@Article{chd.12479,
AUTHOR = {Chih-Hsin Hsu, Jun-Neng Roan, Jieh-Neng Wang, Chien-Chi Huang, Chao-Jung Shih, Jyh-Hong Chen, Jing-Ming Wu, Chen-Fuh Lam},
TITLE = {Hemodynamic, biological, and right ventricular functional changes following intraatrial shunt repair in patients with flow-induced pulmonary hypertension},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {4},
PAGES = {533--539},
URL = {http://www.techscience.com/schd/v12n4/39184},
ISSN = {3071-1738},
ABSTRACT = {<b>Objectives:</b> Atrial septal defects may result in pulmonary hypertension and right heart remodeling.
We analyzed improvements in patients with flow-induced pulmonary hypertension and the activation of endothelial progenitor cells after flow reduction.<br/>
<b>Design:</b> This prospective cohort study included 37 patients who were admitted for an occluder
implantation. Blood samples were collected before and after the procedure. We determined the
number of endothelial progenitor cells in outgrowth colonies and serum Hsp27 concentrations.
Daily performance and cardiothoracic ratio were reevaluated later.<br/>
<b>Results:</b> Closure of the defect significantly reduced the pulmonary pressure and B-type natriuretic
peptide levels. The cardiothoracic ratio and daily performance status also improved. The number
of endothelial progenitor cell outgrowth colony-forming units significantly increased and was positively correlated with daily performance. In patients with enhanced colony formation, Hsp27
levels were significantly increased.<br/>
<b>Conclusions:</b> The implantation of an occluder successfully improved hemodynamic, right ventricular, and daily performance. Qualitative enhancement of colony formation for endothelial
progenitor cells was also noted and positively correlated with daily performance. Closure of
defects may serve as a valid, reliable model to obtain a deeper understanding of the modulation of
endothelial progenitor cell activity and its relationship with pulmonary hypertension prognosis.},
DOI = {10.1111/chd.12479}
}