Atrial septal defect in adults is associated with airway hyperresponsiveness

Nassif, Martina; Steenwijk, Reindert P. van; Hogenhout, Jacqueline M.; Lu, Huangling; Bruin‐Bon, Rianne H.A.C.M. de; Hirsch, Alexander; Sterk, Peter J.; Bouma, Berto J.; Straver, Bart; Tijssen, Jan G.P.; Mulder, Barbara J.M.; Winter, Robbert J. de

doi:10.1111/chd.12665

Cited by 7 publications

(9 citation statements)

References 32 publications

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“…The -81%) prevalence of airway hyperresponsiveness in adult patients, which remained unchanged after device closure. 9 Therefore, the present study results are supportive evidence of irreversible, possibly ASD-associated pulmonary function impairment in a subgroup of repaired adults, requiring the use of pulmonary inhalants for obstructive airway disease.…”

Section: Resultssupporting

confidence: 78%

Use of Pulmonary Inhalants Remains Remarkably High After Atrial Septal Defect Closure

Nassif

Woudstra

Kuijpers

et al. 2018

Circ J

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Background: Post-repair atrial septal defects (ASD) patients are frequently discharged from follow-up, but the extent of pulmonary symptoms long-term post-repair is unknown. Methods and Results:The national CONgenital CORvitia registry was linked to the national Drug Registry to investigate all ambulatory-dispensed pulmonary inhalants for 2006-2014. ASD patients were compared with age-and sex-matched referents from the general population. A total of 1,959 adult patients (age 42±17 years; 66% female; 1,223 [62%] repaired) were included. Compared with the referents, ASD patients had more inhalant use, even at long-term post-repair follow-up (OR=1.81 [95% CI 1.62-2.03]; P<0.001).Conclusions: ASD patients had 2-fold higher inhalant use compared with referents even at long-term post-repair follow-up, suggesting persistent pulmonary functional impairment.

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Section: Resultssupporting

confidence: 78%

Use of Pulmonary Inhalants Remains Remarkably High After Atrial Septal Defect Closure

Nassif

Woudstra

Kuijpers

et al. 2018

Circ J

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“…Older subjects with ASD should be screened for respiratory elements in suspected cases and treated appropriately. This has the double benefit of symptomatic improvement and reduction in the PAH and associated challenges in device closure also found in the present study [22,23].…”

Section: Discussionsupporting

confidence: 76%

“…The ASD can increase the hyperresponsiveness of the airway in up to 63% of the patients. COPD can partly contribute to pulmonary hypertension [22]. A significant reduction in the COPD symptoms was found in up to 80% of patients with initial COPD symptoms.…”

Section: Discussionmentioning

confidence: 99%

Challenges in Device Closure of Secundum Atrial Septal Defect in Older Patients in Their Fifth Decade and Beyond

Singhi¹,

Mahapatra²,

Dey³

et al. 2022

Cureus

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Transcatheter atrial septal defect (ASD) device closure in the older population presents a greater challenge due to the long-standing effect of atrial left-to-right shunt. This study analyzes the challenges encountered in transcatheter ASD device closure in older patients in their fifth decade and beyond. MethodsAdults aged 40 years and above with significant secundum ASD who underwent transcatheter ASD device closure between June 2015 and April 2021 were analyzed. Challenges were classified as major and minor challenges based on their impact on the alteration of the treatment protocol. Patients were categorized into three subgroups according to age. Group 1 consisted of patients aged 40-49 years (n = 13), Group 2 consisted of patients aged 50-59 years (n = 16), and Group 3 consisted of patients aged 60 years and above (n = 8). ResultsA total of 37 patients were analyzed. The challenges encountered were arrhythmia, pulmonary hypertension, left ventricular diastolic dysfunction, bleeding, stroke, coronary artery disease (CAD), hypertension, and airway disease. Thirteen percent of challenges were seen in pre-procedure time, whereas 79% of challenges during the procedure and 8% of challenges during post-procedure were seen. Thirty-five patients (94.6%) underwent transcatheter ASD device closure. Two patients (5.4%) did not undergo transcatheter ASD device closure due to severe diastolic dysfunction and associated CAD, respectively. Eleven major challenges were encountered in 10 patients in which one patient had a dual challenge of bleeding and arrhythmia. Thirteen patients (35.1%) had smooth procedures without any challenges encountered. Twentyseven minor challenges were encountered in 20 patients with some patients having an overlap of multiple major and minor challenges. The patients were doing well at the mean follow-up of 28 months. ConclusionsTranscatheter ASD device closure in older patients who are 40 years and above is safe and effective. Such high-risk patients are prone to various challenges that can be effectively managed if optimally monitored on the basis of a proper understanding of the altered physiology and anticipation of the deviated course at various stages of the procedure.

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“…For example, there is a high prevalence of airway hyperresponsiveness in patients with atrial septal defects (ASD), and it is suggested that airway hyperresponsiveness may be a possible mechanism for recurrent attacks of CVA. Unlike bronchial asthma, 11 asthma-like symptoms associated with ASD are not necessarily experienced every few hours or days, but can be progressive [ 11 ]. This better understanding of ASD-associated dyspnea could potentially prevent delays to the treatment of unrepaired ASD.…”

Section: Discussionmentioning

confidence: 99%

Effect of congenital heart disease on the recurrence of cough variant asthma in children

Feng

Liu

et al. 2021

BMC Cardiovasc Disord

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Background The research into the recurrence of cough variant asthma (CVA) in congenital heart disease (CHD) are few in number. The purpose of this study is to investigate the effect of CHD on the risk of the recurrence of CVA. Methods This study was a retrospective cohort study of 489 children with CVA aged between one and 14 years, of whom 67 had CHD complicated with CVA and 134 had CVA without CHD at a ratio of 1:2 according to age, sex and index year. The adjusted hazard ratio (aHR) of CVA recurrence in both the CHD cohort and the non-CHD cohort was determined by multivariate analysis using the Cox proportional hazard regression model. Results Adjusting for CHD classification, Mycoplasma pneumonia (MP) infection and immunoglobulin E (IgE) sensitization, the recurrence hazard of CVA in the complex congenital heart disease (CCHD) group (aHR = 3.281; 95% CI 1.648–6.530; P < 0.01) was significantly higher than that in the simple congenital heart disease group (aHR = 2.555; 95% CI 1.739–3.752; P < 0.01). Further, children with IgE sensitization (aHR = 2.172; 95% CI 1.482–3.184; P < 0.01) had a higher recurrence hazard of CVA than those without IgE sensitization, and children with MP infection (aHR = 1.777; 95% CI 1.188–2.657; P < 0.01) had a higher recurrence hazard of CVA than those without the MP infection. Conclusion The hazard of recurrent CVA is higher in children with CHD, especially in the CCHD children. In addition, those children with IgE sensitization or a MP infection had an increased hazard of recurrent CVA.

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Atrial septal defect in adults is associated with airway hyperresponsiveness

Cited by 7 publications

References 32 publications

Use of Pulmonary Inhalants Remains Remarkably High After Atrial Septal Defect Closure

Use of Pulmonary Inhalants Remains Remarkably High After Atrial Septal Defect Closure

Challenges in Device Closure of Secundum Atrial Septal Defect in Older Patients in Their Fifth Decade and Beyond

Effect of congenital heart disease on the recurrence of cough variant asthma in children

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