Symptom Improvement and Cachexia Reversal in an 84‐Year‐Old Woman After Percutaneous Closure of Atrial Septal Defect

Giannakópoulos, Georgios F.; Roffi, Marco; Frangos, Caroline; Noble, Stéphane

doi:10.1111/jgs.13259

Cited by 4 publications

(2 citation statements)

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“…The reversing of wasting process with improvement of RV dysfunction has been reported earlier, albeit small studies. Serum protein level in a patient with severe TR complicated by severe hypoproteinemia became normalized after tricuspid valve replacement [ 24 ], and patients with atrial septal defect (ASD) and massive TR showed a significant weight gain after successful ASD device closure [ 25 ]. Patients with HF and severe pulmonary hypertension, who underwent phosphodiesterase 5 inhibitor therapy, showed a significant decrease in pulmonary arterial pressure and maintained a steady body weight when compared with controls who experienced significant weight loss [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Changes of body composition after valve surgery in patients with mitral valve disease

et al. 2018

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BackgroundPatients with chronic heart failure have alteration in body composition as a reduction in fat mass, lean body mass and bone mass. However, body wasting in valvular heart disease and the impact of corrective valvular surgery on body composition has not been investigated.ObjectivesWe hypothesized that body wasting in severe mitral valve (MV) diseases is reversible through MV surgery.MethodsForty eight patients who were scheduled to undergo MV surgery were consecutively enrolled after excluding patients with combined valvular heart disease, ischemic heart disease, cardiomyopathies, and diseases or who were taking medications that could affect metabolism. All patients were subjected to simplified nutritional assessment questionnaire (SNAQ) for appetite, laboratory tests, echocardiography, and dual-energy X-ray absorptiometry (DXA) before and one year after MV surgery.ResultsOne year after MV surgery, the patients showed increased appetite and improved laboratory data as well as hemodynamic improvement.When we classified the patients according to the primary MV lesion, no changes in body weight were observed in both patients with mitral regurgitation (MR) and mitral stenosis (MS). However, significant increase in bone mineral density and body fat percentage were observed in patients with MR and not in patients with MS. In patients with MR, patients with Δfat ≥ 2% showed significantly higher pre-operative estimated right ventricular systolic pressure (eRVSP) level and greater decrease in eRVSP after surgery than those with Δfat < 2% and both ΔSNAQ and Δfat showed significant negative relationship with ΔeRVSP, respectively.ConclusionsIn patients with severe MV disease, corrective MV surgery led to favorable outcomes in wasting process as well as hemodynamic improvement. Particularly, right ventricular pressure overload showed a close association with the changes in appetite and body fat percentage in patients with MR.

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Section: Discussionmentioning

confidence: 99%

Changes of body composition after valve surgery in patients with mitral valve disease

et al. 2018

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“…Recent studies have assessed benefits in long‐term follow‐up after transcatheter ASD closure in older adults, including those aged 75 and older, but this group had higher rates of heart failure and hospitalization than younger individuals . Furthermore, case reports of elderly adults with heart failure and severe pulmonary hypertension undergoing ASD closure have demonstrated favorable results in improving symptoms . Nevertheless, the most controversial issue is selection of candidates who have normal or slight high pulmonary artery pressure, absent or negligible clinical symptoms, and are aged 60 and older.…”

Section: Commentmentioning

confidence: 99%