Changing of Left Atrial Function Index in Symptomatic Patients with Patent Foramen Ovale After Device Closure

BACKGROUND
Left atrial function is impaired in patients with patent foramen ovale. This study aimed to evaluate the role of left atrial function index in monitoring the course of left atrial function in a patient with patent foramen ovale before and after percutaneous closure.

METHODS
We retrospectively reviewed the findings of consecutive patients evaluated in our tertiary center for patent foramen ovale closure to identify those subjects with acute ischemic stroke, transient ischemic attack, or radiological evidence of cerebral ischemic events (index event) who performed a complete echocardiography evaluation reporting evidence of patent foramen ovale between September 2004 and September 2018. The left atrial function was evaluated at baseline and then yearly using the left atrial function index.

RESULTS
The cohort of 448 consecutive patients (mean age 43.4 ± 10.4 years, 257 males) was divided into 2 groups according to the temporal window between the index event and patent foramen ovale closure, defined as <1-year (216 patients) and ≥1-year (232 patients). Patients treated within 1 year from the index event maintained similar parameters of left atrial function and left atrial function index over the time, also after the interventional procedure. Conversely, patients treated after 1 year demonstrated a significant reduction of left atrial emptying func- tion and maximal left atrial volume (P <.001 for all) compared to the basal values. The same parameters slightly increased after the percutaneous closure during the second year without reaching the basal values.

CONCLUSIONS
Left atrial function index can be used as a non-invasive marker of atrial dys- function severity in patients with patent foramen ovale before and after the interventional procedure.