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Introduction:Atrial septal defects (ASD) are treated with percutaneous closures that subsequently increase the left ventricular volume load. This retrospective study aimed to assess the change in transesophageal ultrasound indices and to determine the search associated post-closure left diastolic index.Subjects:We enrolled 62 patients who underwent percutaneous closure of ASD in our hospital between January 2018 and November 2020.Method:Percutaneous ASD closure was performed under general anesthesia. We measured left ventricular inflow (early diastolic flow velocity, E; atrial contraction flow velocity, A; E-wave deceleration time, DT), mitral annulus velocity by tissue doppler imaging at lateral annulus (early diastolic myocardial velocity, E'; atrial contraction velocity, A'), and pulmonary venous blood flow velocity (peak systolic velocity, S; diastolic velocity, D; atrial systolic regurgitation velocity, AR; atrial systolic regurgitation time, AD) using transesophageal echocardiography (TEE). The ratio of E and E' (E/E') was calculated for and compared between before (pre) and after (post) ASD closure. Statistical analysis was performed using the EZR software. Wilcoxon's code order test was used for comparison, and multivariate correlation analysis was performed with post-occlusion E/E' as the objective variable. Statistical significance was set at p<0.05.Results:Significant changes were seen in A', E', E, S, D, AD, and E/E'. Multivariate correlation analyses revealed a significant association of post E/E’ with the pre E/E’ and pre AR.Conclusion:In this study, the pulmonary venous flow velocity was found to decrease during systole and diastole following ASD closure. The DT did not change; thus, there was no change in the stiffness of the left ventricle. We concluded that the increased left ventricular volume load caused the increase in the left end-diastolic pressure.

Background:Increasing left ventricular end diastolic pressure (LVEDP) after transcatheter closure of an atrial septal defect (ASD) is often observed. The aim of this study was to assess retrospectively, the changes in echocardiographic indexes that are associated with increased LVEDP after the procedure.Subjects:From August 2012 to May 2018, 93 patients underwent transcatheter closure of ASDs. The patients were divided into a high LVEDP group(H; post-LVEDP?15, n=16; pre-LVEDP, 12(10-17)mmHg; age 51(24-74)years; Qp/Qs, 2.1(1.6-3.5)) and a low LVEDP group ( L;post-LVEDP <15, n=77, pre-LVEDP 8(0-18)mmHg, age 57(12-81) years; Qp/Qs, 2.2(1.2-5.1)).Methods:Transthoracic echocardiographic (TTE) examination was performed. Left ventricular end-diastolic volume index (LVEDVI), left ventricular mass index, left atrial volume index, left atrial diameter(LAD), peak velocity of mitral inflow during early diastole (E) and during atrial contraction (A), mitral deceleration time, peak lateral mitral annular velocity during early diastole(E?) and atrial contraction(A?) were assessed using TTE. E/E?was calculated. The study was conducted before(pre) and 1 day, 1 month and 6 months after ASD closure. Statistical analysis was performed using the EZR software, and p values of <0.05 were considered significant.Results:LVEDVI and LV mass I were increased both groups from pre to 6 months after closure (H; from 43.4(33.5-58.1) to 52.9(39.3-68.8) vs L; from 45.2(26.1-83.6) to 58.9(28.2-81.2)ml/m2) and LV massI was significantly higher in group L than in group H at 1 months. (H; 70.7(47.1-104.7, L;77.6(39.3-195.0) )The E/E?in group H was increased only from pre to 1 day after closure. (H; 11.4(5.2-22.1, L;9.6(2.9-20.7) )Conclusions:The patients with high LVEDP after closure did not show any features on pre-ultrasonographic echocardiographic indexes. However, the LV changes in patients with high LVEDP were different from that in patients with low LVEDP after closure.