Chen Liang, Bai Yuan, Wang Fei-Yu, Zhang Zhi-Gang, Shan Xing-Hua, Chen Tao, Zhao Xian-Xian, Qin Yong-Wen
Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.
Chin Med J (Engl). 2015 Mar 20;128(6):780-3. doi: 10.4103/0366-6999.152617.
Permanent atrial fibrillation (AF) is the most common form of dysrhythmia associated with atrial septal defects (ASDs) in patients older than 40 years. However, little is known about cardiac remodeling after transcatheter closure in patients with permanent AF. This study was designed to compare cardiac events and remodeling effects after transcatheter closure in such patients.
Clinical data of 289 adult patients older than 40 years who underwent ASD closure at our center were analyzed retrospectively. Of them, 63 patients with permanent AF were assigned to the case group, and the other 226 patients without permanent AF were assigned to the control group. Cardiac events and changes in left and right cardiac cavity dimensions before the procedure and 6 months after the procedure were compared between the two groups.
Patients in the case group were significantly older than those in the control group. The right ventricular (RV) volume and right atrial (RA) volume were decreased significantly in both the groups during a median follow-up period of 6 months after closure (P < 0.001). The left atrial dimensions, left ventricular end-systolic dimensions, left ventricular end-diastolic dimensions and left ventricular ejection fraction showed no significant change before and after the procedure in both the groups. Changes of the RV volume and RA volume in the case group were significantly smaller than those in the control group (P = 0.005 and P < 0.001). The New York Heart Association cardiac function was improved in both the groups during the 6 months follow-up period.
The transcatheter closure of ASD can improve the cardiac remodeling and cardiac function in patients with or without AF.
永久性心房颤动（房颤）是40岁以上房间隔缺损（ASD）患者最常见的心律失常形式。然而，关于永久性房颤患者经导管封堵术后的心脏重塑情况知之甚少。本研究旨在比较此类患者经导管封堵术后的心脏事件和重塑效果。
回顾性分析在本中心接受ASD封堵的289例40岁以上成年患者的临床资料。其中，63例永久性房颤患者被分配到病例组，另外226例无永久性房颤患者被分配到对照组。比较两组术前及术后6个月的心脏事件以及左右心腔尺寸的变化。
病例组患者年龄显著大于对照组。在封堵术后6个月的中位随访期内，两组的右心室（RV）容积和右心房（RA）容积均显著减小（P<0.001）。两组术前及术后左心房尺寸、左心室收缩末期尺寸、左心室舒张末期尺寸和左心室射血分数均无显著变化。病例组RV容积和RA容积的变化显著小于对照组（P=0.005和P<0.001）。在6个月的随访期内，两组的纽约心脏协会心功能均得到改善。
ASD经导管封堵术可改善有或无房颤患者的心脏重塑和心功能。
