Turk Kardiyol Dern Ars. 2019; 47(4): 258-264 | DOI: 10.5543/tkda.2018.84408
Association of cardiac adaptations with NT-proBNP 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 The aim of this study was to evaluate the early effects of transcatheter closure of secundum atrial septal defect (ASD) on atrial and ventricular diameters and functions evaluated by transthoracic echocardiography, and to assess the relation of morphological changes to N-terminal pro-brain natriuretic peptide (NT-proBNP) levels.
METHODS Twenty-two patients with secundum-type ASD referred for percutaneous closure were included in the study as well as 22 healthy individuals who served as a control group. TTE and concurrent blood sampling were performed prior to and 24 hours and 30 days after the closure procedure.
RESULTS At follow-up 24 hours and 30 days after the closure, the right atrial (RA) area, right ventricular (RV) area, RV end-diastolic volume (EDV), and RV end-systolic volume (ESV) decreased, while left ventricle (LV) EDV (LVEDV), LVESV, and LV stroke volume (LVSV) increased. Global RV systolic and diastolic function indices, such as the tricuspid annular plane systolic excursion, the tricuspid E/A and E/e ratio decreased immediately after the closure. The NT-proBNP value increased in the 24 hours following closure, and after 30 days, it was still higher than the measurement recorded before the transcatheter closure. The LV structural and functional parameters were significantly correlated with the NT-proBNP value (LVEDV: r=0.37, p=0.02; LVESV: r=0.38, p=0.01; left atrium area: r=0.46, p=0.002; mitral E/e: r=0.28, p=0.04).
CONCLUSION Percutaneous ASD closure can lead to both early and sustained changes in cardiac anatomy and function involving both sides of the heart. The NT-proBNP level had increased at 24 hours post procedure, and was also notably increased 30 days after the percutaneous ASD closure, which is associated with increased LV diameter and volume.
Atrial septal defect, echocardiography, left ventricular remodeling, bnp
How to cite this article
Barış Kılıçaslan, Selim Ekinci, Mustafa Kurşun, Erdem Özel, Hatice Solmaz, Ali Kemal Çabuk, Nihan Kahya Eren, Hüseyin Dursun. Association of cardiac adaptations with NT-proBNP levels after percutaneous closure of atrial septal defect. Turk Kardiyol Dern Ars. 2019; 47(4): 258-264
Corresponding Author: Barış Kılıçaslan, Türkiye