Key result
Percutaneous atrial septal defect closure in adults led to an acute increase in blood biomarkers, including a median increase of 12 ng/L in hs-TnT and 1.9 mg/L in hs-CRP one day post-procedure, which returned to baseline by three months.
Why the study?
The effects of percutaneous atrial septal defect closure on blood biomarker levels possibly reflecting reverse cardiac remodeling were uncertain.
Does percutaneous atrial septal defect closure alter blood biomarker levels reflecting reverse cardiac remodeling in adults?
Cohort (n=50)
No
Does percutaneous atrial septal defect closure alter blood biomarker levels reflecting reverse cardiac remodeling in adults?
Percutaneous ASD closure induces a transient acute rise in cardiac and inflammatory biomarkers that normalizes by 3 months, but these biomarkers do not decrease further to reflect long-term echocardiographic reverse remodeling.
Observed biomarker rises after ASD closure should not guide practice; leaves open links to remodeling or outcomes.
BACKGROUND: We sought to assess the effects of percutaneous atrial septal defect (ASD) closure on blood biomarker levels that possibly reflect reverse cardiac remodeling. Therefore, this study investigated temporal changes in six blood biomarkers following percutaneous ASD closure in adults. METHODS: In this prospective observational cohort study, adults with ASD type II scheduled for percutaneous closure were included (2012-2016). NT-proBNP, high-sensitive troponin-T (hs-TnT), high-sensitive C-reactive protein (hs-CRP), red blood cell distribution width (RDW), growth differentiation factor-15 (GDF-15) and galectin-3 were measured one day prior to ASD closure and one day, three months and one year post ASD closure, and changes were evaluated using paired T-tests. Echocardiographic measurements were obtained. RESULTS: Fifty patients were included (median age 50 years, 62% women, 32% NYHA II). At baseline, biomarker levels were elevated in a substantial number of patients; NT-proBNP n = 22 (45%), hs-TnT n = 6 (13%) hs-CRP n = 19 (40%), galectin-3 n = 5 (11%) and GDF n = 10 (23%). One day after ASD closure, significant increases of hs-TnT (median change (Δ) = 12 ng/L), hs-CRP (Δ = 1.9 mg/L), GDF-15(Δ = 129 pg/mL) and RDW (Δ = 0.1%) were observed, and a decrease in galectin-3 (Δ = -1.0 ng/mL). Consequently, 92% had at least one abnormal biomarker directly after closure. At three months biomarker levels returned to baseline, and while echocardiographic measures 1 year post closure were indicative of reverse cardiac remodeling, biomarker levels did not further decrease. CONCLUSION: Percutaneous ASD closure in adults leads to a direct increase in most blood biomarkers, in particular hs-CRP and hs-TnT. After three months, biomarkers returned to baseline levels and remained stable up to one year.
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Geenen et al. (2020) conducted a cohort in Atrial septal defect (ASD) type II (n=50). Percutaneous atrial septal defect closure vs. Baseline (pre-closure) was evaluated on Change in blood biomarker levels (hs-TnT, hs-CRP, GDF-15, RDW, galectin-3) one day after percutaneous ASD closure (median change 12 ng/L for hs-TnT, p=<0.05). Percutaneous atrial septal defect closure in adults led to an acute increase in blood biomarkers, including a median increase of 12 ng/L in hs-TnT and 1.9 mg/L in hs-CRP one day post-procedure, which returned to baseline by three months.
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