Transthoracic 3-D echocardiography improves the quantification of atrial septal defect size before amplatzer closure

Background Atrial septal defect (ASD) is one of the most common forms of congenital heart disease (CHD). Brain natriuretic peptide (BNP) is a heart marker released into the circulation during pressure overload, heart volume expansion, and increased stress on +the myocardial wall. Objective To assess for a possible association between atrial septal defect size and BNP level in pediatric patients. Methods This cross sectional study on children with ASD was done from March to December 2018 in pediatric outpatients and inpatients at Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Measurement of ASD defect was conducted using echocardiography and categorized as small defect (<3 mm), medium defect (3-8 mm), and large defect (>8 mm). Brain natriuretic peptide was measured using radioimmunoassay and immunoradiometricassay. Nutritional status was categorized using WHO if the patients aged younger than 5 years and NCHS for patients aged equal or more than 5-year-old. Results Mean BNP levels were 65.5 pg/mL in the small ASD group, 273.2 pg/mL in the moderate ASD group, and in 654.5 pg/mL in the large ASD group, with significant differences among ASD groups. We found a significant positive correlation between BNP levels and ASD diameter (r=0.829; P=0.001), with Y regression equation of: (BNP level) =2.624 + 0.009X (ASD diameter in mm). Conclusion Brain natriuretic peptide levels have significant positive correlation with ASD size. Hence, BNP measurements can be used to predict septal defect size in children with ASD. Acyanotic CHD patients with suspected ASD and high BNP levels may have moderate-to-large ASDs.

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Real Time 3D Echocardiography for Assessing the Atrial Septal Defect Size and Shunting: Quantitative Studies in a Chronic Animal Model

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(97)84835-8 ◽

1998 ◽

Vol 31 (2) ◽

pp. 259A ◽

Cited By ~ 1

Author(s):

T Shiota

Keyword(s):

Animal Model ◽

Atrial Septal Defect ◽

Real Time ◽

Septal Defect ◽

Defect Size ◽

3D Echocardiography ◽

Quantitative Studies

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Determination of atrial septal defect size by nuclear magnetic resonance imaging

Journal of the American College of Cardiology ◽

10.1016/0735-1097(91)92267-p ◽

1991 ◽

Vol 17 (2) ◽

pp. A326

Author(s):

Godtfred Holmvang ◽

Richard Liberthson ◽

Gus Vlahakes ◽

Igor F. Palacios ◽

Howard E. Waldman ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Nuclear Magnetic Resonance ◽

Magnetic Resonance ◽

Atrial Septal Defect ◽

Septal Defect ◽

Defect Size ◽

Nuclear Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Nuclear Magnetic

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Can the atrial septal defect size in newborn patient predict spontaneous closure?

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jeaa356.001 ◽

2021 ◽

Vol 22 (Supplement_1) ◽

Author(s):

K Sawamura ◽

TR Afonso ◽

WAA Oliveira ◽

ACL Lianza ◽

GMP Tavares ◽

...

Keyword(s):

Birth Weight ◽

Atrial Septal Defect ◽

Gestational Age ◽

Septal Defect ◽

Statistical Significance ◽

Ductus Arteriosus ◽

Defect Size ◽

Spontaneous Closure ◽

Continuous Variables ◽

Closure Group

Abstract Funding Acknowledgements Type of funding sources: None. onbehalf Hospital Albert Eisntein"s pediatric echocardiogram team Can atrial septal defect size in newborn predict spontaneous closure? Introduction Spontaneous closure of atrial septal defect (ASD) has been reported to occur in 33%-75% of patients. Factors that influence spontaneous closure are size of the ASD and age of the patients. Purpose We aimed to investigate if the diameter of ASD measured by echocardiogram in the newborn can anticipate clinical outcome and predict spontaneous closure. Methods We reviewed 1012 two-dimensional echocardiograms (2DE) performed in the first days of life of newborn at our hospital from January 2015 to December 2019 with ASD or patent foramen ovale (PFO) as initial diagnoses. The exclusion criteria were associated congenital heart disease, except ventricular septal defect and patent ductus arteriosus both without repercussion. 153 newborns with ASD or PFO in the first 2DE were included in this study. The individual data collected were age at the exam, birth weight, gestational age, height by birth, ASD diameter, total diameter of atrial septum and Septum/ASD ratio (Table 1). The results were expressed as mean ± SD, or percentage. Comparisons of continuous variables between groups of patients were performed using the Student T test. Statistical significance was determined by p <0,05. The newborn was grouped according to the observation or not of spontaneous closure. Results ASD or PFO was found in 153 newborns. 60 had PFO, spontaneous closure was reported in 38 (63%). 93 had ASD in the first 2DE, spontaneous closure was reported in 41 (44%). The mean age of diagnosis was 3,37 ±4,39 days of life. The diameter of the ASD in the first exam and the septum/ASD ratio were associated with spontaneous closure. There was no association between spontaneous closure of ASD and birth weight or gestational age in this studied group. Conclusion The ASD diameter obtained at the first 2DE in the first days of life was associated with spontaneous closure of the defect. Table 1 Non-closure group (N = 52) Closure group (N= 41) P Age at the exam (days) 3,48 (±4,52) 3,2 (±4,27) 0,78 Birth weight (grams) 2459,85 (±1098,79) 2350,12 (±1247,70) 0,65 Gestational age (weeks) 34,88 (±5,17) 34,54 (±5,10) 0,75 Height by birth (cm) 44,46 (±6,81) 43,67 (±6,77) 0,57 ASD diameter (mm) 3,66 (± 2,66 (±0,57) <0,01 Septum diameter (mm) 18,74 (±3,9) 18,92(±4,51) 0,83 Septum/ ASD ratio 5,74 (±2,38) 7,28 (±1,96) <0,01 cm = centimeter, mm = millimeter, ASD = atrial septal defect. Unit: Mean and standard deviation.

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