Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect

Objective. The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. Background. RV dilatation is an indication of tra...

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Main Authors: Rie Nakayama, Yoichi Takaya, Teiji Akagi, Koji Nakagawa, Nobuhisa Watanabe, Saori Nobusada, Toshi Matsushita, Norihisa Toh, Susumu Kanazawa, Hiroshi Ito
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Interventional Cardiology
Online Access:http://dx.doi.org/10.1155/2020/9509105
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author Rie Nakayama
Yoichi Takaya
Teiji Akagi
Koji Nakagawa
Nobuhisa Watanabe
Saori Nobusada
Toshi Matsushita
Norihisa Toh
Susumu Kanazawa
Hiroshi Ito
author_facet Rie Nakayama
Yoichi Takaya
Teiji Akagi
Koji Nakagawa
Nobuhisa Watanabe
Saori Nobusada
Toshi Matsushita
Norihisa Toh
Susumu Kanazawa
Hiroshi Ito
author_sort Rie Nakayama
collection DOAJ
description Objective. The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. Background. RV dilatation is an indication of transcatheter ASD closure; however, few studies have reported the clinical significance of RV dilatation. Methods. We enrolled 82 consecutive patients (mean age, 49 ± 18 years; female, 68%) who underwent cardiac magnetic resonance imaging and symptom-limited cardiopulmonary exercise test before ASD closure. The relationship between RV volume and peak oxygen uptake (VO2) was evaluated. Results. The mean RV end-diastolic volume index was 108 ± 27 ml/m2 (range, 46 to 180 ml/m2). The mean peak VO2 was 24 ± 7 ml/min/kg (range, 14 to 48 ml/min/kg), and the mean predicted peak VO2 was 90 ± 23%. There were significant negative relationships of RV end-diastolic volume index with peak VO2 (r = −0.28, p<0.01) and predicted peak VO2 (r = −0.29, p<0.01). The cutoff value of RV end-diastolic volume index <80% of predicted peak VO2 was 120 ml/m2, with the sensitivity of 49% and the specificity of 89%. Conclusions. There was a relationship between RV dilatation and exercise capacity in adult patients with ASD. RV end-diastolic volume index ≥120 ml/m2 was related to the reduction in peak VO2. This criterion of RV dilatation may be valuable for the indication of transcatheter ASD closure.
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spelling doaj-art-bc245cdf8cc94f788789bbcd9fae78d82025-08-20T02:18:42ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/95091059509105Impact of Right Ventricular Dilatation in Patients with Atrial Septal DefectRie Nakayama0Yoichi Takaya1Teiji Akagi2Koji Nakagawa3Nobuhisa Watanabe4Saori Nobusada5Toshi Matsushita6Norihisa Toh7Susumu Kanazawa8Hiroshi Ito9Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDivision of Medical Support, Okayama University Hospital, Okayama, JapanDivision of Medical Support, Okayama University Hospital, Okayama, JapanDivision of Medical Support, Okayama University Hospital, Okayama, JapanDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanDepartment of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, JapanObjective. The aim of this study was to examine the relationship between right ventricular (RV) volume and exercise capacity in adult patients with atrial septal defect (ASD) and to determine the degree of RV dilatation for transcatheter ASD closure. Background. RV dilatation is an indication of transcatheter ASD closure; however, few studies have reported the clinical significance of RV dilatation. Methods. We enrolled 82 consecutive patients (mean age, 49 ± 18 years; female, 68%) who underwent cardiac magnetic resonance imaging and symptom-limited cardiopulmonary exercise test before ASD closure. The relationship between RV volume and peak oxygen uptake (VO2) was evaluated. Results. The mean RV end-diastolic volume index was 108 ± 27 ml/m2 (range, 46 to 180 ml/m2). The mean peak VO2 was 24 ± 7 ml/min/kg (range, 14 to 48 ml/min/kg), and the mean predicted peak VO2 was 90 ± 23%. There were significant negative relationships of RV end-diastolic volume index with peak VO2 (r = −0.28, p<0.01) and predicted peak VO2 (r = −0.29, p<0.01). The cutoff value of RV end-diastolic volume index <80% of predicted peak VO2 was 120 ml/m2, with the sensitivity of 49% and the specificity of 89%. Conclusions. There was a relationship between RV dilatation and exercise capacity in adult patients with ASD. RV end-diastolic volume index ≥120 ml/m2 was related to the reduction in peak VO2. This criterion of RV dilatation may be valuable for the indication of transcatheter ASD closure.http://dx.doi.org/10.1155/2020/9509105
spellingShingle Rie Nakayama
Yoichi Takaya
Teiji Akagi
Koji Nakagawa
Nobuhisa Watanabe
Saori Nobusada
Toshi Matsushita
Norihisa Toh
Susumu Kanazawa
Hiroshi Ito
Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
Journal of Interventional Cardiology
title Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
title_full Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
title_fullStr Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
title_full_unstemmed Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
title_short Impact of Right Ventricular Dilatation in Patients with Atrial Septal Defect
title_sort impact of right ventricular dilatation in patients with atrial septal defect
url http://dx.doi.org/10.1155/2020/9509105
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