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Effects of age on hemodynamic changes after transcatheter closure of atrial septal defect: importance of ventricular diastolic function

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Abstract

Some older patients develop symptoms of clinical heart failure after closure of an atrial septal defect (ASD). The present study tested the hypothesis that baseline hemodynamics and hemodynamic changes induced by transcatheter ASD closure are different between younger and older patients due to age-related differences in left ventricular (LV) diastolic dysfunction. Forty-three consecutive patients (27.7 ± 16.3 years of age, range 5–63, median 25) who underwent device closure for ASD were divided into younger (age ≤25, n = 24, 15.1 ± 1.2 years) and older (> 25 years, n = 19, 43.7 ± 2.2 years) groups. Echocardiographic evaluations were performed 1 day before and 2 days after ASD closure. Before ASD repair, early diastolic mitral annular velocity (e′) on lateral, an index of ventricular relaxation, showed an age-related decrease. After closure, e′ decreased by similar amount in both groups (p < 0.05). In addition, E/e′, an index of LV filling pressure, was relatively unchanged in the younger group (from 5.4 to 5.9) but significantly increased (p < 0.05) in the older group (from 6.3 to 8.1) over similar increase of normalized LV diastolic dimension. In older patients, ASD closure resulted in further deterioration of baseline impairment in LV relaxation and the increased LV stiffness caused a more marked rise in LV filling pressure, compared to the younger group. Thus, ASD should be closed at a younger age before the development of age-related LV diastolic dysfunction.

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References

  1. Eerola A, Pihkala JI, Boldt T, Mattila IP, Poutanen T, Jokinen E (2007) Hemodynamic improvement is faster after percutaneous ASD closure than after surgery. Catheter Cardiovasc Interv 69:432–441

    Article  PubMed  Google Scholar 

  2. Du ZD, Hijazi ZM, Kleinman CS, Silverman NH, Larntz K (2002) Comparison between transcatheter and surgical closure of secundum atrial septal defect in children and adults: results of a multicenter nonrandomized trial. J Am Coll Cardiol 39:1836–1844

    Article  PubMed  Google Scholar 

  3. Ewert P, Berger F, Nagdyman N, Kretschmar O, Dittrich S, Abdul-Khaliq H, Lange P (2001) Masked left ventricular restriction in elderly patients with atrial septal defects: a contraindication for closure? Catheter Cardiovasc Interv 52:177–180

    Article  PubMed  CAS  Google Scholar 

  4. Holzer R, Cao QL, Hijazi ZM (2005) Closure of a moderately large atrial septal defect with a self-fabricated fenestrated Amplatzer septal occluder in an 85-year-old patient with reduced diastolic elasticity of the left ventricle. Catheter Cardiovasc Interv 64:513–518

    Article  PubMed  Google Scholar 

  5. Thanopoulos BD, Laskari CV, Tsaousis GS, Zarayelyan A, Vekiou A, Papadopoulos GS (1998) Closure of atrial septal defects with the Amplatzer occlusion device: preliminary results. J Am Coll Cardiol 31:1110–1116

    Article  PubMed  CAS  Google Scholar 

  6. Masutani S, Taketazu M, Mihara C, Mimura Y, Ishido H, Matsunaga T, Kobayashi T, Senzaki H (2009) Usefulness of early diastolic mitral annular velocity to predict plasma levels of brain natriuretic peptide and transient heart failure development after device closure of atrial septal defect. Am J Cardiol 104:1732–1736

    Article  PubMed  Google Scholar 

  7. Nagueh SF, Sun H, Kopelen HA, Middleton KJ, Khoury DS (2001) Hemodynamic determinants of the mitral annulus diastolic velocities by tissue Doppler. J Am Coll Cardiol 37:278–285

    Article  PubMed  CAS  Google Scholar 

  8. Ommen SR, Nishimura RA, Appleton CP, Miller FA, Oh JK, Redfield MM, Tajik AJ (2000) Clinical utility of Doppler echocardiography and tissue Doppler imaging in the estimation of left ventricular filling pressures: a comparative simultaneous Doppler-catheterization study. Circulation 102:1788–1794

    PubMed  CAS  Google Scholar 

  9. Chrysohoou C, Pitsavos C, Barbetseas J, Kotroyiannis I, Brili S, Vasiliadou K, Papadimitriou L, Stefanadis C (2009) Chronic systemic inflammation accompanies impaired ventricular diastolic function, detected by Doppler imaging, in patients with newly diagnosed systolic heart failure (Hellenic Heart Failure Study). Heart Vessels 24:22–26

    Article  PubMed  Google Scholar 

  10. Fukuta H, Ohte N, Wakami K, Asada K, Goto T, Mukai S, Kimura G (2011) Reduced renal function is associated with combined increases in ventricular-systolic stiffness and arterial load in patients undergoing cardiac catheterization for coronary artery disease. Heart Vessels (in press)

  11. Schnittger I, Gordon EP, Fitzgerald PJ, Popp RL (1983) Standardized intracardiac measurements of two-dimensional echocardiography. J Am Coll Cardiol 2:934–938

    Article  PubMed  CAS  Google Scholar 

  12. Henry WL, Ware J, Gardin JM, Hepner SI, McKay J, Weiner M (1978) Echocardiographic measurements in normal subjects. Growth-related changes that occur between infancy and early adulthood. Circulation 57:278–285

    PubMed  CAS  Google Scholar 

  13. Tei C (1995) New non-invasive index for combined systolic and diastolic ventricular function. J Cardiol 26:135–136

    PubMed  CAS  Google Scholar 

  14. Masutani S, Little WC, Hasegawa H, Cheng HJ, Cheng CP (2008) Restrictive left ventricular filling pattern does not result from increased left atrial pressure alone. Circulation 117:1550–1554

    Article  PubMed  Google Scholar 

  15. Hasegawa H, Little WC, Ohno M, Brucks S, Morimoto A, Cheng HJ, Cheng CP (2003) Diastolic mitral annular velocity during the development of heart failure. J Am Coll Cardiol 41:1590–1597

    Article  PubMed  Google Scholar 

  16. Su HM, Lin TH, Voon WC, Lee KT, Chu CS, Yen HW, Lai WT, Sheu SH (2007) Correlation of Tei index obtained from tissue Doppler echocardiography with invasive measurements of left ventricular performance. Echocardiography 24:252–257

    Article  PubMed  Google Scholar 

  17. Cannesson M, Jacques D, Pinsky MR, Gorcsan J 3rd (2006) Effects of modulation of left ventricular contractile state and loading conditions on tissue Doppler myocardial performance index. Am J Physiol Heart Circ Physiol 290:H1952–H1959

    Article  PubMed  CAS  Google Scholar 

  18. Duzenli MA, Ozdemir K, Aygul N, Soylu A, Aygul MU, Gok H (2009) Comparison of myocardial performance index obtained either by conventional echocardiography or tissue Doppler echocardiography in healthy subjects and patients with heart failure. Heart Vessels 24:8–15

    Article  PubMed  Google Scholar 

  19. Pascotto M, Santoro G, Caso P, Cerrato F, Caso I, Caputo S, Bigazzi MC, D’Andrea A, Russo MG, Calabro R (2005) Global and regional left ventricular function in patients undergoing transcatheter closure of secundum atrial septal defect. Am J Cardiol 96:439–442

    Article  PubMed  Google Scholar 

  20. Walker RE, Moran AM, Gauvreau K, Colan SD (2004) Evidence of adverse ventricular interdependence in patients with atrial septal defects. Am J Cardiol 93:1374–1377

    Article  PubMed  Google Scholar 

  21. Harada K, Tamura M, Toyono M, Oyama K, Takada G (2001) Assessment of global left ventricular function by tissue Doppler imaging. Am J Cardiol 88:927–932, A929

    Google Scholar 

  22. Spencer KT, Kirkpatrick JN, Mor-Avi V, Decara JM, Lang RM (2004) Age dependency of the Tei index of myocardial performance. J Am Soc Echocardiogr 17:350–352

    Article  PubMed  Google Scholar 

  23. Cui W, Roberson DA, Chen Z, Madronero LF, Cuneo BF (2008) Systolic and diastolic time intervals measured from Doppler tissue imaging: normal values and Z-score tables, and effects of age, heart rate, and body surface area. J Am Soc Echocardiogr 21:361–370

    Article  PubMed  Google Scholar 

  24. Hanseus KC, Bjorkhem GE, Brodin LA, Pesonen E (2002) Analysis of atrioventricular plane movements by Doppler tissue imaging and M-mode in children with atrial septal defects before and after surgical and device closure. Pediatr Cardiol 23:152–159

    Article  PubMed  CAS  Google Scholar 

  25. Pauliks LB, Chan KC, Chang D, Kirby SK, Logan L, DeGroff CG, Boucek MM, Valdes-Cruz LM (2005) Regional myocardial velocities and isovolumic contraction acceleration before and after device closure of atrial septal defects: a color tissue Doppler study. Am Heart J 150:294–301

    Article  PubMed  Google Scholar 

  26. Lange A, Coleman DM, Palka P, Burstow DJ, Wilkinson JL, Godman MJ (2003) Effect of catheter device closure of atrial septal defect on diastolic mitral annular motion. Am J Cardiol 91:104–108

    Article  PubMed  Google Scholar 

  27. Jacques DC, Pinsky MR, Severyn D, Gorcsan J 3rd (2004) Influence of alterations in loading on mitral annular velocity by tissue Doppler echocardiography and its associated ability to predict filling pressures. Chest 126:1910–1918

    Article  PubMed  Google Scholar 

  28. Hees PS, Fleg JL, Dong SJ, Shapiro EP (2004) MRI and echocardiographic assessment of the diastolic dysfunction of normal aging: altered LV pressure decline or load? Am J Physiol Heart Circ Physiol 286:H782–H788

    Article  PubMed  CAS  Google Scholar 

  29. Park HS, Naik SD, Aronow WS, Ahn CW, McClung JA, Belkin RN (2007) Age- and sex-related differences in the tissue Doppler imaging parameters of left ventricular diastolic dysfunction. Echocardiography 24:567–571

    Article  PubMed  Google Scholar 

  30. Prasad A, Popovic ZB, Arbab-Zadeh A, Fu Q, Palmer D, Dijk E, Greenberg NL, Garcia MJ, Thomas JD, Levine BD (2007) The effects of aging and physical activity on Doppler measures of diastolic function. Am J Cardiol 99:1629–1636

    Article  PubMed  Google Scholar 

  31. Borlaug BA, Melenovsky V, Redfield MM, Kessler K, Chang HJ, Abraham TP, Kass DA (2007) Impact of arterial load and loading sequence on left ventricular tissue velocities in humans. J Am Coll Cardiol 50:1570–1577

    Article  PubMed  Google Scholar 

  32. Campbell M (1970) Natural history of atrial septal defect. Br Heart J 32:820–826

    Article  PubMed  CAS  Google Scholar 

  33. Oliver JM, Gallego P, Gonzalez A, Benito F, Mesa JM, Sobrino JA (2002) Predisposing conditions for atrial fibrillation in atrial septal defect with and without operative closure. Am J Cardiol 89:39–43

    Article  PubMed  Google Scholar 

  34. Steele PM, Fuster V, Cohen M, Ritter DG, McGoon DC (1987) Isolated atrial septal defect with pulmonary vascular obstructive disease—long-term follow-up and prediction of outcome after surgical correction. Circulation 76:1037–1042

    Article  PubMed  CAS  Google Scholar 

  35. Thomson JD, Aburawi EH, Watterson KG, Van Doorn C, Gibbs JL (2002) Surgical and transcatheter (Amplatzer) closure of atrial septal defects: a prospective comparison of results and cost. Heart 87:466–469

    Article  PubMed  CAS  Google Scholar 

  36. Santoro G, Pascotto M, Caputo S, Cerrato F, Cappelli Bigazzi M, Palladino MT, Iacono C, Carrozza M, Russo MG, Calabro R (2006) Similar cardiac remodelling after transcatheter atrial septal defect closure in children and young adults. Heart 92:958–962

    Article  PubMed  CAS  Google Scholar 

  37. Salehian O, Horlick E, Schwerzmann M, Haberer K, McLaughlin P, Siu SC, Webb G, Therrien J (2005) Improvements in cardiac form and function after transcatheter closure of secundum atrial septal defects. J Am Coll Cardiol 45:499–504

    Article  PubMed  Google Scholar 

  38. Pascotto M, Caso P, Santoro G, Caso I, Cerrato F, Pisacane C, D’Andrea A, Severino S, Russo MG, Calabro R (2004) Analysis of right ventricular Doppler tissue imaging and load dependence in patients undergoing percutaneous closure of atrial septal defect. Am J Cardiol 94:1202–1205

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors gratefully acknowledge Chihiro Mihara, BS, and Yuko Mimura, BS, for their dedicated echocardiographic data collection. This study was supported by national grant (no. 8025127) from the Japan Society for the Promotion of Science and Medical Research (Dr. Senzaki), Grants from Nipro Corporation (Dr. Senzaki), Kawano Memorial Foundation (Dr. Senzaki), and Tenshindo Medical Institution (Dr. Senzaki).

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Authors and Affiliations

  1. Department of Pediatric Cardiology and Cardiovascular Surgery, International Medical Center, Saitama Medical University, Staff Office Building 419, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan

    Satoshi Masutani, Mio Taketazu, Hirotaka Ishido, Yoichi Iwamoto, Shigeki Yoshiba, Tamotsu Matsunaga, Toshiki Kobayashi & Hideaki Senzaki

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  1. Satoshi Masutani
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  2. Mio Taketazu
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  3. Hirotaka Ishido
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Correspondence to Satoshi Masutani.

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Masutani, S., Taketazu, M., Ishido, H. et al. Effects of age on hemodynamic changes after transcatheter closure of atrial septal defect: importance of ventricular diastolic function. Heart Vessels 27, 71–78 (2012). https://doi.org/10.1007/s00380-011-0122-8

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  • DOI: https://doi.org/10.1007/s00380-011-0122-8

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