Publication
Title
A different view on predictors of pulmonary hypertension in secundum atrial septal defect
Author
Abstract
Background/objectives: Pulmonary arterial hypertension is an important complication in hemodynamically relevant atrial septal defects (ASD) and negatively affects outcome. This retrospective study aimed at (1) estimating the prevalence of pulmonary hypertension (PH) in patients with secundum ASD and (2) identifying predictors of PH development or persistence after ASD closure. Methods: Consecutive patients with an isolated secundum ASD from the Belgian Registry on Adult Congenital Heart Disease were studied. Demographic, clinical, echocardiographic and invasive hemodynamic measurements were analyzed. PH was defined upon the echocardiographic PH probability (tricuspid regurgitation velocity = 2.9 m/s). Results: PH prevalence in the entire ASD population (295 patients, 68.8% females, mean age 46 +/- 21 years) was 15.9% compared to 13.3% in patients after ASD closure. PH after ASD closure was significantly related to mortality (p = 0.001), atrial arrhythmia (p < 0.001) and right heart failure (p = 0.019). Age at repair was the most important predictor for PH (HR 1.11). In the highest tertile of age at repair (>55 years), PH prevalence was the highest (34%) and mean pulmonary artery pressure (mPAP) at catheterization before was related to PH after closure (HR 1.09). Twenty patients in the PH group had mPAp <25 mm Hg before closure. Conclusions: PH in closed secundum ASD patients is not uncommon. Its prevalence was the highest when the defect was repaired above 55 years of age. Clinical outcome was worse. PH may even develop despite normal mPAp before closure. The present findings raise the question whether the cutoff value for mPAp before closure should be age-adjusted. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
Language
English
Source (journal)
International journal of cardiology. - Amsterdam, 1981, currens
Publication
Amsterdam : 2014
ISSN
0167-5273
DOI
10.1016/J.IJCARD.2014.08.009
Volume/pages
176 :3 (2014) , p. 833-840
ISI
000343893300065
Pubmed ID
25149406
Full text (Publisher's DOI)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 10.12.2014
Last edited 09.10.2023
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