Effects of Transcatheter Atrial Septal Defect Closure in Elderly Patients with Long-Standing Persistent Atrial Fibrillation.

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International heart journal Pub Date : 2025-01-01 DOI:10.1536/ihj.25-244

Yuki Matsubara, Michiyo Yamano, Tetsuhiro Yamano, Takeshi Nakamura, Naohiko Nakanishi, Kan Zen, Hirokazu Shiraishi, Satoaki Matoba

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Abstract

Although the safety and efficacy of transcatheter atrial septal defect (ASD) closure has been reported in elderly patients, postprocedural outcomes in elderly patients with long-standing persistent atrial fibrillation (AF) have not been fully assessed. The aim of this study was to elucidate the cardiac remodeling process and symptom improvement after transcatheter ASD closure in elderly patients with AF (AF-ASD) compared to those in sinus rhythm (SR-ASD).We enrolled 52 patients aged > 70 years out of 253 consecutive patients who underwent transcatheter ASD closure. We retrospectively analyzed serial echocardiograms, New York Heart Association (NYHA) functional classification, and plasma brain natriuretic peptide (BNP) levels from baseline to 1 year after the procedure.With respect to the right-sided chambers, significant reverse remodeling began immediately after the procedure and continued in both groups up to 1 year after the procedure. Left ventricular augmentation was comparable in both groups. Left atrial volume increase was prominent in the AF-ASD group, with a statistically significant difference compared with the SR-ASD group from 2 days to 1 year after the procedure (all P < 0.05). NYHA functional classification improved in both groups. Plasma BNP levels decreased only in the AF-ASD group from baseline to 1 year (median value [interquartile range], 336.2 pg/mL [145.1-491.4] to 173.8 pg/mL [73.6-261.7], P = 0.032).Transcatheter ASD closure is an effective treatment for heart failure in elderly patients with ASD and long-standing persistent AF.

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经导管房间隔缺损封堵对老年长期持续性心房颤动患者的影响。

虽然经导管房间隔缺损（ASD）关闭在老年患者中的安全性和有效性已有报道，但长期持续性心房颤动（AF）老年患者的术后预后尚未得到充分评估。本研究的目的是阐明老年房颤（AF-ASD）患者与窦性心律（SR-ASD）患者相比，经导管ASD关闭后心脏重塑过程和症状改善。我们从253例连续接受经导管ASD闭合治疗的患者中招募了52例年龄在50 ~ 70岁之间的患者。我们回顾性分析了从基线到手术后1年的连续超声心动图、纽约心脏协会（NYHA）功能分类和血浆脑利钠肽（BNP）水平。对于右侧心室，手术后立即开始明显的反向重塑，并在两组中持续到手术后1年。两组左心室增强效果相当。AF-ASD组左房容积增大明显，术后2 d ~ 1年与SR-ASD组比较，差异有统计学意义（P < 0.05）。两组患者NYHA功能分级均有改善。血浆BNP水平仅在AF-ASD组从基线到1年内下降（中位数[四分位数范围]，336.2 pg/mL[145.1-491.4]至173.8 pg/mL [73.6-261.7], P = 0.032）。经导管ASD闭合是老年ASD合并长期持续性房颤患者心力衰竭的有效治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International heart journal 医学-心血管系统

CiteScore

2.50

自引率

6.70%

发文量

148

审稿时长

6-12 weeks

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