PMID- 12356636
OWN - NLM
STAT- MEDLINE
DCOM- 20021024
LR  - 20220317
IS  - 1524-4539 (Electronic)
IS  - 0009-7322 (Linking)
VI  - 106
IP  - 14
DP  - 2002 Oct 1
TI  - Improvement in exercise capacity in asymptomatic and mildly symptomatic adults 
      after atrial septal defect percutaneous closure.
PG  - 1821-6
AB  - BACKGROUND: Controversy exists as to whether secundum atrial septal defects 
      (ASDs) in asymptomatic or mildly symptomatic New York Heart Association (NYHA) 
      class I or II adult patients should be closed. METHODS AND RESULTS: Thirty-seven 
      patients (24 females; mean age 49.4 years, range 19 to 76) with a mean pulmonary 
      to systemic flow ratio (Qp:Qs) of 2.1 (1.2 to 3.4) had a maximal oxygen uptake 
      (VO2max) determination and echocardiographic measurement of right ventricular 
      dimensions before and 6 months after elective percutaneous closure of ASD. At 
      baseline, mean VO2max was 23.5+/-6.4 mL/kg per minute and was higher in the 15 
      NYHA I patients than in the 22 NYHA II patients (27+/-6.9 versus 20.8+/-4.6 mL/kg 
      per minute; P=0.0015). VO2max increased significantly at 6 months (23.5+/-6.4 to 
      26.9+/-6.9 mL/kg per minute; P<0.0001). Improvement was as marked in NYHA I 
      (+22%; P<0.0001) as in NYHA II patients (+12%; P<0.0001), in patients with Qp:Qs 
      1.2 to 2.0 (+16%; P<0.0001) as in those with Qp:Qs >2 (+12%; P<0.0001), and in 
      patients > or =40 years of age (+14%; P<0.0001) as in those <40 years of age 
      (+16%; P<0.0001). Compared with 15 of 37 patients before closure, 35 of 37 
      patients were in NYHA I at 6 months. Right ventricular dimensions decreased 
      significantly (P<0.0001). CONCLUSIONS: Adult ASD patients significantly increase 
      their functional capacity after percutaneous defect closure. This is observed 
      even in patients classified as asymptomatic, in those with lesser shunts, and in 
      older patients. These findings suggest that ASD closure in an adult population 
      should be considered even in the absence of symptoms.
FAU - Brochu, Marie-Claude
AU  - Brochu MC
AD  - Montreal Heart Institute, Montreal, Quebec, Canada.
FAU - Baril, Jean-Francois
AU  - Baril JF
FAU - Dore, Annie
AU  - Dore A
FAU - Juneau, Martin
AU  - Juneau M
FAU - De Guise, Pierre
AU  - De Guise P
FAU - Mercier, Lise-Andree
AU  - Mercier LA
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - Circulation
JT  - Circulation
JID - 0147763
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Blood Pressure
MH  - *Cardiac Surgical Procedures/adverse effects
MH  - Echocardiography, Transesophageal
MH  - *Exercise Tolerance
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Function Tests
MH  - Heart Septal Defects, Atrial/classification/*physiopathology/surgery
MH  - Hemodynamics
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Minimally Invasive Surgical Procedures/adverse effects
MH  - Oxygen Consumption
MH  - Pulmonary Artery/physiology
MH  - Respiratory Function Tests
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Tricuspid Valve Insufficiency/etiology
EDAT- 2002/10/03 04:00
MHDA- 2002/10/31 04:00
CRDT- 2002/10/03 04:00
PHST- 2002/10/03 04:00 [pubmed]
PHST- 2002/10/31 04:00 [medline]
PHST- 2002/10/03 04:00 [entrez]
AID - 10.1161/01.cir.0000029924.90823.e0 [doi]
PST - ppublish
SO  - Circulation. 2002 Oct 1;106(14):1821-6. doi: 10.1161/01.cir.0000029924.90823.e0.