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首页> 外文期刊>The Egyptian Heart Journal >Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults
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Comparison of the early cardiac electromechanical remodeling following transcatheter and surgical secundum atrial septal defect closure in adults

机译：经导管和外科手术外隔缺损闭合闭合的早期心脏机电重塑的比较

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Background:Secundum atrial septal defect (ASD) closure leads to electrical and mechanical remodeling that occurs early after shunt disappearance. The relationship between electromechanical remodeling using electrocardiogram (ECG) and cardiac magnetic resonance (CMR) after percutaneous and surgical closure has not yet been recorded in prospective studies.ObjectiveWe thought to study right atrium (RA) and right ventricle (RV) changes by CMR 3 months after transcatheter and surgical closure and their comparison with electrical remodeling by ECG.ResultsWe prospectively evaluated 30 consecutive adult patients with isolated secundum ASD who were referred for (transcatheter and surgical) ASD closure.There was significant reduction in all of the electrical parameters within the same group as compared to the baseline values, except P wave dispersion (Pd). (P max was 97.33 ± 16.67 (pre closure) to 76 ± 15.49 (post closure) in the device group and 97.33 ± 12.79 (preclosure) to 73.33 ± 16.32 (post closure) in the surgical group, QRS complex was 104 ± 18.82 (preclosure) to 80 ± 18.51 (post closure) in the device group and 106.67 ± 14.47 (preclosure) to 86.67 ± 17.99 (post closure) in the surgical group. QTc maximum was 478.53 ± 36.79 (preclosure) to 412.53 ± 38.03 (post closure) in the device group and 470.53 ± 65.70 (preclosure) to 405.93 ± 63.08 (post closure) in the surgical group, and QTc dispersion was 70.33 ± 24.04 (preclosure) to 60.26 ± 28.56 (post closure) in the device group and 80.73 ± 30.38 (preclosure) to 60.27 ± 28.57 (post closure) in the surgical group).There was no significant difference between two groups indicating that transcatheter and surgical closure had led to equivalent value of electrical remodeling.In CMR study, we measured RA maximal volume and right ventricle end diastolic volume (RVEDV), RA maximal volume decreased significantly as compared to the base line values post closure in both groups (P value < 0.001). The reduction in RA max volume was more in the transcatheter closure group; however, this difference was not statistically significant when compared with the surgical arm (P value = 0.5).RVEDV decreased significantly in both groups as compared to the baseline values (P value < 0.001). Transcatheter closure resulted in more significant reduction in the RVEDV than the surgical closure (P value = 0.03).ConclusionOur study showed early significant electromechanical reverse remodeling in most of the study parameters from the baseline values after ASD closure. We found no significant differences in all of the electrical and RA mechanical remodeling parameters with significantly better mechanical remodeling of RV in the device group.
机译：背景：Secundum心房隔膜缺损（ASD）闭合导致电气和机械重塑，在分流消失后早期发生。在经皮和外科闭合后使用心电图（ECG）和心脏磁共振（CMR）的机电重塑与心脏磁共振（CMR）之间的关系尚未记录在预期的研究中。目的程认为，研究右心房（RA）和右心室（RV）的CMR 3变化经截管和手术闭合后的月份及其与ECG.Resultwe的电气重塑比较前瞻性地评估了30名连续30名成年患者（经转截管和外科）ASD闭合的孤立的Secundum ASD。所有电气参数都大幅减少与P波色散（PD）相比，相同的组与基线值相比。 （P MAX为97.33±16.67（PERE CLOSURE）到设备组中的76±15.49（封闭件），在手术组中97.33±12.79（PRESTLOURE）至73.33±16.32（封闭柱），QRS复合物为104±18.82（在设备组中的80±18.51（封闭件）和106.67±14.47（预闭）到86.67±17.99（闭合）在外科群体中。QTC最大值为478.53±36.79（Preclosure）至412.53±38.03（关闭后）在手术组中，在设备组和470.53±65.70（Prectlosure）中的470.53±65.08（闭合闭合），QTC分散体为70.33±24.04（预流），在设备组中为60.26±28.56（封闭件）和80.73± 30.38（预流）在手术组中至60.27±28.57（闭合柱））。两组之间没有显着差异，表明经导管和手术闭合导致电气重塑的等同值。在CMR研究中，我们测量了RA最大体积和右心室结束舒张分体积（RVEDV），RA最大卷与基线值相比，与两组中的基线值相比，如两组的闭合（P值<0.001）相比。转膜闭闭合组的RA最大体积的减少更多;然而，与外科手臂（ P 值= 0.5）相比，这种差异没有统计学意义。与基线值相比，在两组中显着降低（ p 值<0.001）。经截管闭合导致RVEDV的减少比手术闭合更显着（ P 值= 0.03）。CONCLUSIONOUR研究在ASD闭合后的基线值中的大多数研究参数中显示出早期显着的机电反向重塑。我们发现所有电气和RA机械重塑参数都没有显着差异，并且在器件组中具有明显更好的机械重塑。

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