Key result
Transcatheter closure of atrial septal defects significantly improved exercise capacity from 7.7 to 8.7 metabolic equivalents at 1 month, correlating with changes in right ventricular strain.
Why the study?
Does transcatheter closure of atrial septal defects improve exercise capacity and strain patterns in patients with ASDs?
Observational (n=30)
No
Does transcatheter closure of atrial septal defects improve exercise capacity and strain patterns in patients with ASDs?
Absolute Event Rate: 8.7% vs 7.7%
p-value: p=0.001
Transcatheter closure of ASDs significantly improves exercise capacity at 1 month, which correlates with improvements in global right ventricular longitudinal strain.
May support ASD closure for functional gains; leaves open RV strain mediation pending prospective trials.
BACKGROUND AND OBJECTIVES: Assessment of left ventricle (LV) function by using strain and strain rate is popular in the clinical setting. However, the use of these echocardiographic tools in assessing right ventricle (RV) failure, and the manner in which they both reflect the functional capacity of the patient, remains poorly understood. This study aimed to investigate the change in exercise capacity and strain between before and (1 month) after the transcatheter closure of atrial septal defects (ASDs). SUBJECTS AND METHODS: Thirty patients who underwent transcatheter closure of ASD between May 2014 and June 2015 at the Division of Pediatric Cardiology, Severance Cardiovascular Hospital, were enrolled. We compared and analyzed the results of the following examinations, before and (1 month) after the procedure: echocardiography, cardiopulmonary exercise test (CPET), and N-terminal pro-brain natriuretic peptide level. RESULTS: There were no mortalities, and the male-to-female ratio was 1:2. The mean defect size was 22.3±4.9 mm; the mean Qp/Qs ratio, 2.1±0.5; and the mean device size, 22.3±4.9 mm. Changes in global RV longitudinal (GRVL) strain and LV torsion were measured echocardiographically. Exercise capacity improved from 7.7±1.2 to 8.7±1.8 metabolic equivalents (p=0.001). These findings correlated to the change in GRVL strain (p=0.03). CONCLUSION: The average exercise capacity increased after device closure of ASD. The change in strain was evident on echocardiography, especially for GRVL strain and LV torsion. Further studies comparing CPET and strain in various patients may show increased exercise capacity in patients with improved RV function.
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Kim et al. (2016) conducted an observational in Atrial septal defects (n=30). Transcatheter closure of atrial septal defects vs. Pre-procedure baseline was evaluated on Exercise capacity (metabolic equivalents) (p=0.001). Transcatheter closure of atrial septal defects significantly improved exercise capacity from 7.7 to 8.7 metabolic equivalents at 1 month, correlating with changes in right ventricular strain.
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