Key result
Percutaneous atrial septal defect closure significantly improved mean global left atrial contractile strain rate at 6 months compared to baseline (0.33 vs -0.43, p=0.006), indicating left atrial reverse remodeling.
Why the study?
AF is a recognized long-term complication of ASD in adults even after device closure, and this study aimed to determine changes in LA chamber function after closure.
Does percutaneous ASD device closure improve left atrial function in adults with secundum ASD?
Cohort (n=11)
No
Does percutaneous ASD device closure improve left atrial function in adults with secundum ASD?
Absolute Event Rate: -0.43% vs 0.33%
p-value: p=0.006
Percutaneous ASD closure in adults leads to left atrial reverse remodeling, evidenced by the restoration of LA late diastolic contractile function at 6 months, despite no significant geometric changes.
ASD closure was associated with improved LA contractile strain; leaves open effects on AF risk or outcomes.
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. 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. 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). 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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Choi et al. (2022) conducted a cohort in Secundum atrial septal defect (n=11). Percutaneous atrial septal defect device closure vs. Pre-procedure baseline was evaluated on Mean global left atrial contractile strain rate (p=0.006). Percutaneous atrial septal defect closure significantly improved mean global left atrial contractile strain rate at 6 months compared to baseline (0.33 vs -0.43, p=0.006), indicating left atrial reverse remodeling.
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