Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults
Abstract Background Secundum atrial septal defect (ASD) closure leads to electrical and mechanical remodeling that occurs early after shunt disappearance. The relationship between electromechanical remodeling using electrocardiogram (ECG) and cardiac magnetic resonance (CMR) after percutaneous and s...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-06-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-021-00174-5 |
| _version_ | 1818436206669594624 |
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| author | Amr Mansour Noha M. Gamal M. Alaa Nady Salwa R. Demitry H. Shams-Eddin Khaled M. El-maghraby |
| author_facet | Amr Mansour Noha M. Gamal M. Alaa Nady Salwa R. Demitry H. Shams-Eddin Khaled M. El-maghraby |
| author_sort | Amr Mansour |
| collection | DOAJ |
| description | Abstract Background Secundum atrial septal defect (ASD) closure leads to electrical and mechanical remodeling that occurs early after shunt disappearance. The relationship between electromechanical remodeling using electrocardiogram (ECG) and cardiac magnetic resonance (CMR) after percutaneous and surgical closure has not yet been recorded in prospective studies. Objective We thought to study right atrium (RA) and right ventricle (RV) changes by CMR 3 months after transcatheter and surgical closure and their comparison with electrical remodeling by ECG. Results We prospectively evaluated 30 consecutive adult patients with isolated secundum ASD who were referred for (transcatheter and surgical) ASD closure. There was significant reduction in all of the electrical parameters within the same group as compared to the baseline values, except P wave dispersion (Pd). (P max was 97.33 ± 16.67 (pre closure) to 76 ± 15.49 (post closure) in the device group and 97.33 ± 12.79 (preclosure) to 73.33 ± 16.32 (post closure) in the surgical group, QRS complex was 104 ± 18.82 (preclosure) to 80 ± 18.51 (post closure) in the device group and 106.67 ± 14.47 (preclosure) to 86.67 ± 17.99 (post closure) in the surgical group. QTc maximum was 478.53 ± 36.79 (preclosure) to 412.53 ± 38.03 (post closure) in the device group and 470.53 ± 65.70 (preclosure) to 405.93 ± 63.08 (post closure) in the surgical group, and QTc dispersion was 70.33 ± 24.04 (preclosure) to 60.26 ± 28.56 (post closure) in the device group and 80.73 ± 30.38 (preclosure) to 60.27 ± 28.57 (post closure) in the surgical group).There was no significant difference between two groups indicating that transcatheter and surgical closure had led to equivalent value of electrical remodeling. In CMR study, we measured RA maximal volume and right ventricle end diastolic volume (RVEDV), RA maximal volume decreased significantly as compared to the base line values post closure in both groups (P value < 0.001). The reduction in RA max volume was more in the transcatheter closure group; however, this difference was not statistically significant when compared with the surgical arm (P value = 0.5).RVEDV decreased significantly in both groups as compared to the baseline values (P value < 0.001). Transcatheter closure resulted in more significant reduction in the RVEDV than the surgical closure (P value = 0.03). Conclusion Our study showed early significant electromechanical reverse remodeling in most of the study parameters from the baseline values after ASD closure. We found no significant differences in all of the electrical and RA mechanical remodeling parameters with significantly better mechanical remodeling of RV in the device group. |
| first_indexed | 2024-12-14T17:05:06Z |
| format | Article |
| id | doaj.art-74c0c2fa67fd44acbdca62bee2d14841 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-12-14T17:05:06Z |
| publishDate | 2021-06-01 |
| publisher | SpringerOpen |
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| series | The Egyptian Heart Journal |
| spelling | doaj.art-74c0c2fa67fd44acbdca62bee2d148412022-12-21T22:53:45ZengSpringerOpenThe Egyptian Heart Journal2090-911X2021-06-0173111010.1186/s43044-021-00174-5Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adultsAmr Mansour0Noha M. Gamal1M. Alaa Nady2Salwa R. Demitry3H. Shams-Eddin4Khaled M. El-maghraby5Cardiology Department, Congenital and Structural Heart Disease Unit, Faculty of Medicine, Ain Shams University HospitalsCardiology Department, Faculty of Medicine, Assiut UniversityCardiothoracic Surgery Department, Faculty of Medicine, Assiut UniversityCardiology Department, Faculty of Medicine, Assiut UniversityCardiology Department, Faculty of Medicine, Assiut UniversityCardiology Department, Faculty of Medicine, Assiut UniversityAbstract Background Secundum atrial septal defect (ASD) closure leads to electrical and mechanical remodeling that occurs early after shunt disappearance. The relationship between electromechanical remodeling using electrocardiogram (ECG) and cardiac magnetic resonance (CMR) after percutaneous and surgical closure has not yet been recorded in prospective studies. Objective We thought to study right atrium (RA) and right ventricle (RV) changes by CMR 3 months after transcatheter and surgical closure and their comparison with electrical remodeling by ECG. Results We prospectively evaluated 30 consecutive adult patients with isolated secundum ASD who were referred for (transcatheter and surgical) ASD closure. There was significant reduction in all of the electrical parameters within the same group as compared to the baseline values, except P wave dispersion (Pd). (P max was 97.33 ± 16.67 (pre closure) to 76 ± 15.49 (post closure) in the device group and 97.33 ± 12.79 (preclosure) to 73.33 ± 16.32 (post closure) in the surgical group, QRS complex was 104 ± 18.82 (preclosure) to 80 ± 18.51 (post closure) in the device group and 106.67 ± 14.47 (preclosure) to 86.67 ± 17.99 (post closure) in the surgical group. QTc maximum was 478.53 ± 36.79 (preclosure) to 412.53 ± 38.03 (post closure) in the device group and 470.53 ± 65.70 (preclosure) to 405.93 ± 63.08 (post closure) in the surgical group, and QTc dispersion was 70.33 ± 24.04 (preclosure) to 60.26 ± 28.56 (post closure) in the device group and 80.73 ± 30.38 (preclosure) to 60.27 ± 28.57 (post closure) in the surgical group).There was no significant difference between two groups indicating that transcatheter and surgical closure had led to equivalent value of electrical remodeling. In CMR study, we measured RA maximal volume and right ventricle end diastolic volume (RVEDV), RA maximal volume decreased significantly as compared to the base line values post closure in both groups (P value < 0.001). The reduction in RA max volume was more in the transcatheter closure group; however, this difference was not statistically significant when compared with the surgical arm (P value = 0.5).RVEDV decreased significantly in both groups as compared to the baseline values (P value < 0.001). Transcatheter closure resulted in more significant reduction in the RVEDV than the surgical closure (P value = 0.03). Conclusion Our study showed early significant electromechanical reverse remodeling in most of the study parameters from the baseline values after ASD closure. We found no significant differences in all of the electrical and RA mechanical remodeling parameters with significantly better mechanical remodeling of RV in the device group.https://doi.org/10.1186/s43044-021-00174-5Transcatheter ASD closureSurgical ASD closureElectrical remodelingMechanical remodelingCardiac MRI |
| spellingShingle | Amr Mansour Noha M. Gamal M. Alaa Nady Salwa R. Demitry H. Shams-Eddin Khaled M. El-maghraby Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults The Egyptian Heart Journal Transcatheter ASD closure Surgical ASD closure Electrical remodeling Mechanical remodeling Cardiac MRI |
| title | Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| title_full | Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| title_fullStr | Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| title_full_unstemmed | Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| title_short | Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| title_sort | comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults |
| topic | Transcatheter ASD closure Surgical ASD closure Electrical remodeling Mechanical remodeling Cardiac MRI |
| url | https://doi.org/10.1186/s43044-021-00174-5 |
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