UNASSIGNED: We prospectively studied 40 patients, 20 undergoing PFO closure by occluder and 20 by suture. Trans-thoracic echocardiography was carried out the day before and 1 year after the procedure. Left atrial (LA) and right atrial (RA) function was evaluated by using speckle-tracking analysis assessing the strain values of the reservoir (st-RES), conduit (st-CD), and contraction phase (st-CT). Compared with values baseline PFO closure, at 1-year follow-up, patients with occluder implantation had significantly worse indices of LA and RA reservoir (LA st-RES P < 0.001; RA st-RES P < 0.001), conduit (LA st-CD P < 0.001; RA st-CD P < 0.001), and contraction function (LA st-CT P < 0.05; RA st-CT P < 0.05). In patients with suture-mediated PFO closure, no significant differences were observed in the same indices of reservoir (LA st-RES P = 0.848; RA st-RES P = 0.183), conduit (LA st-CD P = 0.156; RA st-CD P = 0.419), and contraction function (LA st-CT P = 0.193; RA st-CT P = 0.375).
UNASSIGNED: Suture-mediated PFO closure does not alter atrial function. Conversely, PFO closure by metallic occluders is associated with a deterioration of atrial function. This detrimental effect on atrial function could favour the development of atrial arrhythmias.
■我们前瞻性研究了40例患者,20通过封堵器进行PFO闭合,20通过缝线进行PFO闭合。在手术前一天和手术后1年进行经胸超声心动图检查。左心房(LA)和右心房(RA)功能通过散斑追踪分析评估储层(st-RES)的应变值,导管(st-CD),和收缩阶段(ST-CT)。与基准PFO闭合值相比,在1年的随访中,封堵器植入患者的LA和RA储层指数明显较差(LAst-RESP<0.001;RAst-RESP<0.001),导管(LAst-CDP<0.001;RAst-CDP<0.001),和收缩功能(LAst-CTP<0.05;RAst-CTP<0.05)。在缝合介导的PFO闭合患者中,在相同的储层指数中没有观察到显着差异(LAst-RESP=0.848;RAst-RESP=0.183),导管(LAst-CDP=0.156;RAst-CDP=0.419),和收缩功能(LAst-CTP=0.193;RAst-CTP=0.375)。
■缝合介导的PFO闭合不改变心房功能。相反,通过金属封堵器关闭PFO与心房功能的恶化有关。这种对心房功能的不利影响可能会促进房性心律失常的发展。