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Long‐Term Effects of Transcatheter Closure of Atrial Septal Defect on Cardiac Remodeling and Exercise Capacity in Patients Older than 40 Years with a Reduction in Cardiopulmonary Function

2012; Wiley; Volume: 26; Issue: 2 Linguagem: Inglês

10.1111/joic.12002

1540-8183

Yoichi Takaya, Manabu Taniguchi, Teiji Akagi, Saori Nobusada, Kengo Kusano, Hiroshi Ito, Shunji Sano,

Aortic Disease and Treatment Approaches

Background Although it has been demonstrated that cardiac remodeling and exercise capacity improve after transcatheter closure of atrial septal defect (ASD), little is known about long‐term benefits in middle‐aged and elderly patients with a reduction in cardiopulmonary function. Objectives To evaluate long‐term extent and time course of improvements in cardiac remodeling and exercise capacity in those patients. Methods: Twenty ASD patients ≥ 40 years of age with a reduction in cardiopulmonary function (predicted peak oxygen uptake [VO 2 ] < 65%) were enrolled. Transthoracic echocardiography and cardiopulmonary exercise testing were performed at baseline and at 1 month, 3 months, 6 months, and >12 months after the procedure. Results At 1 month after the procedure, significant decreases in right ventricular (RV) end‐diastolic diameter (38.2 ± 4.4 to 31.9 ± 4.4 mm; P < 0.001) and RV/left ventricular end‐diastolic diameter ratio (0.95 ± 0.17 to 0.71 ± 0.13; P < 0.001) occurred, and they were maintained during the follow‐up period. Normal RV size was achieved in 11 of 18 patients with RV enlargement. Predicted peak VO 2 did not change at 1 month and 3 months, but it improved significantly after 6 months (53.6 ± 6.5 to 62.1 ± 12.6%; P < 0.01). Sixteen of the 20 patients showed improved predicted peak VO 2 . Conclusions Cardiac remodeling and exercise capacity could be improved over the long‐term period after transcatheter closure of ASD in middle‐aged and elderly patients with a reduction in cardiopulmonary function. There were differences in the time course of improvement between cardiac remodeling and exercise capacity in those patients. (J Interven Cardiol 2013;26:195–199)