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Risk Factors for Pulmonary Hypertension in Adults After Atrial Septal Defect Closure.

Roxanne D Zwijnenburg1, Vivan J M Baggen1, Maarten Witsenburg2

  • 1Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands; Cardiovascular Research School COEUR, Rotterdam, the Netherlands.

The American Journal of Cardiology
|February 3, 2019
PubMed
Summary
This summary is machine-generated.

Atrial septal defect (ASD) closure significantly reduces pulmonary hypertension (PH) prevalence from 13.1% to 5.0%. Patients with severe symptoms, lung disease, or poor heart function before closure face higher PH risks post-procedure.

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Area of Science:

  • Cardiology
  • Pulmonology
  • Medical Diagnostics

Background:

  • Atrial septal defect (ASD) closure aims to prevent pulmonary hypertension (PH), a condition linked to adverse outcomes.
  • PH prevalence and risk factors post-ASD closure in adults require further investigation.

Purpose of the Study:

  • To determine the prevalence of PH in adults before and after ASD closure.
  • To identify patient characteristics associated with the development of PH after ASD closure.

Main Methods:

  • Retrospective analysis of echocardiograms from adult patients undergoing ASD closure (2000-2014).
  • Patients categorized into no PH, possible PH, or PH groups based on echocardiographic parameters.
  • Cox regression analysis to identify predictors of PH post-closure.

Main Results:

  • PH prevalence decreased from 13.1% before closure to 5.0% after closure in 198 adult patients.
  • Significant predictors of post-closure PH included high New York Heart Association class, pulmonary disease, cardiac medication use, and impaired right ventricular function.

Conclusions:

  • Adult patients with normal pulmonary pressures pre-closure have a low risk of developing PH.
  • PH remains a concern in approximately 5% of patients post-closure, particularly those with pre-existing risk factors.