Why the study?
PDA causes left heart volume overload and central arterial stiffening contributes to cardiovascular diseases, but the effect of time delay of PDA closure on aortic stiffness and cardiac function was unknown.
Does delaying transcatheter PDA closure beyond one year of age increase aortic stiffness and impair cardiac function in children?
Does delaying transcatheter PDA closure beyond one year of age increase aortic stiffness and impair cardiac function in children?
Delaying transcatheter PDA closure beyond one year of age is associated with significantly elevated aortic stiffness and impaired cardiac function.
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Small PDAs may elevate aortic stiffness with cardiac impairment; leaves open optimal closure timing for reversal.
BACKGROUND: Patent ductus arteriosus (PDA) causes volume overload of the left side of the heart. Stiffening in the larger central arterial system, such as the aortic tree, significantly contributes to cardiovascular diseases in older individuals and is positively associated with systolic hypertension and coronary artery disease. In this study, we evaluated the effect of time delay of PDA closure on aortic stiffness and its relationship with cardiac function before and after transcatheter closure of the PDA. METHODS: Our study population consisted of 60 children who were scheduled for transcatheter closure of the PDA. They were divided into two groups as follows: group A in whom PDA closure was performed before the age of one year, and group B in whom PDA closure was performed after the age of one year. RESULTS: Before PDA closure, the aortic stiffness index (ASI) was significantly higher in children in group B than in those in group A (p < 0.001), and was it significantly higher in both groups than in the control group (p < 0.001). CONCLUSIONS: Aortic stiffness was significantly elevated in patients with PDA, even small-sized PDAs, and was associated with impairment in cardiac function, particularly if PDA closure was delayed after the age of one year.
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Elsaughier et al. (2019) studied this question.
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