Long-term efficacy of the treat-to-close strategy for patients with atrial septal defect-pulmonary artery hypertension and characteristics of indicated populations

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-11 DOI:10.1016/j.clinsp.2026.100861

Jianing Fan , Yuliang Long , Jin Qi , Dawei Lin , Feng Zhang , Zhi Zhan , Dandan Chen , Wenzhi Pan , Lihua Guan , Daxin Zhou , Junbo Ge

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引用次数: 0

Abstract

Objective

“Treat-to-close” strategy in the treatment of patients with Atrial Septal Defects (ASD) combined with severe Pulmonary Hypertension (PAH). This study explored the long-term survival of patients undergoing the “treat-to-close” strategy and the characteristics of the applicable population.

Methods

A total of 141 ASD-PAH patients were collected. Patients were classified as “Occlusion Group” (OG) and “Conservative Treatment Group” (CTG) depending on the suitability of ASD occlusion after drug treatment. The baseline characteristics and long-term follow-up outcomes of the two groups were recorded.

Results

Patients in the OG underwent 5 (3.8) months of Pulmonary Artery-targeted Drug Therapy (PADT) before ASD occlusion. OG patients had better long-term survival (p = 0.043). Pulmonary Vascular Resistance (PVR): Area Under the Curve (AUC) 0.813 (0.726‒0.899, p < 0.001), Pulmonary Arterial Oxygen Saturation (PASO2): AUC = 0.794 (95% CI: 0.682‒0.904 p < 0.001), Pulmonary Artery Systolic Pressure (PASP): AUC = 0.808 (95% Confidence Interval [95% CI]: 0.733‒0.883 p < 0.001) and PASO2 combined with PASP: 0.918 (95% CI: 0.854‒0.979 p < 0.001) contribute to the screening of drug-sensitive populations.

Conclusions

The treat-to-close strategy significantly improves long-term patient survival. Initial intraoperative indications can help screen the beneficiary population. Larger-scale prospective studies are needed to validate the present findings.

查看原文本刊更多论文

房间隔缺损-肺动脉高压患者治疗至闭合策略的长期疗效及适应症人群特点

目的探讨房间隔缺损（ASD）合并重度肺动脉高压（PAH）患者的“从治疗到封闭”治疗策略。本研究探讨了采用“治疗至闭合”策略的患者的长期生存率及适用人群的特点。方法收集141例ASD-PAH患者。根据药物治疗后ASD闭塞的适宜性将患者分为“闭塞组”（OG）和“保守治疗组”（CTG）。记录两组患者的基线特征及长期随访结果。结果OG组患者在ASD闭塞前接受了5（3.8）个月的肺动脉靶向药物治疗（PADT）。OG患者有较好的长期生存率（p = 0.043）。肺血管阻力（PVR）：曲线下面积（AUC） 0.813 (0.726-0.899, p < 0.001)，肺动脉氧饱和度（PASO2）： AUC = 0.794 (95% CI: 0.682-0.904 p < 0.001)，肺动脉收缩压（PASP）： AUC = 0.808(95%置信区间[95% CI]: 0.733-0.883 p < 0.001)， PASO2联合PASP: 0.918 （95% CI: 0.854-0.979 p < 0.001）有助于筛选药物敏感人群。结论治疗-闭合策略可显著提高患者的长期生存率。初始术中指征有助于筛选受益人群。需要更大规模的前瞻性研究来验证目前的发现。

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

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.