Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults
Differences in right and left ventricular remodeling after transcatheter closure of atrial septal defect among adults
复制标题
DOI：
10.1002/ccd.21075
复制
发表时间：
2007-05-01
影响因子：
2.3
通讯作者：
Sano, Shunji
中科院分区：
文献类型：
--
作者：
Wu, En-Ting;Akagi, Teiji;Sano, Shunji
目的：评价成人房间隔缺损（ASD）经导管封堵术后的急性心脏重构。背景：成人ASD患者，由于长期RV容量超负荷和随后的肺血管变化，术后应预期较长时间的心脏适应。有关于这种重塑在adult patients.Methods：我们前瞻性地招募了17名成年人（平均年龄58.4 +/- 17.3岁）谁经历了成功的经导管封堵他们的ASD从2005年8月至2006年7月的报告有限。结果：ASD封堵术后1 d、1个月、3个月，左室舒张末期内径明显增大，右室舒张末期内径明显减小，左室和右室适应性存在差异。左室Tei指数在术后很快改善，右室Tei指数在术后1个月开始恶化，3个月随访时恢复正常;（3）BNP在ASD封堵术后1天升高，1个月随访时下降。ASD的器械闭合导致LV功能快速改善，但RV功能出现短暂性恶化，可能是由于该老年队列中面临急性容量减少时RV心室质量的延迟变化。(c)2006 Wiley-Liss，Inc.
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 I day, I 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. (c) 2006 Wiley-Liss, Inc.