Long-Term Effects of Transcatheter Closure of Atrial Septal Defect on Cardiac Remodeling and Exercise Capacity in Patients Older than 40 Years with a Reduction in Cardiopulmonary Function

• Published in: Journal of interventional cardiology Vol. 26; no. 2; pp. 195 - 199
• Main Authors: TAKAYA, YOICHI, TANIGUCHI, MANABU, AKAGI, TEIJI, NOBUSADA, SAORI, KUSANO, KENGO, ITO, HIROSHI, SANO, SHUNJI
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.04.2013
• Subjects: Adult; Aged; Cardiac Catheterization - methods; Echocardiography - methods; Exercise - physiology; Exercise Test - methods; Female; Follow-Up Studies; Heart Septal Defects, Atrial - diagnostic imaging; Heart Septal Defects, Atrial - physiopathology; Heart Septal Defects, Atrial - surgery; Humans; Male; Middle Aged; Time; Treatment Outcome; Ventricular Remodeling - physiology
• ISSN: 0896-4327; 1540-8183
• DOI: 10.1111/joic.12002

Background Although it has been demonstrated that cardiac remodeling and exercise capacity improve after transcatheter closure of atrial septal defect (ASD), little is known about long‐term benefits in middle‐aged and elderly patients with a reduction in cardiopulmonary function. Objectives To evaluate long‐term extent and time course of improvements in cardiac remodeling and exercise capacity in those patients. Methods: Twenty ASD patients ≥ 40 years of age with a reduction in cardiopulmonary function (predicted peak oxygen uptake [VO2] < 65%) were enrolled. Transthoracic echocardiography and cardiopulmonary exercise testing were performed at baseline and at 1 month, 3 months, 6 months, and >12 months after the procedure. Results At 1 month after the procedure, significant decreases in right ventricular (RV) end‐diastolic diameter (38.2 ± 4.4 to 31.9 ± 4.4 mm; P < 0.001) and RV/left ventricular end‐diastolic diameter ratio (0.95 ± 0.17 to 0.71 ± 0.13; P < 0.001) occurred, and they were maintained during the follow‐up period. Normal RV size was achieved in 11 of 18 patients with RV enlargement. Predicted peak VO2 did not change at 1 month and 3 months, but it improved significantly after 6 months (53.6 ± 6.5 to 62.1 ± 12.6%; P < 0.01). Sixteen of the 20 patients showed improved predicted peak VO2. Conclusions Cardiac remodeling and exercise capacity could be improved over the long‐term period after transcatheter closure of ASD in middle‐aged and elderly patients with a reduction in cardiopulmonary function. There were differences in the time course of improvement between cardiac remodeling and exercise capacity in those patients. (J Interven Cardiol 2013;26:195–199)