Key result
Resting Qp:Qs may fail to capture true exercise pulmonary blood flow burden in ASD.
Why the study?
Despite advancements in ASD diagnosis and management, key hemodynamic aspects remain poorly understood.
Current metrics like resting Qp:Qs may inadequately capture the dynamic physiological burden of ASDs during physical activity, underscoring the need for advanced hemodynamic and imaging assessments to optimize risk stratification.
Resting Qp:Qs may miss exercise shunt burden in ASD; leaves open whether dynamic assessments refine risk stratification.
Despite advancements in the diagnosis and management of atrial septal defect (ASD), key hemodynamic aspects remain poorly understood. This review explores limitations of the pulmonary-to-systemic flow ratio (Qp:Qs), the impact of exercise on shunt volume, and predictors of pulmonary arterial hypertension. We highlight that Qp:Qs may not reflect true pulmonary blood flow, particularly during exertion, and that exercise-induced augmentation of shunt flow could predispose to right heart overload. Future studies integrating advanced imaging and hemodynamic measures are essential to refine risk stratification and management in patients with ASD.
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A. H. Shah (2025) conducted a review in Atrial septal defect (ASD). The resting Qp:Qs ratio may fail to reflect the true pulmonary blood flow burden in patients with atrial septal defects during exercise, necessitating more dynamic physiological assessments.
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