Atrial septal defect and patent foramen ovale: early and long-term effects on endothelial function after percutaneous occlusion procedure

Scicchitano, Pietro; Gesualdo, Michele; Cortese, Francesca; Acquaviva, Tommaso; Cillis, Emanuela De; Bortone, Alessandro Santo; Ciccone, Marco Matteo

doi:10.1007/s00380-019-01385-2

Cited by 8 publications

(3 citation statements)

References 48 publications

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“…High sympathetic activity reduces arterial distensibility and affects the endothelial function so there is an imbalance between endothelium-derived vasocontriction and vasodilatation ( Quarti-Trevano et al, 2021 ). Studies have shown that adults with rToF or ASD have diminished endothelial function ( Scicchitano et al, 2019 ; Goeder et al, 2022 ). Patients after heart-transplantation also have increased arterial elastance which has been proposed to play a role in late graft failure ( Latus et al, 2023 ) but the prognostic value has not to our knowledge been studied in patients with ASD or rToF.…”

Section: Discussionmentioning

confidence: 99%

“…This might be a factor adding to why the patients did not improve their exercise capacity after intervention. Studies have shown that the endothelial function can improve after ASD closure ( Scicchitano et al, 2019 ), aortic valve replacement in aortic stenosis patients ( Takata et al, 2015 ) and cardiac resynchronization therapy in heart failure ( Santini et al, 2013 ). Further studies are needed to elucidate if early intervention and thus shorter duration with high sympathetic tone might decrease the risk of cardiovascular disease.…”

Section: Discussionmentioning

confidence: 99%

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Patients with volume-loaded right ventricle - quantification of left ventricular hemodynamic response to intervention measured by noninvasive pressure-volume loops

Sjöberg,

Stephensen,

Arheden

et al. 2023

Front. Physiol.

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Volume loading of the right ventricle (RV) in patients with atrial septal defect (ASD) and patients with repaired Tetralogy of Fallot (rToF) affects the pumping mechanics of the left ventricle (LV). Intervention of the lesion will relieve the RV volume load however quantifiable impact on exercise capacity, arrhytmias or death are limited. A possible explanation could be remaining effects on the function of the LV. The aim of this study was therefore to investigate if hemodynamics of the LV differs between patients with RV volume load due to ASD or rToF and healthy controls and if they change after intervention. Eighteen patients with ASD, 17 patients with rToF and 16 healthy controls underwent cardiac magnetic resonance imaging (CMR) and maximal exercise test with continuous gas analysis. Reexamination was performed 13 ± 2 months after closure of the ASD in 13 of the patients and 10 ± 4 months after pulmonary valve replacement (PVR) in 9 of the patients with rToF. Non-invasive PV-loops from CMR and brachial pressures were analyzed. Stroke work (SW) and potential energy (PE) increased after ASD closure but not in ToF patients after valve repair. Patients with ASD or rToF had higher contractility and arterial elastance than controls. No major effects were seen in LV energetics or in peak VO2 after ASD closure or PVR. Peak VO2 correlated positively with SW and PE in patients with ASD (r = 0.54, p < 0.05; r = 0.61, p < 0.01) and controls (r = 0.72, p < 0.01; r = 0.53, p < 0.05) to approximately the same degree as peak VO2 and end-diastolic volume (EDV) or end-systolic volume (ESV). In ToF patients there was no correlation between PV loop parameters and peak VO2 even if correlation was found between peak VO2 and EDV or ESV. In conclusion, the LV seems to adapt its pumping according to anatomic circumstances without losing efficiency, however there are indications of persistent vascular dysfunction, expressed as high arterial elastance, which might have impact on exercise performance and prognosis. Future studies might elucidate if the duration of RV volume load and decreased LV filling have any impact on the ability of the vascular function to normalize after ASD closure or PVR.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Patients with volume-loaded right ventricle - quantification of left ventricular hemodynamic response to intervention measured by noninvasive pressure-volume loops

Sjöberg,

Stephensen,

Arheden

et al. 2023

Front. Physiol.

View full text Add to dashboard Cite

show abstract

“…The surgical option may also vary according to the severity of RV hypoplasia from biventricular repair with ASD closure to univentricular repair with a Glenn operation and one and a half ventricular repair ( 2 , 11 , 23 , 30 , 33 , 44 ). Although cyanosis was found in both the living and deceased patients, heart failure, reflecting on higher RVEDP, was observed more frequently in deceased patients, indicating that ASD closure could be undertaken in patients with mild IRVH.…”

Section: Discussionmentioning

confidence: 99%

Clinical Status and Outcome of Isolated Right Ventricular Hypoplasia: A Systematic Review and Pooled Analysis of Case Reports

et al. 2022

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BackgroundIsolated right ventricular hypoplasia (IRVH), not associated with severe pulmonary or tricuspid valve malformation, is a rare congenital myocardial disease. This study aims to evaluate the clinical status and outcome of IRVH.MethodsA systematic search of keywords on IRVH was conducted. Studies were searched from MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Ichushi) published between January 1950 and August 2021.ResultsThirty studies met the inclusion criteria. All of these studies were case reports and included 54 patients (25 males and 29 females). The median age of the patients was 2.5 years old (0–15.3 years). Of the 54 patients, 13 (24.1%) reported a family history of cardiomyopathy. Moreover, 50 (92.6%), 19 (35.2%), and 17 (31.5%) patients were diagnosed with cyanosis, finger clubbing, and dyspnea, respectively. Furthermore, 53 (98.2%) patients had a patent foramen ovale or an atrial septal defect (ASD). Z-score of the tricuspid valve diameter on echocardiogram was −2.16 ± 1.53, concomitant with small right ventricular end-diastolic volume. In addition, 29 (53.7%), 21 (38.9%), 7 (13.0%), and 2 (3.7%) patients underwent surgery, ASD closure, Glenn operation, and one and a half ventricular repair, respectively. Among them, nine (20.4%) patients expired, and the multivariable logistic regression analysis showed that infancy, heart failure, and higher right ventricular end-diastolic pressure were risk factors for death.ConclusionsIRVH was diagnosed early in children with cyanosis and was associated with high mortality. This systematic review and pooled analysis provided evidence to assess the of IRVH degree in order to evaluate the clinical status and outcome of IRVH.

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Efficacy and safety of atrial septal defect closure using Occlutech Figulla Flex II compared with Amplatzer Septal Occluder

et al. 2021

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Atrial septal defect and patent foramen ovale: early and long-term effects on endothelial function after percutaneous occlusion procedure

Cited by 8 publications

References 48 publications

Patients with volume-loaded right ventricle - quantification of left ventricular hemodynamic response to intervention measured by noninvasive pressure-volume loops

Patients with volume-loaded right ventricle - quantification of left ventricular hemodynamic response to intervention measured by noninvasive pressure-volume loops

Clinical Status and Outcome of Isolated Right Ventricular Hypoplasia: A Systematic Review and Pooled Analysis of Case Reports

Efficacy and safety of atrial septal defect closure using Occlutech Figulla Flex II compared with Amplatzer Septal Occluder

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