Changes in left atrial function after percutaneous closure of patent foramen ovale

Purpose This study aimed to investigate left atrial (LA) function following patent foramen ovale (PFO) closure.Methods Patients with PFO who underwent transcatheter closure between 2015 and 2022 and had complete echocardiography examination data available at baseline and at least twice during 1-year of follow-up were enrolled. LA function was evaluated by measuring LA reservoir strain (LASr), conduit strain (LAScd), and contractile strain (LASct) through speckle-tracking echocardiography. Differences in LA strain between baseline and at the different follow-up times were compared using repeated-measures analysis. The association between risk factors and LA strain was evaluated in a univariable and multivariable linear regression model.Results Forty-five patients were included. After 3 months, we observed a decrease in LASr (from 40.98–33.09%, P < 0.05), which recovered to 37.30% at 6 months (P = 0.06). LAScd decreased significantly from baseline after the procedure (P < 0.05) but had recovered by 3 months (19.96% vs 19.04%, P = 0.06). LASct decreased significantly between baseline and 6 months (from 17.92–14.01%, P < 0.05). All changes resolved by 1 year. Multivariable models showed that LA strain at baseline was the most important factor affecting LA function. LA diameter was significantly associated with sustained changes in LAScd (β = 7.19, P = 0.038). Age was a risk factor for difficult recovery of LASct after PFO at 3 months.Conclusions Implantation of a PFO occluder has a transient adverse impact on LA function in the area adjacent to the device but resolves within 1 year.