TY - JOUR
T1 - Relationship between atrial septal defects and asthma-like dyspnoea: the impact of transcatheter closure
AU - Nassif, M.
AU - Heuschen, C. B. B. C.
AU - Lu, H.
AU - Bouma, B. J.
AU - van Steenwijk, R. P.
AU - Sterk, P. J.
AU - Mulder, B. J. M.
AU - de Winter, R. J.
PY - 2016
Y1 - 2016
N2 - Background Patients with atrial septal defects (ASD) are often misdiagnosed as asthma patients and accordingly receive erroneous bronchodilator treatment. In order to characterise their symptoms of dyspnoea to explain this clinical observation, we investigated the prevalence of asthma-like symptoms in patients with secundum ASD who then underwent successful percutaneous closure. Methods A total of 80 ASD patients (74% female, mean age 46.7 +/- 16.8 years, median follow-up 3.0 [2.0-5.0] years) retrospectively completed dyspnoea questionnaires determining the presence and extent of cough, wheezing, chest tightness, effort dyspnoea and bronchodilator use on a 7-point scale (0 = none, 6 = maximum) before and after ASD closure. The Mini Asthma Quality of Life (Mini-AQLQ) and Asthma Control Questionnaire with bronchodilator use (ACQ6) were administered. Results A total of 48 (60%) patients reported cough, 27 (34%) wheezing, 26 (33%) chest tightness and 62 (78%) effort dyspnoea. Symptom resolution or reduction was found in 64 (80%) patients after ASD closure. Asthma symptom scores decreased significantly on the Mini-AQLQ and ACQ6 (both p <0.001). The number of patients using bronchodilators decreased from 16 (20%) to 8 (10%) patients after ASD closure (p = 0.039) with less frequent use of bronchodilators (p = 0.015). Conclusions A high prevalence of asthma-like symptoms and bronchodilator use is present in ASD patients, which exceeds the low prevalence of bronchial asthma in this study population. Future prospective research is required to confirm this phenomenon. The presence of an ASD should be considered in the differential diagnosis of patients with asthma-like symptoms, after which significant symptom relief can be achieved by ASD closure
AB - Background Patients with atrial septal defects (ASD) are often misdiagnosed as asthma patients and accordingly receive erroneous bronchodilator treatment. In order to characterise their symptoms of dyspnoea to explain this clinical observation, we investigated the prevalence of asthma-like symptoms in patients with secundum ASD who then underwent successful percutaneous closure. Methods A total of 80 ASD patients (74% female, mean age 46.7 +/- 16.8 years, median follow-up 3.0 [2.0-5.0] years) retrospectively completed dyspnoea questionnaires determining the presence and extent of cough, wheezing, chest tightness, effort dyspnoea and bronchodilator use on a 7-point scale (0 = none, 6 = maximum) before and after ASD closure. The Mini Asthma Quality of Life (Mini-AQLQ) and Asthma Control Questionnaire with bronchodilator use (ACQ6) were administered. Results A total of 48 (60%) patients reported cough, 27 (34%) wheezing, 26 (33%) chest tightness and 62 (78%) effort dyspnoea. Symptom resolution or reduction was found in 64 (80%) patients after ASD closure. Asthma symptom scores decreased significantly on the Mini-AQLQ and ACQ6 (both p <0.001). The number of patients using bronchodilators decreased from 16 (20%) to 8 (10%) patients after ASD closure (p = 0.039) with less frequent use of bronchodilators (p = 0.015). Conclusions A high prevalence of asthma-like symptoms and bronchodilator use is present in ASD patients, which exceeds the low prevalence of bronchial asthma in this study population. Future prospective research is required to confirm this phenomenon. The presence of an ASD should be considered in the differential diagnosis of patients with asthma-like symptoms, after which significant symptom relief can be achieved by ASD closure
U2 - https://doi.org/10.1007/s12471-016-0879-6
DO - https://doi.org/10.1007/s12471-016-0879-6
M3 - Article
C2 - 27561281
SN - 1568-5888
VL - 24
SP - 640
EP - 646
JO - Netherlands heart journal
JF - Netherlands heart journal
IS - 11
ER -