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Title: The increase of pulmonary artery pressures is higher in patients with an open ASD than in patients with a closed ASD
Authors: Van De Bruaene, Alexander ×
Hermans, Hadewich
Delcroix, Marion
Voigt, Jens-Uwe
Budts, Werner #
Issue Date: Dec-2009
Publisher: W.B. Saunders CO.
Conference: EUROECHO edition:13th location:Madrid, Spain date:10-12-2009
Article number: European Journal of Echocardiography
Abstract: Objective: A prospective, monocentric study was performed to analyze pulmonary haemodynamics in patients with an open and closed atrial septal defect (ASD). We hypothesized that patients with an open ASD more frequently develop higher pulmonary artery pressures.
Methods: Tricuspid regurgitation velocity (TRV), left ventricular (LV) and right ventricular (RV) velocity time integral (VTI) were measured by Doppler echocardiography during supine bicycle exercise in 6 patients with an open ASD and in 6 patients with a closed ASD. The protocol started at 25 Watts with increments of 25 Watts every 2-minute stage. 2D, Doppler and Tissue Doppler images were digitized at each stage for off-line analysis. Tricuspid regurgitation pressure gradient (TRPG) was estimated using the simplified Bernouillie equation; pulmonary vascular resistance (PVR) was estimated as the ratio of peak TRV and RV VTI.
Results: Whereas there was no difference in TRPG at rest (19,6  5,0 versus 22,15  8,2; p = 0,546), mean TRPGs at 125 Watts tended to be higher in patients with an open ASD compared to patients with a closed ASD (53,5  11,3 versus 36,7  2,5; p = 0,066). During exercis RV cardiac output were higher in patients with an open ASD (12,32  2,35 versus 6,75  0,67; p = 0,026 at 100 Watt). PVR tended to increase in patients with an open ASD (0,123  0,022 at rest; 0,208  0,036; p = 0,078), but not in patients with a closed ASD.
Conclusions: Patients with an open ASD more frequently develop higher pulmonary artery pressures compared to patients with a closed ASD. This response is likely due to higher RV cardiac output because of left-to-right shunting in patients with an open ASD and possibly also due to an increase in PVR at high RV cardiac output in these patients during exercise.
Publication status: published
KU Leuven publication type: IMa
Appears in Collections:Cardiology
Pneumology
× corresponding author
# (joint) last author

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