P278Atrial septal defect in adults: reasons for closure


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Abstract

Doppler techniques are widely used for assessment of ventricular diastolic function.Purpose: The aim of the study was to evaluate the influence of atrial septal defect (ASD) closure in adults on left ventricular (LV) diastolic function assessed by conventional and tissue Doppler imaging.Methods: Thirty consecutive patients with a history of ASD (77% type secundum, 10% type primum, 13% type sinus venosus) and 30 healthy controls matched by sex and age were involved in our research (43.3% M; mean age 36.2± 12.5 years). 23.3% pts had transcatheter ASD closure. All patients were observed before, a month and a year after closure. Conventional Doppler (pulsed and continual) and pulsed tissue Doppler imaging examination were performed in all patients before and after closure and in all control subjects. The parameters for LV diastolic function assessed by conventional Doppler examination were mitral diastolic flow peak velocity ratio (E/A) and mitral flow deceleration time (MF DT). The basal free LV wall was sampled. The parameters for LV diastolic function assessed by tissue Doppler examination were early and late myocardial peak diastolic velocity ratio (Em/Am ratio) and isovolumic relaxation time (IVRt). The ratio of early mitral diastolic flow peak velocity and early myocardial peak diastolic velocity (E/Em) was calculated as an index of LV filling pressure.Results: In our study there was no significant difference between parameters obtained in patients before closure and control subjects (E/A, MF DT, Em/Am, IVRt, E/Em). We also didn't observe significant difference between these parameters obtained one month and one year after closure compared with controls and baseline (Table 1).Conclusions: The presence of ASD in adults doesn't have influence on left ventricular diastolic function and filling pressure assessed by Doppler techniques. Closure preserves this function, immediately and one year after it.

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