Right Heart Remodeling and Autonomic Function After Atrial Septal Defect Closure in Children: Surgical Versus...

Area of Science:

• Cardiology
• Physiology

Background:

• Atrial septal defect (ASD) leads to chronic right ventricular (RV) volume overload.
• Successful ASD closure is expected to normalize RV function and autonomic regulation.

Purpose of the Study:

• To evaluate mid-term RV mechanics and autonomic regulation after ASD closure.
• To compare outcomes between surgical and transcatheter ASD closure methods.

Main Methods:

• Compared patients with secundum ASD post-closure to healthy controls.
• Assessed RV systolic function, dimensions, and autonomic balance using heart rate variability (HRV).

Main Results:

• Patients showed subclinical RV systolic impairment and persistent RV enlargement post-closure.
• Autonomic assessment indicated sympathovagal imbalance (higher LF/HF ratio).
• Surgical closure was associated with lower TAPSE and more abnormal RV S' compared to transcatheter closure.

Conclusions:

• ASD closure does not uniformly restore RV mechanics or autonomic balance in the mid-term.
• Further research is needed to understand the clinical implications of these persistent abnormalities.