Related Experiment Video
Updated: Apr 18, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Enhanced platelet activity in atrial septal defect
Mehmet Gungor Kaya1, Deniz Elcik, Bekir Calapkorur
1aDepartment of Cardiology, Erciyes University School of Medicine, Kayseri, Turkey bDivision of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR.
Insights
Platelet activation, indicated by elevated mean platelet volume (MPV), is present in atrial septal defect (ASD) and linked to pulmonary vascular disease. Device closure of ASD significantly reverses this platelet hyperactivity.
Area of Science:
- Cardiology
- Hematology
- Pulmonary Hypertension
Background:
- Enhanced platelet activity, measured by mean platelet volume (MPV), is a known characteristic of pulmonary arterial hypertension.
- Atrial septal defect (ASD) can lead to pulmonary vascular disease, but the role of platelet activation in this context is less understood.
Purpose of the Study:
- To investigate platelet activation in adults with ASD.
- To determine the relationship between platelet activation and pulmonary vascular disease severity in ASD patients.
- To assess the impact of transcatheter ASD device closure on platelet activity.
Main Methods:
- Prospective enrollment of 76 consecutive patients undergoing transcatheter ASD closure and 40 healthy controls.
- Collection of blood samples for MPV measurement and transthoracic echocardiography to assess systolic pulmonary arterial pressures (PAP) and right ventricular end-diastolic diameters.
- Comparison of MPV, PAP, and ventricular dimensions before and 6 months after ASD device closure.
Main Results:
- Baseline MPV levels were significantly higher in ASD patients compared to controls (10.1 ± 1.3 fl vs. 8.6 ± 0.9 fl).
- A positive correlation was found between MPV and systolic PAP in ASD patients (r=0.542).
- Six months post-device closure, MPV, systolic PAP, and right ventricular end-diastolic diameters significantly decreased, returning to levels comparable to healthy individuals.
Conclusions:
- Adults with ASD exhibit enhanced platelet activity, evidenced by elevated MPV.
- This platelet hyperactivity is associated with the severity of pulmonary vascular disease in ASD.
- Transcatheter closure of ASD effectively reverses platelet activation and improves pulmonary hemodynamics.
Aims:
Enhanced platelet activity assessed by mean platelet volume (MPV) was observed in pulmonary arterial hypertension. This study examined the presence of platelet activation in adults with atrial septal defect (ASD), its relationship with pulmonary vascular disease and its changes following device closure of the defects.
Methods:
A total of 76 consecutive patients received transcatheter ASD closure and 40 matched healthy volunteers were prospectively enrolled for blood tests and transthoracic echocardiography (patients: aged 36 ± 13, 37% men; controls: aged 36 ± 8, 38% men). MPV, systolic pulmonary arterial pressures (PAP), and right ventricular end-diastolic diameters were collected before and after ASD closure in patients.
Results:
The mean MPV levels were significantly higher in patients than in controls (10.1 ± 1.3 to 8.6 ± 0.9 fl; P < 0.001) at baseline. A moderate, positive correlation was also observed between baseline MPV levels and systolic PAP (r = 0.542, P < 0.001) in patients. Both MPV levels, systolic PAP and right ventricular end-diastolic diameters reduced significantly 6 months following ASD closure. The 6-month MPV and systolic PAP values were comparable to those of the normals.
Conclusion:
Enhanced platelet activity was present in ASD and associated with the presence of pulmonary vascular disease. This phenomenon was largely reversible following device closure of the defects.
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