Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2019, vol. 28, nr 8, August, p. 1079–1085

doi: 10.17219/acem/102440

Publication type: original article

Language: English

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Transcatheter closure of atrial septal communication: Impact on quality of life in mid-term follow-up

Maria Lelakowska1,A,B,C,D, Paweł Tomasz Matusik2,C,D,E, Piotr Stanisław Podolec3,F, Maria Olszowska3,E, Jadwiga Maria Nessler1,E, Natalia Podolec4,B, Tadeusz Przewłocki3,B, Monika Komar3,A,B

1 Department of Coronary Disease and Heart Failure, John Paul II Hospital, Kraków, Poland

2 Department of Electrocardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland

3 Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Kraków, Poland

4 Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland

Abstract

Background. Atrial septal defect (ASD) and patent foramen ovale (PFO) are specific types of atrial septal communications (ASC).
Objectives. We aimed to assess quality of life (QoL) in patients before and after percutaneous closure of ASC and determine the factors influencing QoL in this group of patients.
Material and Methods. We performed a clinical assessment and conducted an SF-36 questionnaire, electrocardiography and echocardiography studies in patients before and 6 months after percutaneous ASC closure.
Results. Patients with ASD (n = 56) had a lower SF-36 total score than those with PFO (n = 73), before and after percutaneous ASC occlusion (both p < 0.001). After the procedure, the improvement of SF-36 total score in patients with ASD or atrial fibrillation was greater (p < 0.001 and p = 0.005, respectively). We observed correlations between improvement of QoL and baseline supraventricular extrasystolic beats (rs = 0.28; p = 0.002), but not ventricular extrasystolic beats (rs = 0.03; p = 0.76). Quality of life improvement was predicted in patients with ASD by higher baseline tricuspid annular plane systolic excursion (TAPSE) and right ventricular longitudinal dimension R2 = 0.38; p < 0.001. However, in patients with PFO, this was predicted by TAPSE, lack of arterial hypertension and usage of angiotensin-converting enzyme inhibitors, R2 = 0.30; p < 0.001.
Conclusion. Patients with ASD have lower QoL than those with PFO before and after percutaneous ASC occlusion. Six months after the procedure, the improvement of QoL in patients with ASD was higher than in those with PFO. The change in QoL self-assessed by patients after the procedure was associated with episodes of arrhythmia and was predicted with echocardiographic and clinical parameters.

Key words

quality of life, patent foramen ovale, atrial septal defect, transcatheter closure

References (24)

  1. Komar M, Podolec P, Przewłocki T, et al. Transoesophageal echocardiography can help distinguish between patients with “symptomatic” and “asymptomatic” patent foramen ovale. Kardiol Pol. 2012;70(12):1258–1263.
  2. Hari P, Pai RG, Varadarajan P. Echocardiographic evaluation of patent foramen ovale and atrial septal defect. Echocardiography. 2015;32(Suppl 2):S110–124.
  3. Sabiniewicz R. Interventional, percutaneous closure of interatrial communication: Atrial septal defect and patent foramen ovale. Ann Acad Med Gedan. 2012;62 (Suppl. 4):1–219.
  4. Komar M, Przewłocki T, Olszowska M, Sobień B, Podolec P. The benefit of atrial septal defect closure in elderly patients. Clin Interv Aging. 2014;9:1101–1107.
  5. Komar M, Przewłocki T, Olszowska M, Sobień B, Tomkiewicz-Pająk L, Podolec P. Is it worth closing the atrial septal defect in patients with insig-nificant shunt? Postepy Kardiol Interwencyjnej. 2014;10(2):78–83.
  6. Komar M, Przewłocki T, Olszowska M, et al. Conduction abnormality and arrhythmia after transcatheter closure of atrial septal defect. Circ J. 2014;78(10):2415–2421.
  7. Podolec P, Przewłocki T, Pieculewicz M, et al. Early haemodynamic changes after transcatheter closure of atrial septal defect [in Polish]. Przegl Lek. 2004;61(6):640–643.
  8. Fang F, Luo XX, Lin QS, et al. Characterization of mid-term atrial geometrical and electrical remodeling following device closure of atrial septal defects in adults. Int J Cardiol. 2013;168(1):467–471.
  9. Lelakowska-Pieła M, Pudło J, Rydlewska A, Senderek T, Lelakowski J. Quality of life in patients after anti-arrhythmic devices implantation [in Polish]. Pol Merkur Lekarski. 2013;35(210):331–338.
  10. Liszniański P, Pudło J, Lelakowska-Pieła M, Nowak J, Lelakowski J. Analysis of RF ablation treatment on quality of life in patients with cardiac arrhythmias [in Polish]. Przegl Lek. 2015;72(1):1–5.
  11. Siudalska H, Lipczyńska M, Leszczyńska K, et al. Quality of life in patients following atrial septal defect surgical repair. Folia Cardiol. 2004;11(8):599–606.
  12. Cieślik B. Influence of the heart diseases on quality of life – literature review [in Polish]. Acta Bio-Opt Inf Med Biomed Eng. 2014;20(2):101–118.
  13. Lelakowska M, Komar M, Matusik PT, Nessler J, Podolec P, Olszow­ska M. Transcatheter closure of atrial septal communication: Impact on P-wave dispersion, duration and arrhythmia in mid-term follow-up. Kardiol Pol. 2018;76(10):1465–1473.
  14. Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118(23):714–833.
  15. Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: A report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23(7):685–713.
  16. Lang RM, Badano LP, Tsang W, et al; American Society of Echocardiography; European Association of Echocardiography. EAE/ASE recommendations for image acquisition and display using three-dimensional echocardiography. J Am Soc Echocardiogr. 2012;25(1):3–46.
  17. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.
  18. Błażejewski J, Sinkiewicz W. Echocardiographic assessment of the right heart – 2015 expert guidelines in clinical practice. Folia Cardiol. 2017;12:171–178.
  19. Pepi M, Evangelista A, Nihoyannopoulos P, et al; European Association of Echocardiography. Recommendations for echocardiography use in the diagnosis and management of cardiac sources of embolism: European Association of Echocardiography (EAE) (a registered branch of the ESC). Eur J Echocardiogr. 2010;11(6):461–476.
  20. Gutiérrez-Barrios A, Lacal-Peña JM, Vignau-Cano JM, et al. Silent early migration of a Figulla® septal occluder into the left ventricle. Kardiol Pol. 2017;75(7):724.
  21. Cottini M, Pergolini A, Musumeci F. Atrial septal defect occluder dislocation engaged through the tricuspid valve: Surgical removal via right thoracotomy. Kardiol Pol. 2017;75(3):279.
  22. Goreczny S, Bedair R, Bilska K, Morgan G. Retrieving a large embolised atrial septal occluder – hooked... and landed. Kardiol Pol. 2017;75(3):277.
  23. Wolfel EE. Effects of ACE inhibitor therapy on quality of life in patients with heart failure. Pharmacotherapy. 1998;18(6):1323–1334.
  24. Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: A systematic review and meta-analysis of observational studies. J Hypertens. 2011;29(2):179–188.
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