Abstract
Objective The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. Background RV dilatation is an indication of transcatheter ASD closure; however, few studies have reported the clinical significance of RV dilatation. Methods We enrolled 82 consecutive patients (mean age, 49 ± 18 years; female, 68%) who underwent cardiac magnetic resonance imaging and symptom-limited cardiopulmonary exercise test before ASD closure. The relationship between RV volume and peak oxygen uptake (VO2) was evaluated. Results The mean RV end-diastolic volume index was 108 ± 27 ml/m2 (range, 46 to 180 ml/m2). The mean peak VO2 was 24 ± 7 ml/min/kg (range, 14 to 48 ml/min/kg), and the mean predicted peak VO2 was 90 ± 23%. There were significant negative relationships of RV end-diastolic volume index with peak VO2 (r = −0.28, p < 0.01) and predicted peak VO2 (r = −0.29, p < 0.01). The cutoff value of RV end-diastolic volume index <80% of predicted peak VO2 was 120 ml/m2, with the sensitivity of 49% and the specificity of 89%. Conclusions There was a relationship between RV dilatation and exercise capacity in adult patients with ASD. RV end-diastolic volume index ≥120 ml/m2 was related to the reduction in peak VO2. This criterion of RV dilatation may be valuable for the indication of transcatheter ASD closure.
Highlights
Atrial septal defect (ASD) is the most common congenital heart disease with a left-to-right shunt in adults and is recognized in 7% of all congenital heart diseases [1]
Several studies have reported that transcatheter ASD closure results in right ventricular (RV) remodeling and exercise capacity improvement [9,10,11,12,13]
Cardiac magnetic resonance (CMR) imaging can accurately quantify RV volume. us, we hypothesized that RV dilatation evaluated by CMR imaging was closely related to exercise capacity. e aim of this study was to examine the relationship between RV volume and exercise capacity in patients with ASD and to determine the degree of RV dilatation for ASD closure
Summary
Atrial septal defect (ASD) is the most common congenital heart disease with a left-to-right shunt in adults and is recognized in 7% of all congenital heart diseases [1]. Transcatheter closure is a general therapy for secundum ASD [6, 7]. A significant left-to-right shunt causing right ventricular (RV) dilatation is an accepted indication of ASD closure [8]. Several studies have reported that transcatheter ASD closure results in RV remodeling and exercise capacity improvement [9,10,11,12,13]. The relationship between RV dilatation and the reduction in exercise capacity before ASD closure remains unclear. Cardiac magnetic resonance (CMR) imaging can accurately quantify RV volume. E aim of this study was to examine the relationship between RV volume and exercise capacity in patients with ASD and to determine the degree of RV dilatation for ASD closure Cardiac magnetic resonance (CMR) imaging can accurately quantify RV volume. us, we hypothesized that RV dilatation evaluated by CMR imaging was closely related to exercise capacity. e aim of this study was to examine the relationship between RV volume and exercise capacity in patients with ASD and to determine the degree of RV dilatation for ASD closure
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