Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Closure of atrial septal defect normalizes left and right ventricular hemodynamic forces in children and adolescents

Arvidsson, Per M. LU ; Clausen, Henning LU orcid and Sjöberg, Pia LU orcid (2026) In Journal of Cardiovascular Magnetic Resonance 28(1).
Abstract

Background Atrial septal defect (ASD) is one of the most common congenital heart defects and leads to chronic right ventricular (RV) volume loading, which may progress to heart failure if untreated. Surgical or transcatheter closure unloads the RV and improves hemodynamics, but the impact on intraventricular hemodynamic forces (HDF) remains unclear. Here, we evaluated the effects of ASD closure on biventricular HDF. Methods Cardiac magnetic resonance imaging was performed at 1.5T on 21 patients and 11 sex- and age-matched healthy controls. Whole-heart 4D flow and cine images in standard views were acquired and used to compute HDF using custom software (Segment). Paired analysis was used to compare HDF pre-/post ASD closure. Results At... (More)

Background Atrial septal defect (ASD) is one of the most common congenital heart defects and leads to chronic right ventricular (RV) volume loading, which may progress to heart failure if untreated. Surgical or transcatheter closure unloads the RV and improves hemodynamics, but the impact on intraventricular hemodynamic forces (HDF) remains unclear. Here, we evaluated the effects of ASD closure on biventricular HDF. Methods Cardiac magnetic resonance imaging was performed at 1.5T on 21 patients and 11 sex- and age-matched healthy controls. Whole-heart 4D flow and cine images in standard views were acquired and used to compute HDF using custom software (Segment). Paired analysis was used to compare HDF pre-/post ASD closure. Results At baseline, patients showed aberrant RV HDF in both longitudinal and transverse directions (p<0.05 vs controls), largely explained by volume loading (R = 0.83–0.92 for volume parameters, p<0.0001). At 8-month follow-up (n = 16), LV HDF increased in the apical-basal and septal-lateral directions (p<0.05), while RV HDF decreased in all directions (p<0.05), effectively normalizing HDF to control levels (p>0.05). Changes in HDF were associated with remodeling of ventricular volumes and with shunt reduction. Conclusion Children and adolescents with ASD exhibit a wide range of alterations to ventricular HDF partially reflective of altered loading conditions. Successful ASD closure normalizes HDF in many but not all cases, highlighting the potential of force analysis to improve our understanding of ventricular remodeling processes in congenital heart disease.

(Less)
Please use this url to cite or link to this publication:
author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
4D flow, Atrial septal defect, Congenital heart disease, Hemodynamic force analysis, Intervention
in
Journal of Cardiovascular Magnetic Resonance
volume
28
issue
1
article number
102704
publisher
Elsevier
external identifiers
  • pmid:41690406
  • scopus:105038934356
ISSN
1097-6647
DOI
10.1016/j.jocmr.2026.102704
language
English
LU publication?
yes
id
5fd78b26-0f87-4918-91e8-7e934527f857
date added to LUP
2026-08-17 09:22:32
date last changed
2026-09-14 11:01:11
@article{5fd78b26-0f87-4918-91e8-7e934527f857,
  abstract     = {{<p>Background Atrial septal defect (ASD) is one of the most common congenital heart defects and leads to chronic right ventricular (RV) volume loading, which may progress to heart failure if untreated. Surgical or transcatheter closure unloads the RV and improves hemodynamics, but the impact on intraventricular hemodynamic forces (HDF) remains unclear. Here, we evaluated the effects of ASD closure on biventricular HDF. Methods Cardiac magnetic resonance imaging was performed at 1.5T on 21 patients and 11 sex- and age-matched healthy controls. Whole-heart 4D flow and cine images in standard views were acquired and used to compute HDF using custom software (Segment). Paired analysis was used to compare HDF pre-/post ASD closure. Results At baseline, patients showed aberrant RV HDF in both longitudinal and transverse directions (p&lt;0.05 vs controls), largely explained by volume loading (R = 0.83–0.92 for volume parameters, p&lt;0.0001). At 8-month follow-up (n = 16), LV HDF increased in the apical-basal and septal-lateral directions (p&lt;0.05), while RV HDF decreased in all directions (p&lt;0.05), effectively normalizing HDF to control levels (p&gt;0.05). Changes in HDF were associated with remodeling of ventricular volumes and with shunt reduction. Conclusion Children and adolescents with ASD exhibit a wide range of alterations to ventricular HDF partially reflective of altered loading conditions. Successful ASD closure normalizes HDF in many but not all cases, highlighting the potential of force analysis to improve our understanding of ventricular remodeling processes in congenital heart disease.</p>}},
  author       = {{Arvidsson, Per M. and Clausen, Henning and Sjöberg, Pia}},
  issn         = {{1097-6647}},
  keywords     = {{4D flow; Atrial septal defect; Congenital heart disease; Hemodynamic force analysis; Intervention}},
  language     = {{eng}},
  number       = {{1}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Cardiovascular Magnetic Resonance}},
  title        = {{Closure of atrial septal defect normalizes left and right ventricular hemodynamic forces in children and adolescents}},
  url          = {{http://dx.doi.org/10.1016/j.jocmr.2026.102704}},
  doi          = {{10.1016/j.jocmr.2026.102704}},
  volume       = {{28}},
  year         = {{2026}},
}