BACKGROUND/ OBJECTIVES: Pulmonary arterial hypertension is an important complication in hemodynamically relevant atrial septal defects (ASD) and negatively affects outcome. This retrospective study aimed at (1) estimating the prevalence of pulmonary hypertension (PH) in patients with secundum ASD and (2) identifying predictors of PH development or persistence after ASD closure. METHODS: Consecutive patients with an isolated secundum ASD from the Belgian Registry on Adult Congenital Heart Disease were studied. Demographic, clinical, echocardiographic and invasive hemodynamic measurements were analyzed. PH was defined upon the echocardiographic PH probability (tricuspid regurgitation velocity≥2.9 m/s). RESULTS: PH prevalence in the entire ASD population (295 patients, 68.8% females, mean age 46±21 years) was 15.9% compared to 13.3% in patients after ASD closure. PH after ASD closure was significantly related to mortality (p=0.001), atrial arrhythmia (p<0.001) and right heart failure (p=0.019). Age at repair was the most important predictor for PH (HR 1.11). In the highest tertile of age at repair (>55 years), PH prevalence was the highest (34%) and mean pulmonary artery pressure (mPAP) at catheterization before was related to PH after closure (HR 1.09). Twenty patients in the PH group had mPAP<25 mmHg before closure. CONCLUSIONS: PH in closed secundum ASD patients is not uncommon. Its prevalence was the highest when the defect was repaired above 55 years of age. Clinical outcome was worse. PH may even develop despite normal mPAP before closure. The present findings raise the question whether the cutoff value for mPAP before closure should be age-adjusted.
BACKGROUND/ OBJECTIVES:Pulmonary arterial hypertension is an important complication in hemodynamically relevant atrial septal defects (ASD) and negatively affects outcome. This retrospective study aimed at (1) estimating the prevalence of pulmonary hypertension (PH) in patients with secundum ASD and (2) identifying predictors of PH development or persistence after ASD closure. METHODS: Consecutive patients with an isolated secundum ASD from the Belgian Registry on Adult Congenital Heart Disease were studied. Demographic, clinical, echocardiographic and invasive hemodynamic measurements were analyzed. PH was defined upon the echocardiographic PH probability (tricuspid regurgitation velocity≥2.9 m/s). RESULTS: PH prevalence in the entire ASD population (295 patients, 68.8% females, mean age 46±21 years) was 15.9% compared to 13.3% in patients after ASD closure. PH after ASD closure was significantly related to mortality (p=0.001), atrial arrhythmia (p<0.001) and right heart failure (p=0.019). Age at repair was the most important predictor for PH (HR 1.11). In the highest tertile of age at repair (>55 years), PH prevalence was the highest (34%) and mean pulmonary artery pressure (mPAP) at catheterization before was related to PH after closure (HR 1.09). Twenty patients in the PH group had mPAP<25 mmHg before closure. CONCLUSIONS: PH in closed secundum ASDpatients is not uncommon. Its prevalence was the highest when the defect was repaired above 55 years of age. Clinical outcome was worse. PH may even develop despite normal mPAP before closure. The present findings raise the question whether the cutoff value for mPAP before closure should be age-adjusted.
Authors: Xianzhi Wang; Cunfu Mu; Wenlin Zhang; Chunzhu Xue; Xi Yong; Kai Chen; Dianyuan Li Journal: Am J Transl Res Date: 2021-12-15 Impact factor: 4.060
Authors: Maria Jesus Del Cerro; Shahin Moledina; Sheila G Haworth; Dunbar Ivy; Maha Al Dabbagh; Hanaa Banjar; Gabriel Diaz; Alexandria Heath-Freudenthal; Ahmed Nasser Galal; Tilman Humpl; Snehal Kulkarni; Antonio Lopes; Ana Olga Mocumbi; G D Puri; Beyra Rossouw; S Harikrishnan; Anita Saxena; Patience Udo; Lina Caicedo; Omar Tamimi; Ian Adatia Journal: Pulm Circ Date: 2016-03 Impact factor: 3.017
Authors: Turkay Saritas; Ilker Kemal Yucel; Ibrahim Halil Demir; Fadli Demir; Abdullah Erdem; Ahmet Celebi Journal: Korean Circ J Date: 2016-10-20 Impact factor: 3.243