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Choi JH, Kim JY, Hwang JK, Kim HR, Chung TW, Kim J, Park SW, Kang IS, Song J, Park SJ, Park KM, On YK, Kim JS, Huh J. Assessment of left atrial remodeling using speckle tracking echocardiography after percutaneous atrial septal defect closure in adult patients. INTERNATIONAL JOURNAL OF ARRHYTHMIA 2022. [DOI: 10.1186/s42444-022-00074-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a well-known, long-term complication of atrial septal defect (ASD) in adults, even after device closure. Left atrial (LA) strain rate applied to the analysis of chamber function has been demonstrated to be an important predictor of LA reverse remodeling. This study aimed to determine the changes in chamber function after device closure of ASD.
Methods
This prospective study enrolled adults with secundum ASD undergoing transcatheter device closure from December 2016 to August 2017. We analyzed the clinical characteristics and LA strain rate before and six months after ASD closure.
Results
A total of 11 patients were enrolled. The mean age was 42.6 ± 9.9 years, and six (54.5%) were females. There was no significant change of conventional echocardiographic parameters after ASD closure. The mean global LA reservoir strain rate before ASD closure was 1.17 ± 0.34 and 0.85 ± 0.30 after ASD closure (p = 0.030). The median global LA conduit strain rate was 0.68 (0.42–1.16) and 0.41 (0.16–0.79) before and after ASD closure (p = 0.213), respectively. The mean global LA contractile strain rate at the six-month follow-up showed significant improvement compared with pre-procedural strain rate (0.33 ± 0.65 vs. − 0.43 ± 0.38, p = 0.006).
Conclusions
LA functional changes occurred during the six-month follow-up, while LA and right atrial (RA) geometric changes were not significant. LA reverse remodeling was proved by restoration of LA late diastolic contractile function.
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Seo JS, Park YA, Wi JH, Jin HY, Han IY, Jang JS, Yang TH, Kim DK, Kim DS. Long-Term Left Atrial Function after Device Closure and Surgical Closure in Adult Patients with Atrial Septal Defect. J Cardiovasc Imaging 2020; 29:123-132. [PMID: 33605098 PMCID: PMC8099578 DOI: 10.4250/jcvi.2020.0142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/28/2020] [Accepted: 11/02/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Studies comparing left atrial (LA) function after surgical closure or percutaneous closure in patients with an atrial septal defect (ASD) are lacking. METHODS Between 1 and 3 years after ASD treatment, we retrospectively analyzed the medical records and transthoracic echocardiographic images of patients who had been diagnosed with an ASD after 20 years of age and who had undergone surgical closure (ASD-S) or percutaneous device closure (ASD-D). We measured LA peak systolic, early diastolic, and late diastolic strain values using 2-dimensional (2D) speckle tracking echocardiography (STE) and calculated reservoir, conduit, and contraction strain. RESULTS The reservoir strain value of the ASD-D groups was 25.2% ± 7.4%, which was lower compared to the control group (33.6% ± 5.5%) (p = 0.004). The LA conduit strain and the LA contraction values of the ASD-D group were also lower compared to the control group (−13.8% ± 5.8% vs. −20.4% ± 4.7%, p = 0.034; −11.3% ± 4.2% vs. −13.2% ± 2.5%, p = 0.037, respectively). The reservoir, conduit, and contraction strains of the ASD-S group were 27.8% ± 8.8%, −15.3% ± 6.4%, and −12.5% ± 5.8%, respectively, and were not different from those of the control group or the ASD-D group. CONCLUSIONS The 2D STE is a suitable method for evaluating LA function after ASD closure. Our results demonstrate that 1 year after device closure, the LA reservoir, conduit and contraction function were reduced in ASD-D group compared to healthy controls, while there was no difference between the ASD-S and ASD-D groups.
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Affiliation(s)
- Jeong Sook Seo
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea.
| | - Young Ah Park
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Jin Hong Wi
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Busan, Korea
| | - Han Young Jin
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Il Yong Han
- Department of Thoracic and Cardiovascular Surgery, Inje University Busan Paik Hospital, Busan, Korea
| | - Jae Sik Jang
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Tae Hyun Yang
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Dae Kyeong Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
| | - Dong Soo Kim
- Division of Cardiology, Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
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Ortega MC, Ramos DBB, Novoa JCR, Suarez FJO, Ramírez FD, González MD. Impact of Transcatheter Device Closure of Atrial Septal Defect on Atrial Arrhythmias Propensity in Young Adults. Pediatr Cardiol 2020; 41:54-61. [PMID: 31673734 DOI: 10.1007/s00246-019-02221-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 10/15/2019] [Indexed: 11/29/2022]
Abstract
Atrial septal defect (ASD) is a condition that requires early intervention because of the consequences over the right-side heart. Chronic atrial stretching promotes atrial conduction delay and the imbalance of the conduction homogeneity, which lead to the propensity to atrial arrhythmias (AA). We aim to evaluate the impact of transcatheter closure of ASD on atrial vulnerability markers leading to late AA in young adults. We conducted a prospective, longitudinal study in one hundred patients (mean age 25.2 ± 5.4 years) who underwent transcatheter closure of ASD at Cardiocentro Pediátrico William Soler. P-wave maximum (Pmax) and P-wave dispersion (Pd) were analyzed from 12-lead electrocardiogram. Left-side and right-side intraatrial and interatrial electromechanical delay (EMD) were measured with tissue Doppler imaging. Both electrocardiographic and echocardiographic analyses were performed during the study period. Compared to baseline, there was a significant reduction in P max (p ≤ 0.001) and Pd (p ≤ 0.001) after 3 months of procedure. All atrial electromechanical coupling parameters significantly reduced at 6 months of ASD closure and tend to remain at lower values till the last evaluation. Over 9.2 ± 1.6 years of follow-up, 15 subjects (15%) developed AA, of which intraatrial reentrant tachycardia (66.6%) became the main rhythm disturbance. Intra-right atrial EMD ≥ 16 ms (HR 4.08, 95% CI 1.15-14.56; p = 0.03) and Pd 45 ms (HR 1.66, 95% CI 1.06-2.59; p = 0.02) were identified as predictors of late AA. Transcatheter device closure of ASD in young adults promotes a significant reduction of electrocardiographic and echocardiographic markers of AA vulnerability, which persist during the long-term follow-up. Nevertheless, Pd and interatrial EMD were identified as independent risk factors of AA.
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Affiliation(s)
- Michel Cabrera Ortega
- Section of Arrhythmia and Cardiac Pacing, Cardiocentro Pediátrico William Soler, San Francisco e/ 100 y Perla, 10800, Boyeros, La Habana, Cuba.
| | - Dunia Bárbara Benítez Ramos
- Department of Pediatric Cardiology, Cardiocentro Pediátrico William Soler, 100 y Perla, Boyeros, Havana, Cuba
| | - Juan Carlos Ramiro Novoa
- Laboratory of Hemodynamia, Cardiocentro Pediátrico William Soler, 100 y Perla, Boyeros, Havana, Cuba
| | | | - Francisco Díaz Ramírez
- Laboratory of Hemodynamia, Cardiocentro Pediátrico William Soler, 100 y Perla, Boyeros, Havana, Cuba
| | - Mabel Domínguez González
- Laboratory of Hemodynamia, Cardiocentro Pediátrico William Soler, 100 y Perla, Boyeros, Havana, Cuba
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Long term evaluation of electromechanical delay in patients with atrial septal defect after transcatheter closure. Int J Cardiovasc Imaging 2018; 35:33-39. [PMID: 30062536 DOI: 10.1007/s10554-018-1426-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022]
Abstract
Some studies have been showed that electromechanical delay, which may pose an increased tendency to atrial fibrillation, may prolong in patients with various clinical conditions. In addition, the electromechanical delay in patients with secundum type atrial septal defect (ASD) compared to healthy people have been reported previously. Therefore, in the present study, we prospectively evaluated the mid-term and long-term effects of the transcatheter closure of secundum type ASD on the lateral atrial conduction time (PA), septal PA, tricuspid PA, left and right intra-atrial electromechanical delay (ILeft-EMD and IRight-EMD, respectively) and inter-atrial electromechanical delay (IA-EMD) measured by means of Doppler echocardiography. Our prospective study included a total of 45 secundum type ASD patients who undergone percutaneous transcatheter closure from December 2012 to April 2015. All patients underwent transthoracic echocardiography (TTE) before the closure, at sixth and twelfth months after the closure. In comparison of the EMD sixth months after the device closure, there were statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to pre-device closure values. Twelfth months after the device closure, we also observed statistically significant decrease in lateral PA, septal PA, tricuspid PA, ILeft-EMD, IRight-EMD and IA-EMD compared to 6-month post-device closure values. In the present study, we observed that the atrial EMD improves after device closure and continues to improve after twelfth month following post-device closure.
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Çimen T, Sunman H, Efe TH, Akyel A, Yayla K, Şahan HF, Bilgin M, Asarcıklı LD, Nallbani A, Doğan M, Açıkel S, Yeter E. Early changes in atrial conduction times in hypertensive patients with elevated pulse pressure. Rev Port Cardiol 2017; 36:453-459. [DOI: 10.1016/j.repc.2016.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 08/09/2016] [Accepted: 10/13/2016] [Indexed: 11/25/2022] Open
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Early changes in atrial conduction times in hypertensive patients with elevated pulse pressure. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2016.10.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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The atrial conduction time in patients with normal atrial size. Anatol J Cardiol 2016; 16:221-2. [PMID: 27067566 PMCID: PMC5336818 DOI: 10.14744/anatoljcardiol.2016.6972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Lee DH, Choi SY, Park JS, Seo JM, Choi JH, Cho YR, Park K, Kim MH, Kim YD. Comparison of Prolonged Atrial Electromechanical Delays with Different Definitions in the Discrimination of Patients with Non-Valvular Paroxysmal Atrial Fibrillation. Korean Circ J 2015; 45:479-85. [PMID: 26617650 PMCID: PMC4661363 DOI: 10.4070/kcj.2015.45.6.479] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Revised: 05/06/2015] [Accepted: 06/18/2015] [Indexed: 11/30/2022] Open
Abstract
Background and Objectives Previous studies have evaluated atrial electromechanical delays (AEMDs) with a number of different definitions to discriminate patients with paroxysmal atrial fibrillation (PAF) from controls without PAF. However, their discriminative values for PAF have not previously been directly compared. Subjects and Methods A total of 65 PAF patients and 130 control subjects matched for age, sex, history of hypertension, and diabetes mellitus were selected. The AEMDi and AEMDp were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic transmitral inflow on pulsed wave Doppler images, respectively. The AEMDim and AEMDpm were defined as the time intervals from the initiation of the P wave on the surface electrocardiogram to the initiation and peak of the late diastolic lateral mitral annular motion on tissue Doppler images, respectively. Results There were no significant differences in the clinical characteristics between the two groups. All 4 AEMDs were consistently longer in the PAF group, and proven effective to differentiate the PAF patients from the controls. The AEMDi measurement had a larger area under the curve (AUC) than the other AEMDs, left atrial volume index, and P wave amplitude. However, the AEMDp, AEMDim, and AEMDpm measurements had AUCs similar to those of the left atrial volume index and P wave amplitude. Conclusion The findings suggest that the AEMDi is better than the other AEMDs for the discrimination of PAF patients from the controls.
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Affiliation(s)
- Dong Hyun Lee
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Sun Young Choi
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Jong Sung Park
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Jeong-Min Seo
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Jae-Hyuk Choi
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Young-Rak Cho
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Kyungil Park
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
| | - Young-Dae Kim
- Department of Cardiology, Dong-A University Medical Center, Busan, Korea
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Aslan M, Erturk M, Turen S, Uzun F, Surgit O, Ozbay Ozyilmaz S, Rifat Yildirim M, Faruk Baycan O, Uygur B, Yildirim A, Eksik A. Effects of percutaneous closure of atrial septal defect on left atrial mechanical and conduction functions. Eur Heart J Cardiovasc Imaging 2014; 15:1117-24. [DOI: 10.1093/ehjci/jeu089] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Biliciler-Denktas G, Rao PS. Atrial Electromechanical Delay Measured by Tissue Doppler Imaging in Patients with Secundum Atrial Septal Defects. Echocardiography 2013; 30:619-20. [DOI: 10.1111/echo.12251] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Gurur Biliciler-Denktas
- Department of Pediatrics; Division of Pediatric Cardiology; The University of Texas-Houston Medical School/Children's Memorial Hermann Hospital; Houston; Texas
| | - P. Syamasundar Rao
- Department of Pediatrics; Division of Pediatric Cardiology; The University of Texas-Houston Medical School/Children's Memorial Hermann Hospital; Houston; Texas
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