Left ventricular size and function after percutaneous closure of patent ductus arteriosus in Chinese adults.


Journal

International journal of cardiology
ISSN: 1874-1754
Titre abrégé: Int J Cardiol
Pays: Netherlands
ID NLM: 8200291

Informations de publication

Date de publication:
15 09 2020
Historique:
received: 10 11 2019
revised: 10 04 2020
accepted: 20 04 2020
pubmed: 26 4 2020
medline: 15 5 2021
entrez: 26 4 2020
Statut: ppublish

Résumé

Left ventricular (LV) systolic dysfunction can occur after patent ductus arteriosus (PDA) closure and data in adult Chinese patients are lacking. 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). 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 32333933
pii: S0167-5273(19)35588-3
doi: 10.1016/j.ijcard.2020.04.060
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

24-28

Informations de copyright

Copyright © 2020 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors have no conflicts of interest to disclose.

Auteurs

Zhi Zhan (Z)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Lihua Guan (L)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Wenzhi Pan (W)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Xiaochun Zhang (X)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Lei Zhang (L)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China.

Daxin Zhou (D)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: zhou_daxin@zs-hospital.sh.cn.

Junbo Ge (J)

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China; Institutes of Biomedical Sciences, Fudan University, Shanghai, China. Electronic address: jbge@zs-hospital.sh.cn.

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