Assessment of left atrial function after percutaneous closure of patent foramen ovale.
BACKGROUND
The influence of atrial septal occluders in left atrial (LA) function after percutaneous closure of patent foramen ovale (PFO) has not been thoroughly studied.


METHODS
Twenty-five patients (mean age 40.7 ± 12 years) undergoing percutaneous PFO closure were enrolled in this study. Transthoracic echocardiogram (TTE) was performed 3 and 6 months before the procedure. Volumetric indices (active emptying fraction: LA AEF, expansion index: LA EI, and passive emptying fraction: LA PEF), strain and strain rate (SR), were calculated during the contractile, reservoir, and conduit LA phases for the lateral, anterior, and inferior LA walls with TTE.


RESULTS
After 3 months, a decrease in the SR of the LA anterior wall was observed (from 2.12 ± 0.22 to 1.66 ± 0.26, P < 0.045), while the LA lateral wall strain was found to be increased (from 0.708 ± 0.15 to 0.783 ± 0.159, P < 0.001). Moreover, simultaneously LA AEF was greater compared with baseline (from 31.0 ± 1.6 to 34.0 ± 1.6, P < 0.004). However, all these alterations reversed at 6 months.


CONCLUSIONS
Segmental LA function is altered transiently after percutaneous PFO closure with a septal occlude. The LA anterior wall SR decreases, while the lateral wall strain increases. The impact of these alterations needs further clarification.
1st Department of Cardiology, Hippokration Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece. vavouran@otenet.gr
Manolis
M
Vavuranakis
Charalampos
C
Kavouras
Ioannis
I
Vlasseros
Constantina
C
Aggeli
Ioannis
I
Felekos
Dimitrios A
DA
Vrachatis
Christodoulos
C
Stefanadis
D000328:Adult; D016275:Atrial Function; D013504:Cardiovascular Surgical Procedures / Q000295:instrumentation*; D004452:Echocardiography / Q000379:methods*; D055119:Elastic Modulus; D005260:Female; D054092:Foramen Ovale, Patent / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000295:instrumentation; D055989:Septal Occluder Device; D016896:Treatment Outcome
echocardiography; patent foramen ovale; strain; strain rate; structural heart disease