Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis
Structured Abstract: Background: While percutaneous closure is preferred in adults with a patent ductus arteriosus (PDA), the extent of cardiac remodeling following percutaneous PDA closure in adults is not well understood. We performed a meta-analysis to characterize cardiac remodeling following p...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2021-08-01
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| Series: | International Journal of Cardiology Congenital Heart Disease |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666668521000732 |
| _version_ | 1818657633622556672 |
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| author | Sarah Blissett Harsh Agrawal Ahmed Kheiwa Hope Caughron Ian S. Harris Anu Agarwal Elyse Foster Indika Mallawaarachchi Vaikom S. Mahadevan |
| author_facet | Sarah Blissett Harsh Agrawal Ahmed Kheiwa Hope Caughron Ian S. Harris Anu Agarwal Elyse Foster Indika Mallawaarachchi Vaikom S. Mahadevan |
| author_sort | Sarah Blissett |
| collection | DOAJ |
| description | Structured Abstract: Background: While percutaneous closure is preferred in adults with a patent ductus arteriosus (PDA), the extent of cardiac remodeling following percutaneous PDA closure in adults is not well understood. We performed a meta-analysis to characterize cardiac remodeling following percutaneous PDA closure in adults. Methods: MEDLINE and EMBASE were systematically searched for original studies that reported echocardiographic variables at baseline, immediately post-procedure (24 h), and at follow-up (>1 month) in adults undergoing percutaneous PDA closure. Additionally, we included data from patients >18 years of age that underwent percutaneous PDA closure between January 2015–December 2019 at our centre. Weighted averages were calculated for parameters with sufficient data. Pooled differences were presented as weighted mean differences (WMD). Results: After screening 278 abstracts, 5 studies were identified. When combined with our cohort, our meta-analysis encompassed 244 patients. Immediately post-procedure, LVEF was the only parameter to change significantly (64 vs 52%, WMD -8.64 95%, CI -14.04 to −3.25). All parameters significantly decreased from baseline to follow-up: LVEF: 64 vs 60% (WMD -3.95, CI -5.80 to −2.09), LVEDD: 62 vs 53 mm (WMD -8.79, CI -12.78 to −4.81) LVEDVI 172 vs 123 mL/m2 (WMD -26.60, CI -45.4 to −7.85), LVESD 42 vs 36 mm (WMD -4.64, CI -9.10 to −0.17) and LA dimension: 42 vs 37 mm (WMD -5.87, CI -9.85 to −1.90). Conclusions: As compared to the baseline values, left ventricular and left atrial sizes decreased. The LVEF decreased immediately following PDA closure and, while it recovers, it remained lower on follow-up testing. |
| first_indexed | 2024-12-17T03:44:35Z |
| format | Article |
| id | doaj.art-a4380528155740208df71c3f52aec776 |
| institution | Directory Open Access Journal |
| issn | 2666-6685 |
| language | English |
| last_indexed | 2024-12-17T03:44:35Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology Congenital Heart Disease |
| spelling | doaj.art-a4380528155740208df71c3f52aec7762022-12-21T22:04:55ZengElsevierInternational Journal of Cardiology Congenital Heart Disease2666-66852021-08-014100149Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysisSarah Blissett0Harsh Agrawal1Ahmed Kheiwa2Hope Caughron3Ian S. Harris4Anu Agarwal5Elyse Foster6Indika Mallawaarachchi7Vaikom S. Mahadevan8University of California San Francisco, Department of Medicine, San Francisco, California, USA; Western University, Department of Medicine, London, CanadaUniversity of California San Francisco, Department of Medicine, San Francisco, California, USALoma Linda University, Department of Medicine, USAUniversity of California San Francisco, Department of Medicine, San Francisco, California, USAUniversity of California San Francisco, Department of Medicine, San Francisco, California, USAUniversity of California San Francisco, Department of Medicine, San Francisco, California, USAUniversity of California San Francisco, Department of Medicine, San Francisco, California, USADepartment of Public Health Sciences, School of Medicine, University of Virginia, Charlottesville, Virginia, USAUniversity of California San Francisco, Department of Medicine, San Francisco, California, USA; Corresponding author. University of California San Francisco, 505 Parnassus Avenue, L524, UCSF Box 0103, San Francisco, CA, 94117, USA.Structured Abstract: Background: While percutaneous closure is preferred in adults with a patent ductus arteriosus (PDA), the extent of cardiac remodeling following percutaneous PDA closure in adults is not well understood. We performed a meta-analysis to characterize cardiac remodeling following percutaneous PDA closure in adults. Methods: MEDLINE and EMBASE were systematically searched for original studies that reported echocardiographic variables at baseline, immediately post-procedure (24 h), and at follow-up (>1 month) in adults undergoing percutaneous PDA closure. Additionally, we included data from patients >18 years of age that underwent percutaneous PDA closure between January 2015–December 2019 at our centre. Weighted averages were calculated for parameters with sufficient data. Pooled differences were presented as weighted mean differences (WMD). Results: After screening 278 abstracts, 5 studies were identified. When combined with our cohort, our meta-analysis encompassed 244 patients. Immediately post-procedure, LVEF was the only parameter to change significantly (64 vs 52%, WMD -8.64 95%, CI -14.04 to −3.25). All parameters significantly decreased from baseline to follow-up: LVEF: 64 vs 60% (WMD -3.95, CI -5.80 to −2.09), LVEDD: 62 vs 53 mm (WMD -8.79, CI -12.78 to −4.81) LVEDVI 172 vs 123 mL/m2 (WMD -26.60, CI -45.4 to −7.85), LVESD 42 vs 36 mm (WMD -4.64, CI -9.10 to −0.17) and LA dimension: 42 vs 37 mm (WMD -5.87, CI -9.85 to −1.90). Conclusions: As compared to the baseline values, left ventricular and left atrial sizes decreased. The LVEF decreased immediately following PDA closure and, while it recovers, it remained lower on follow-up testing.http://www.sciencedirect.com/science/article/pii/S2666668521000732Congenital heart diseasePatent ductus arteriosusMeta-analysis |
| spellingShingle | Sarah Blissett Harsh Agrawal Ahmed Kheiwa Hope Caughron Ian S. Harris Anu Agarwal Elyse Foster Indika Mallawaarachchi Vaikom S. Mahadevan Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis International Journal of Cardiology Congenital Heart Disease Congenital heart disease Patent ductus arteriosus Meta-analysis |
| title | Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis |
| title_full | Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis |
| title_fullStr | Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis |
| title_full_unstemmed | Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis |
| title_short | Cardiac remodeling in adults following percutaneous PDA closure: A meta-analysis |
| title_sort | cardiac remodeling in adults following percutaneous pda closure a meta analysis |
| topic | Congenital heart disease Patent ductus arteriosus Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666668521000732 |
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