumetric function in mildly symptomatic dilated and hypertrophic cardiomyopathy: cine MR imaging assessment; citation_author=VM Jarvinen, MM Kupari, VP Poutanen, PE Hekali; citation_volume=198; citation_issue=2; citation_publication_date=1996; citation_pages=487-95; citation_id=CR28

citation_journal_title=J Cardiovasc Magn Reson; citation_title=Assessment of left atrial volumes in sinus rhythm and atrial fibrillation using the biplane area-length method and cardiovascular magnetic resonance imaging with TrueFISP; citation_author=B Sievers, S Kirchberg, M Addo, A Bakan, B Brandts, HJ Trappe; citation_volume=6; citation_issue=4; citation_publication_date=2004; citation_pages=855-63; citation_id=CR29

citation_journal_title=Am J Cardiol; citation_title=Effect of surgical repair of secundum-type atrial septal defect on right atrial, right ventricular, and left ventricular volumes in adults; citation_author=J Shaheen, L Alper, D Rosenmann, MW Klutstein, G Falkowsky, D Bitran, D Tzivoni; citation_volume=86; citation_issue=12; citation_publication_date=2000; citation_pages=1395-7; citation_id=CR30

citation_journal_title=J Am Coll Cardiol; citation_title=Resolution of right heart enlargement after closure of secundum atrial septal defect with transcatheter technique; citation_author=HW Kort, DT Balzer, MC Johnson; citation_volume=38; citation_issue=5; citation_publication_date=2001; citation_pages=1528-32; citation_id=CR31

citation_journal_title=Am J Cardiol; citation_title=Speed of normalization of right ventricular volume overload after transcatheter closure of atrial septal defect in children and adults; citation_author=ZD Du, QL Cao, P Koenig, M Heitschmidt, ZM Hijazi; citation_volume=88; citation_issue=12; citation_publication_date=2001; citation_pages=1450-3; citation_id=CR32

citation_journal_title=J Am Coll Cardiol; citation_title=Right ventricular form and function after percutaneous atrial septal defect device closure; citation_author=GR Veldtman, V Razack, S Siu, H El-Hajj, F Walker, GD Webb, LN Benson, PR McLaughlin; citation_volume=37; citation_issue=8; citation_publication_date=2001; citation_pages=2108-13; citation_id=CR33

citation_journal_title=Int J Cardiol; citation_title=Closure of atrial septal defect in the adult. Cardiac remodeling is an early event; citation_author=U Thilen, S Persson; citation_volume=108; citation_issue=3; citation_publication_date=2006; citation_pages=370-5; citation_id=CR34

citation_journal_title=Am J Cardiol; citation_title=Effect on right ventricular volume of percutaneous Amplatzer closure of atrial septal defect in adults; citation_author=JM Schussler, A Anwar, SD Phillips, BJ Roberts, RC Vallabhan, PA Grayburn; citation_volume=95; citation_issue=8; citation_publication_date=2005; citation_pages=993-5; citation_id=CR35

citation_journal_title=Heart; citation_title=Transcatheter closure of atrial septal defect preserves right ventricular function; citation_author=R Dhillon, M Josen, M Henein, A Redington; citation_volume=87; citation_issue=5; citation_publication_date=2002; citation_pages=461-5; citation_id=CR36

citation_journal_title=J Am Soc Echocardiogr; citation_title=Nongeometric quantitative assessment of right and left ventricular function: myocardial performance index in normal children and patients with Ebstein anomaly; citation_author=BW Eidem, C Tei, PW O'Leary, F Cetta, JB Seward; citation_volume=11; citation_issue=9; citation_publication_date=1998; citation_pages=849-56; citation_id=CR37

citation_journal_title=J Am Coll Cardiol; citation_title=Improvements in cardiac form and function after transcatheter closure of secundum atrial septal defects; citation_author=O Salehian, E Horlick, M Schwerzmann, K Haberer, P McLaughlin, SC Siu, G Webb, J Therrien; citation_volume=45; citation_issue=4; citation_publication_date=2005; citation_pages=499-504; citation_id=CR38

citation_journal_title=Scand Cardiovasc J; citation_title=Atrial septal defect in adults. Thirty-eight-year follow-up of a surgically and a conservatively managed group; citation_author=U Thilen, S Berlind, E Varnauskas; citation_volume=34; citation_issue=1; citation_publication_date=2000; citation_pages=79-83; citation_id=CR39

citation_journal_title=Am J Cardiol; citation_title=Usefulness of the myocardial performance index for assessing right ventricular function in congenital heart disease; citation_author=BW Eidem, PW O'Leary, C Tei, JB Seward; citation_volume=86; citation_issue=6; citation_publication_date=2000; citation_pages=654-8; citation_id=CR40

citation_journal_title=Am J Cardiol; citation_title=Evidence of adverse ventricular interdependence in patients with atrial septal defects; citation_author=RE Walker, AM Moran, K Gauvreau, SD Colan; citation_volume=93; citation_issue=11; citation_publication_date=2004; citation_pages=1374-7; citation_id=CR41

citation_journal_title=Circulation; citation_title=Mechanism of abnormal septal motion in patients with right ventricular volume overload: a cross-sectional echocardiographic study; citation_author=AE Weyman, S Wann, H Feigenbaum, JC Dillon; citation_volume=54; citation_issue=2; citation_publication_date=1976; citation_pages=179-86; citation_id=CR42

citation_journal_title=Br Heart J; citation_title=Abnormal left heart function after operation for atrial septal defect; citation_author=H Davies, GC Oliver, WJ Rappoport, N Gazetopoulos; citation_volume=32; citation_issue=6; citation_publication_date=1970; citation_pages=747-53; citation_id=CR43

citation_journal_title=Am J Cardiol; citation_title=Abnormalities of left ventricular function and geometry in adults with an atrial septal defect. Ventriculographic, hemodynamic and echocardiographic studies; citation_author=KA Popio, R Gorlin, LE Teichholz, PF Cohn, D Bechtel, MV Herman; citation_volume=36; citation_issue=3; citation_publication_date=1975; citation_pages=302-8; citation_id=CR44

citation_journal_title=Heart; citation_title=Left ventricular adaptation after atrial septal defect closure assessed by increased concentrations of N-terminal pro-brain natriuretic peptide and cardiac magnetic resonance imaging in adult patients; citation_author=M Weber, T Dill, A Deetjen, T Neumann, O Ekinci, J Hansel, A Elsaesser, V Mitrovic, C Hamm; citation_volume=92; citation_issue=5; citation_publication_date=2006; citation_pages=671-5; citation_id=CR45

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Journal of Cardiovascular Magnetic Resonance

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