Turk Kardiyol Dern Ars. Ahead of Print: TKDA-84408 | DOI: 10.5543/tkda.2018.84408
Assessment of cardiac adaptations along with NTproBNP levels after percutaneous closure of atrial septal defect
, Selim Ekinci1
, Mustafa Kurşun1
, Erdem Özel1
, Hatice Solmaz1
, Ali Kemal Çabuk1
, Nihan Kahya Eren2
, Hüseyin Dursun31
S.b.ü Tepecik Research And Training Hospital, Department Of Cardiology, Izmir.2
Katip Celebi University Medical Faculty, Department Of Cardiology, Izmir.3
Dokuz Eylul University Medical Faculty, Department Of Cardiology, Izmir.
OBJECTIVE We aimed to evaluate the early effects of transcatheter closure of secundum atrial septal defect (ASD) on both atrial and ventricle diameters and functions by transthoracic echocardiography (TTE) and to assess the correlations with N-terminal pro-brain natriuretic peptide (NTproBNP) levels.
METHODS Twenty-two patients with secundum type ASD referred for percutaneous closure and 22 healthy subjects as a control group were included the study. TTE and concurrent blood sampling were performed prior, 24 hours and 30 days after the closure procedure.
RESULTS At follow up; 24 hours and 30 days after the closure right atrial (RA) areas, right ventricular (RV) areas, RV end-diastolic volumes (EDVs), RV end-systolic volumes (ESVs) were decreased on the other hand LVEDV, LVESVs and LVSVs were increased. Global RV systolic and diastolic function indices such as TAPSE, Tricuspid E/A ratios, Tricuspid E/e ratios were immediately decreased after the closure. NT-proBNP values were increased in 24 hours following closure and after 30 days it was still higher than the values measured before the transcatheter closure. LV structural and functional parameters were significantly correlated with these NT-ProBNP values. (LVEDV (r= 0.37; p= 0.02), LVESV (r= 0.38; p= 0.01), LA area (r=0.46; p=0.002), Mitral E/e (r = 0.28; p= 0.04)).
CONCLUSION Percutaneous ASD closure could lead to both early and sustained changes in cardiac anatomy and functions involving both sides of the heart. NT-proBNP levels were increased at the 24 hours and notably 30 days after the percutaneous ASD closure which is associated with increased LV diameters and volumes.
Atrial septal defect, echocardiography, left ventricular remodeling, bnp
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Corresponding Author: Barış Kılıçaslan, Türkiye