Atrial septal defect and patent foramen ovale: early and long-term effects on endothelial function after percutaneous occlusion procedure.
Pietro ScicchitanoMichele GesualdoFrancesca CorteseTommaso AcquavivaEmanuela de CillisAlessandro Santo BortoneMarco Matteo CicconePublished in: Heart and vessels (2019)
Percutaneous closure of atrial septal defect (ASD)/patent foramen ovale (PFO) can influence systemic hemodynamics. The aim of this research was to evaluate the influence of the closure procedure on morphological and functional characteristics of systemic vascular walls. Fourteen ASD (mean age 40 ± 16 years) and 14 PFO (45 ± 8 years) patients were enrolled in this retrospective study. All underwent percutaneous closure procedure; physical, clinical and biochemical evaluations; echocardiography; carotid evaluation; and brachial artery flow-mediated vasodilatation (FMD). All the evaluations were performed at the time of enrollment, 24 h post-procedure, at 1-6-12-month follow-up. FMD at enrollment was higher in PFO patients as compared to ASD (8.5% [7.6-10.7%] versus 6.5% [5.6-7.6%], p < 0.0001). FMD values in ASD patients significantly increased during follow-up (enrollment: 6.5% [5.6-7.6%], 12-month follow-up: 8.8% [7.2-10.3%], p < 0.01). PFO patients showed reduced FMD values 24 h after the procedure (enrollment: 8.5% [7.6-10.7%], 24 h post-procedure: 7% [6.3-9%], p < 0.001), while recovering endothelial function during follow-up period to baseline values (FMD at 12-month follow-up: 8.2% [7.6-10.5%]). At one-year follow-up, FMD remained inversely related to systolic pulmonary arterial pressure and right and left atrial/ventricle chambers dimensions (RV proximal diameter efflux tract, right atrium [RA] longitudinal diameter, RA transverse diameter, RA area, left ventricle [LV] end-diastolic diameter, left atrium [LA] anteroposterior diameter, LA area; p < 0.01) in ASD patients. Endothelial function improved after percutaneous closure of ASD, while remaining stable after PFO closure. Therefore, ASD patients seem to improve their cardiovascular risk profile after percutaneous closure of their defect.
Keyphrases
- end stage renal disease
- ejection fraction
- autism spectrum disorder
- minimally invasive
- chronic kidney disease
- newly diagnosed
- peritoneal dialysis
- prognostic factors
- left ventricular
- attention deficit hyperactivity disorder
- heart failure
- blood pressure
- left atrial
- rheumatoid arthritis
- patient reported outcomes
- healthcare
- systemic lupus erythematosus
- atrial fibrillation
- computed tomography
- ultrasound guided
- working memory
- optic nerve
- left atrial appendage
- congenital heart disease
- systemic sclerosis
- vena cava