Abstract
We sought to assess the effects of percutaneous atrial septal defect (ASD) closure on blood biomarker levels that possibly reflect reverse cardiac remodeling. Therefore, this study investigated temporal changes in six blood biomarkers following percutaneous ASD closure in adults. In this prospective observational cohort study, adults with ASD type II scheduled for percutaneous closure were included (2012-2016). NT-proBNP, high-sensitive troponin-T (hs-TnT), high-sensitive C-reactive protein (hs-CRP), red blood cell distribution width (RDW), growth differentiation factor-15 (GDF-15) and galectin-3 were measured one day prior to ASD closure and one day, three months and one year post ASD closure, and changes were evaluated using paired T-tests. Echocardiographic measurements were obtained. Fifty patients were included (median age 50years, 62% women, 32% NYHA II). At baseline, biomarker levels were elevated in a substantial number of patients; NT-proBNP n=22 (45%), hs-TnT n=6 (13%) hs-CRP n=19 (40%), galectin-3 n=5 (11%) and GDF n=10 (23%). One day after ASD closure, significant increases of hs-TnT (median change (Δ)=12ng/L), hs-CRP (Δ=1.9mg/L), GDF-15(Δ=129pg/mL) and RDW (Δ=0.1%) were observed, and a decrease in galectin-3 (Δ=-1.0ng/mL). Consequently, 92% had at least one abnormal biomarker directly after closure. At three months biomarker levels returned to baseline, and while echocardiographic measures 1year post closure were indicative of reverse cardiac remodeling, biomarker levels did not further decrease. Percutaneous ASD closure in adults leads to a direct increase in most blood biomarkers, in particular hs-CRP and hs-TnT. After three months, biomarkers returned to baseline levels and remained stable up to one year.
Highlights
Atrial septal defect (ASD) accounts for approximately 13% of all congenital heart defects and is the second most prevalent congenital heart defect [1]
This study aimed to investigate the temporal changes of NT-proBNP, high sensitivity troponin-T, high sensitivity C-reactive protein (CRP), red cell distribution width (RDW), galectin-3 and growth differentiation factor-15 (GDF-15) following percutaneous atrial septal defect (ASD) closure in adults
Elevated biomarker levels at baseline were present in a substantial proportion of the patients: NT-proBNP in 22 patients (45%), high-sensitive troponin-T (hs-TnT) in 6 patients (13%), high-sensitive C-reactive protein (hs-CRP) in 19 patients (40%), galectin-3 in 5 patients (11%), GDF-15 in 10 patients (23%). (Table 1)
Summary
Atrial septal defect (ASD) accounts for approximately 13% of all congenital heart defects and is the second most prevalent congenital heart defect [1]. Biomarker levels were elevated in a substantial number of patients; NT-proBNP n = 22 (45%), hs-TnT n = 6 (13%) hs-CRP n = 19 (40%), galectin-3 n = 5 (11%) and GDF n = 10 (23%). One day after ASD closure, significant increases of hs-TnT (median change (D) = 12 ng/L), hs-CRP (D = 1.9 mg/L), GDF-15(D = 129 pg/ mL) and RDW (D = 0.1%) were observed, and a decrease in galectin-3 (D = À1.0 ng/mL). At three months biomarker levels returned to baseline, and while echocardiographic measures 1 year post closure were indicative of reverse cardiac remodeling, biomarker levels did not further decrease. Conclusion: Percutaneous ASD closure in adults leads to a direct increase in most blood biomarkers, in particular hs-CRP and hs-TnT. Biomarkers returned to baseline levels and remained stable up to one year
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