{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T14:56:40Z","timestamp":1788793000059,"version":"build-2803163510"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>\n              Pulmonary hypertension (PH), recently redefined as mean pulmonary arterial pressure &gt;20 mm\u2009Hg (PH\n              <jats:sub>20<\/jats:sub>\n              ), may be observed in patients with atrial septal defects (ASD). We aimed to determine the effect of preprocedural PH\n              <jats:sub>20<\/jats:sub>\n              status on outcomes among patients undergoing ASD closure.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Study population was selected from a retrospective registry of adult patients who underwent percutaneous ASD closure from 1998 to 2016 from a single center and had right heart catheterizations during the procedure. The clinical registry was linked to administrative databases to capture short- and long-term outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              We included a total of 632 ASD closure patients of whom 359 (56.8%) had PH\n              <jats:sub>20<\/jats:sub>\n              . The mean follow-up length was 7.6\u00b14.6 years. Patients with PH\n              <jats:sub>20<\/jats:sub>\n              were older (mean age 56.5 versus 43.1 years,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and a higher prevalence of comorbidities including hypertension (54.3% versus 21.6%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and diabetes (18.1% versus 5.9%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) than those without PH. In a Cox proportional hazards model after covariate adjustment, patients with PH had a significantly higher risk of developing major adverse cardiac and cerebrovascular events (heart failure, stroke, myocardial infarction, or cardiovascular mortality), with hazards ratio 2.45 (95% CI, 1.4\u20134.4). When applying the prior, mean pulmonary arterial pressure \u226525 mm\u2009Hg (PH\n              <jats:sub>25<\/jats:sub>\n              ) cutoff, a significantly higher hazard of developing major adverse cardiac and cerebrovascular events was observed in PH versus non-PH patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>\n              ASD patients with PH undergoing closure suffer from more comorbidities and worse long-term major adverse cardiac and cerebrovascular events outcomes, compared with patients without PH. The use of the new PH\n              <jats:sub>20<\/jats:sub>\n              definition potentially dilutes the effect of this serious condition on outcomes in this population.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.121.011110","type":"journal-article","created":{"date-parts":[[2021,12,16]],"date-time":"2021-12-16T10:00:16Z","timestamp":1639648816000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Long-Term Outcomes in Adult Patients With Pulmonary Hypertension After Percutaneous Closure of Atrial Septal Defects"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5851-0909","authenticated-orcid":true,"given":"Selai","family":"Akseer","sequence":"first","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network (UHN), Ontario, Canada (S.A., L.A., D.S.L., E.H.)."},{"name":"Institute of Health Policy, Management and Evaluation (IHPME) (S.A., L.A., D.S.L., E.H.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2788-4179","authenticated-orcid":true,"given":"Lusine","family":"Abrahamyan","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network (UHN), Ontario, Canada (S.A., L.A., D.S.L., E.H.)."},{"name":"Institute of Health Policy, Management and Evaluation (IHPME) (S.A., L.A., D.S.L., E.H.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-745X","authenticated-orcid":true,"given":"Douglas S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network (UHN), Ontario, Canada (S.A., L.A., D.S.L., E.H.)."},{"name":"Institute of Health Policy, Management and Evaluation (IHPME) (S.A., L.A., D.S.L., E.H.), University of Toronto, Ontario, Canada."},{"name":"Department of Pediatrics, Faculty of Medicine (L.B.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ella","family":"Huszti","sequence":"additional","affiliation":[{"name":"Institute of Health Policy, Management and Evaluation (IHPME) (S.A., L.A., D.S.L., E.H.), University of Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5499-7315","authenticated-orcid":true,"given":"Lukas M.","family":"Meier","sequence":"additional","affiliation":[{"name":"Adult Congenital Heart Disease Program, University Heart Center, University Hospital Zurich, University of Zurich, Switzerland (L.M.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Osten","sequence":"additional","affiliation":[{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, UHN, Toronto, Ontario, Canada (M.O., E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-1825","authenticated-orcid":true,"given":"Lee","family":"Benson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine (L.B.), University of Toronto, Ontario, Canada."},{"name":"Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Ontario, Canada (L.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1303-0586","authenticated-orcid":true,"given":"Eric","family":"Horlick","sequence":"additional","affiliation":[{"name":"Toronto General Hospital Research Institute, University Health Network (UHN), Ontario, Canada (S.A., L.A., D.S.L., E.H.)."},{"name":"Biostatistics Research Unit, UHN, Toronto, Ontario, Canada (E.H.)."},{"name":"Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, UHN, Toronto, Ontario, Canada (M.O., E.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.025"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9149(01)02134-8"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.117.003973"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.126.1_suppl.78S"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2005.07.053"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000603"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV7I3A63"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2012.12.126"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.114660"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.108.826560"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00004712"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2014.08.009"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv317"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.10.030"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01913-2018"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00145608"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.098848"},{"key":"e_1_3_2_19_2","first-page":"1087","article-title":"Pulmonary hypertension in patients with ostium secundum atrial septal defect\u2013is it related to echocardiographic complexity?","volume":"28","author":"Provid\u00eancia R","year":"2009","unstructured":"Provid\u00eancia, R, Botelho, A, Quintal, N, Costa, M, Quaresma, A, Lopes, P, Quintal, I, Santos, MJ, Santos, AP, Leit\u00e3o-Marques, A. Pulmonary hypertension in patients with ostium secundum atrial septal defect\u2013is it related to echocardiographic complexity? Rev Port Cardiol. 2009;28:1087\u20131096.","journal-title":"Rev Port Cardiol"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(83)90396-4"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.37.5.805"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0099-2020"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0828-282x(10)70412-8"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(92)90133-8"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.33.3.06"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.06.006"},{"key":"e_1_3_2_28_2","unstructured":"R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing Vienna Austria. 2019. Accessed October 1 2019. https:\/\/www.R-project.org\/."},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.23119"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-016-0886-y"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2019.07.042"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8183.2007.00324.x"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-010-0830-1"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.23457"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/echo.13358"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq352"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.126121"},{"key":"e_1_3_2_38_2","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00586-2019"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.3882"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003334"},{"key":"e_1_3_2_41_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-019-02238-5"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.121.011110","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:23:07Z","timestamp":1715566987000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.121.011110"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":40,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,1]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.121.011110"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.121.011110","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1]]},"assertion":[{"value":"2021-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-10-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011110"}}