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Left ventricular size and function after percutaneous closure of patent ductus arteriosus in Chinese adults
Zhi Zhan1, Lihua Guan1, Wenzhi Pan1
1Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.
Background:
Left ventricular (LV) systolic dysfunction can occur after patent ductus arteriosus (PDA) closure and data in adult Chinese patients are lacking.
Methods:
We examined adult Chinese patients who underwent successful transcatheter PDA closure at Zhongshan Hospital. Echocardiographic studies were performed before closure, before discharge, and at 1, 3, 6, and 12 months after closure. A total of 430 patients were included between January 2010 and December 2016. Patients were divided into two groups based on LV end-diastolic diameter (LVEDD): Dilated LV Group: >56 mm (n = 191) and Non-dilated LV Group: ≤56 mm (n = 239).
Results:
LVEDD and LV ejection fraction (LVEF) were significantly decreased immediately after closure. Reductions in LVEDD (-10.5% ± 7.1% vs. -4.6% ± 7.0%, P < 0.001) and LVEF (-8.9% ± 12.6% vs. -2.1% ± 8.6%, P < 0.001) were greater in the Dilated LV Group. LV end-systolic diameter (LVESD) remained unchanged compared to levels before closure (-4.0% ± 5.4%, P = 0.257; -2.6% ± 5.4%, P = 0.201). 48 patients in the Dilated LV Group (25.1%) and 7 patients in the Non-dilated LV Group (2.9%) developed late LV systolic dysfunction. In multivariable analysis, LVEF ≥60%, LVEDD <63 mm, and mean pulmonary arterial pressure (mPAP) <29 mmHg were predictive of normal LV function after closure.
Conclusion:
Many adult Chinese patients developed early LV dysfunction after PDA closure and some patients developed late LV dysfunction. LVEF, LVEDD, and mPAP were identified as significant predictors of late LV systolic function.
