{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:39:12Z","timestamp":1790314752455,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Despite correction of the atrial septal defect (ASD), patients experience atrial fibrillation frequently and have increased morbidity and mortality. We examined physical capacity, cardiac performance, and invasive hemodynamics in patients with corrected ASD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Thirty\u2010eight corrected patients with isolated secundum ASD and 19 age\u2010matched healthy controls underwent right heart catheterization at rest and during exercise with simultaneous expired gas assessment and echocardiography. Maximum oxygen uptake was comparable between groups (ASD 32.7\u00b17.7\u00a0mL O\n              <jats:sub>2<\/jats:sub>\n              \/kg per minute, controls 35.2\u00b17.5\u00a0mL O\n              <jats:sub>2<\/jats:sub>\n              \/kg per minute,\n              <jats:italic>P<\/jats:italic>\n              =0.3), as was cardiac index at both rest and peak exercise. In contrast, pulmonary artery wedge v wave pressures were increased at rest and peak exercise (rest: ASD 14\u00b14\u00a0mm\u00a0Hg, controls 10\u00b15\u00a0mm\u00a0Hg,\n              <jats:italic>P<\/jats:italic>\n              =0.01; peak: ASD 25\u00b19\u00a0mm\u00a0Hg, controls 14\u00b19\u00a0mm\u00a0Hg,\n              <jats:italic>P<\/jats:italic>\n              =0.0001). The right atrial v wave pressures were increased at rest but not at peak exercise. The transmural filling pressure gradient (TMFP) was higher at peak exercise among patients with ASD (10\u00b16\u00a0mm\u00a0Hg, controls 7\u00b13\u00a0mm\u00a0Hg,\n              <jats:italic>P<\/jats:italic>\n              =0.03). One third of patients with ASD demonstrated an abnormal hemodynamic exercise response defined as mean pulmonary artery wedge pressure \u226525\u00a0mm\u00a0Hg and\/or mean pulmonary artery pressure \u226535\u00a0mm\u00a0Hg at peak exercise. These patients had significantly elevated peak right and left atrial a wave pressures, right atrial v wave pressures, pulmonary artery wedge v wave pressures, and transmural filling pressure compared with both controls and patients with ASD with a normal exercise response.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Patients with corrected ASD present with elevated right and in particular left atrial pressures at rest and during exercise despite preserved peak exercise capacity. Abnormal atrial compliance and systolic atrial function could predispose to the increased long\u2010term risk of atrial fibrillation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration Information<\/jats:title>\n            <jats:p xml:lang=\"en\">clinicaltrials.gov. Identifier: NCT03565471.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.020692","type":"journal-article","created":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T09:08:18Z","timestamp":1626253698000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Elevated Left and Right Atrial Pressures Long\u2010Term After Atrial Septal Defect Correction: An Invasive Exercise Hemodynamic Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4438-1004","authenticated-orcid":false,"given":"Zarmiga","family":"Karunanithi","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9320-8227","authenticated-orcid":false,"given":"Mads J\u00f8nsson","family":"Andersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3422-2387","authenticated-orcid":false,"given":"S\u00f8ren","family":"Mellemkj\u00e6r","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3151-056X","authenticated-orcid":false,"given":"Mathias","family":"Alstrup","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3583-4366","authenticated-orcid":false,"given":"Farhad","family":"Waziri","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic and Vascular Surgery Aarhus University Hospital Aarhus N Denmark"},{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-6404","authenticated-orcid":false,"given":"Tor","family":"Skibsted Clemmensen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aarhus University Hospital Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8047-0015","authenticated-orcid":false,"given":"Vibeke","family":"Elisabeth Hjortdal","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Cardiothoracic Surgery, Rigshospitalet University of Copenhagen Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9586-835X","authenticated-orcid":false,"given":"Steen","family":"Hvitfeldt Poulsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine Aarhus University Aarhus N Denmark"},{"name":"Department of Cardiology Aarhus University Hospital Aarhus N Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.02.80"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14574-6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx687"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-306552"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2016.10.015"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2014.03.063"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199012133232401"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.10.008"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2006.12.031"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/joic.12002"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.052"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00004712"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12793"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2018.06.004"},{"key":"e_1_3_2_16_2","unstructured":"Wasserman K Hansen JE Sue DY Stringer WW Sietsema KE Sun XG Whipp BJ. 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