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- Title
Effect of concomitant atrial septal defect on left ventricular function in adult patients with unrepaired Ebstein's anomaly: a cardiovascular magnetic resonance imaging study.
- Authors
Liu, Xi; Gao, Yue; Wang, Zhen; Shi, Rui; Qian, Wen-Lei; Shen, Meng-Ting; Sun, Ying-Shi; Yang, Zhi-Gang
- Abstract
Background: Due to the heterogeneity of anatomic anomalies in Ebstein's anomaly (EA), particularly in the subset of patients with atrial septal defect (ASD), hemodynamic changes, which ultimately cause left ventricular (LV) deterioration remain unclear. The current study aimed to investigate the effect of concomitant ASD on LV function using cardiovascular magnetic resonance (CMR) imaging in patients with EA. Methods: This study included 31 EA patients with ASD, 76 EA patients without ASD, 35 patients with simple ASD and 40 healthy controls. Left/right ventricular (RV, the RV was defined as a summation of the functional RV and atrialized RV in EA patients) volumes and functional parameters, LV strain parameters, and echocardiogram indices were compared among the four groups. Associations between variables were evaluated via Spearman or Pearson correlation analyses. The association between risk factors and LV ejection fraction (EF) was determined via multivariate linear regression analysis. Results: Both EA patients and ASD patients had a higher RV/LV end-diastolic volume (RVEDV/LVEDV) as well as lower LV and RV ejection fractions (LVEF/RVEF) compared to healthy controls (all p < 0.05). Moreover, the EA patients with ASD had a significantly higher RVEDV/LVEDV and a lower LVEF and RVEF than those without ASD (all p < 0.05). Multivariate linear regression analysis revealed that the presence of ASD was independently associated with LVEF (β = − 0.337, p < 0.001). The RVEDV/LVEDV index was associated with LVEF (r = − 0.361, p < 0.001). Furthermore, the LV longitudinal peak diastolic strain rate (PDSR) was lower in EA patients with ASD than those without ASD, patients with simple ASD, and healthy controls (p < 0.05). Conclusion: Concomitant ASD is an important risk factor of LV dysfunction in patients with EA, and diastolic dysfunction is likely the predominate mechanism related to LV dysfunction.
- Subjects
LEFT heart ventricle; STATISTICS; VENTRICULAR ejection fraction; MULTIVARIATE analysis; LEFT ventricular dysfunction; CARDIOVASCULAR diseases; MAGNETIC resonance imaging; REGRESSION analysis; ATRIAL septal defects; COMPARATIVE studies; PEARSON correlation (Statistics); RISK assessment; EBSTEIN'S anomaly; RESEARCH funding; HEART physiology; DATA analysis; STROKE volume (Cardiac output); DISEASE risk factors; DISEASE complications; ADULTS
- Publication
Journal of Cardiovascular Magnetic Resonance (BioMed Central), 2023, Vol 25, Issue 1, p1
- ISSN
1532-429X
- Publication type
Article
- DOI
10.1186/s12968-023-00976-3