Abstract 4684: Differences in Baseline Features and Long Term Follow-Up Post-Transcatheter Closure in Patients with Secundum Atrial Septal Defect - A Cohort Study
Bibliographic record
Abstract
Patients with atrial septal defects (ASD) may develop pulmonary arterial hypertension (PAH). We aimed to explore predictors of PAH and characterize the evolution of pulmonary arterial systolic pressures (PASP) after transcatheter ASD closure. A cohort study was performed on 215 consecutive patients who underwent attempted transcatheter ASD closure, of which 194 were successful. Patients were classified into 4 groups based on PAH severity derived from baseline echocardiographic PASP estimates: no PAH (<40mmHg; Group I, n=107), mild PAH (40 –50mmHg; Group 2, n=62), moderate PAH (50 – 60mmHg; Group 3, n=27), and severe PAH (≥60mmHg; Group 4, n=19). Follow-up echocardiography was performed at a median of 10 months (IQR 3, 25 months). Independent predictors of moderate or severe baseline PAH were older age (OR 1.10 per year, p<0.0001), larger ASD size (OR 1.13 per mm, p=0.0052), female gender (OR 3.9, p=0.0313) and moderate or severe tricuspid regurgitation (OR 3.6, p=0.0043). Post closure, baseline PAH severity was associated with a greater likelihood of a ≥5mmHg reduction in PASP (33.7%, 73.9%, 79.2%, 100.0%, in Groups 1 to 4, p <0.0001) and larger reduction in PASP (median reduction 0, 8, 17, 22 mmHg in Groups 1 to 4, p<0.0001). However, likelihood of normalization of PASP (<40mmHg) was inversely correlated with baseline PAH severity (90.2%, 71.7%, 66.7%, 23.5% for Groups 1 to 4, p<0.0001). Higher baseline PASP (OR 1.20 per mmHg, p<0.0001), younger age (OR 0.97, p=0.0202), and smaller body surface area (OR 0.13 per m 2 , p=0.0210) independently predicted a ≥5mmHg reduction in PASP. Among patients with moderate or severe baseline PAH, normalization of PASP occurred in 48.8%, and was independently predicted by a lower baseline PASP (OR 0.91 per mmHg, p=0.0418) and absence of moderate or severe tricuspid regurgitation preceding ASD closure (OR 0.139, p=0.0420). In patients with ASD, severity of PAH is modulated by age, gender, defect size, and presence of moderate or severe tricuspid regurgitation. Patients with moderate or severe PAH benefit from a substantial reduction in PASP post-transcatheter ASD closure, but PASP remains elevated in a sizeable proportion of patients, warranting close long-term follow-up.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".