[Cardiopulmonary capacity and hemodynamic changes in adults with atrial septal defect]

Little is known about the relation between echocardiographic parameters and cardiopulmonary capacity in patients with atrial septal defect (ASD). The study aimed to assess the value of right atrial, right ventricle and left ventricle dimensions and function in predicting cardiopulmonary capacity in adults with ASD. 52 consecutive adult patients with hemodynamic significant ASD (mean age 38.6+/-15, range: 18-68 years; mean Qp/Qs: 2.7+/-0.7, range: 1.5-4.3) were enrolled into the study. The right ventricle indices were defined as follows: end-diastolic and end-systolic area, ejection fraction (area-length method) and right ventricle systolic pressure (RVSP). The following right atrial parameters were taken into consideration: end-diastolic and end-systolic right atrial area. Left ventricular systolic and diastolic diameters and LV ejection fraction were measured as well. All patients underwent the cardiopulmonary exercise test (CPX) with estimation of peak oxygen uptake -VO2, anaerobic threshold -AT and VE/VCO2. The mean VO2 was 23.4+/-18.4 ml/kg/min (63+/-18.4% of the predicted value). The dimensions and ejection fraction of left ventricle did not correlate significantly with any CPX parameter. Echocardiographic parameters of both right atrial and right ventricle function were related to peak oxygen uptake in adults with ASD. The strongest correlation between VO2peak and RVSP was found (r=-0.7; p<0.001). Echocardiography seems to be efficient in predicting cardiopulmonary capacity in ASD patients.