{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T05:16:54Z","timestamp":1788412614588,"version":"build-2803163510"},"reference-count":25,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004775","name":"Natural Science Foundation of Gansu Province","doi-asserted-by":"crossref","award":["24JRRA367"],"award-info":[{"award-number":["24JRRA367"]}],"id":[{"id":"10.13039\/501100004775","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Cuiying Nursing Foundation Project","award":["CY2025-HL-B03"],"award-info":[{"award-number":["CY2025-HL-B03"]}]},{"name":"Provincial Talent Program of Gansu Province Project","award":["2024RCXM44"],"award-info":[{"award-number":["2024RCXM44"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Cardiovasc. Dev. Dis.","JCDD"],"abstract":"<jats:p>Atrial fibrillation (AF) is the most common clinically significant cardiac arrhythmia with a marked age-related increase in prevalence. Current guidelines recommend left atrial appendage closure (LAAC) as an alternative to long-term oral anticoagulation in selected patients at high-risk of both thromboembolic and bleeding events. Although the use of LAAC has increased substantially in recent years, its effects on cardiac function and post-procedural functional recovery remain incompletely understood. Therefore, this study aimed to evaluate changes in periprocedural cardiac function and functional parameters in patients with AF who underwent LAAC while receiving guideline-directed medical therapy. A retrospective cohort study was performed in 250 patients who underwent percutaneous LAAC at Lanzhou University Second Hospital between May 2019 and July 2025. A total of 162 patients were included in the final analysis. Echocardiographic parameters, NYHA functional class, and Barthel Index scores were compared before and after the procedure. Significant improvements were observed in several echocardiographic parameters. Post-procedural changes in NYHA functional class distribution and Barthel Index scores indicated improved functional status, with no evidence of deterioration in cardiac structure or function. These findings support the safety of LAAC with respect to cardiac functional recovery and demonstrate that the procedure does not adversely affect cardiac performance in patients with AF receiving guideline-directed medical therapy. Nevertheless, further large-scale, multi-center prospective studies are warranted to clarify the mechanisms underlying the observed improvements in cardiac function following LAAC.<\/jats:p>","DOI":"10.3390\/jcdd13090425","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T08:31:13Z","timestamp":1788251473000},"page":"425","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Left Atrial Appendage Closure on Cardiac Function"],"prefix":"10.3390","volume":"13","author":[{"given":"Qi","family":"Wang","sequence":"first","affiliation":[{"name":"Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing, Lanzhou University, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujin","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Nursing, Lanzhou University, Lanzhou 730000, China"},{"name":"Department of Cardiology, Lanzhou University Second Hospital, Lanzhou 730000, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","first-page":"100439","article-title":"Prevalence and risk of atrial fibrillation in China: A national cross-sectional epidemiological study","volume":"23","author":"Shi","year":"2022","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Sagris, M., Vardas, E.P., Theofilis, P., Antonopoulos, A.S., Oikonomou, E., and Tousoulis, D. (2021). Atrial Fibrillation: Pathogenesis, Predisposing Factors, and Genetics. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23010006"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1016\/S0735-1097(97)00254-4","article-title":"Hemodynamic effects of an irregular sequence of ventricular cycle lengths during atrial fibrillation","volume":"30","author":"Clark","year":"1997","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jacep.2019.11.017","article-title":"Feasibility of Left Atrial Appendage Occlusion in Left Atrial Appendage Thrombus: A Systematic Review","volume":"6","author":"Sharma","year":"2020","journal-title":"JACC Clin. Electrophysiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1136\/hrt.82.5.547","article-title":"Left atrial appendage: Structure, function, and role in thromboembolism","volume":"82","author":"Obel","year":"1999","journal-title":"Heart"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"ezad074","DOI":"10.1093\/ejcts\/ezad074","article-title":"Surgical and percutaneous left atrial appendage intervention: Silent cerebral embolism considerations","volume":"63","author":"Wang","year":"2023","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e1038","DOI":"10.4244\/EIJ-D-22-00627","article-title":"Left atrial appendage occlusion","volume":"18","author":"Holmes","year":"2023","journal-title":"EuroIntervention"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3122","DOI":"10.1016\/j.jacc.2020.04.067","article-title":"Left Atrial Appendage Closure Versus Direct Oral Anticoagulants in High-Risk Patients With Atrial Fibrillation","volume":"75","author":"Osmancik","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.ijcard.2021.09.051","article-title":"Long-term outcome of left atrial appendage occlusion with multiple devices","volume":"344","author":"Radinovic","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2551","DOI":"10.1016\/j.jacc.2013.03.035","article-title":"Left atrial appendage closure with the Watchman device in patients with a contraindication for oral anticoagulation: The ASAP study (ASA Plavix Feasibility Study with Watchman Left Atrial Appendage Closure Technology)","volume":"61","author":"Reddy","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1161\/01.CIR.0000072767.89944.6E","article-title":"Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: The Framingham Heart Study","volume":"107","author":"Wang","year":"2003","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"519","DOI":"10.5603\/CJ.a2018.0047","article-title":"Impact of left atrial appendage closure on cardiac functional and structural remodeling: A difference-in-difference analysis of propensity score matched samples","volume":"26","author":"Phan","year":"2019","journal-title":"Cardiol. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/j.jcin.2023.01.011","article-title":"SCAI\/HRS expert consensus statement on transcatheter left atrial appendage closure","volume":"16","author":"Saw","year":"2023","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Luani, B., Groscheck, T., Genz, C., Tanev, I., Rauwolf, T., Herold, J., Medunjanin, S., Schmeisser, A., and Braun-Dullaeus, R.C. (2017). Left atrial enlargement and clinical considerations in patients with or without a residual interatrial shunt after closure of the left atrial appendage with the WATCHMAN\u2122-device. BMC Cardiovasc. Disord., 17.","DOI":"10.1186\/s12872-017-0728-6"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1111\/joic.12531","article-title":"The influence of iatrogenic interatrial septum leaks after left atrial appendage closure on cardiac function test results","volume":"31","author":"Mitrega","year":"2018","journal-title":"J. Interv. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1016\/j.hrthm.2017.01.042","article-title":"Percutaneous left atrial appendage closure improves left atrial mechanical function through Frank-Starling mechanism","volume":"14","author":"Coisne","year":"2017","journal-title":"Heart Rhythm"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.jcmg.2016.11.003","article-title":"Left Atrial Reverse Remodeling: Mechanisms, Evaluation, and Clinical Significance","volume":"10","author":"Thomas","year":"2017","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_19","first-page":"267","article-title":"Left Atrial Appendage Occlusion, Shared Decision-Making, and Comprehensive Atrial Fibrillation Management","volume":"7","author":"Hoskins","year":"2018","journal-title":"Interv. Cardiol. Clin."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1159\/000155640","article-title":"Brain natriuretic peptide as a surrogate marker for cardioembolic stroke with paroxysmal atrial fibrillation","volume":"26","author":"Naya","year":"2008","journal-title":"Cerebrovasc. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e70098","DOI":"10.1111\/anec.70098","article-title":"Role of Transesophageal Echocardiography in Guiding and Evaluating Left Atrial Appendage Occlusion in Patients With Non-Organic Heart Disease","volume":"30","author":"Long","year":"2025","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2964","DOI":"10.1016\/j.jacc.2017.10.021","article-title":"5-Year Outcomes After Left Atrial Appendage Closure: From the PREVAIL and PROTECT AF Trials","volume":"70","author":"Reddy","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"205013","DOI":"10.1155\/2015\/205013","article-title":"Left Atrial Appendage: Physiology, Pathology, and Role as a Therapeutic Target","volume":"2015","author":"Regazzoli","year":"2015","journal-title":"BioMed Res. Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2158","DOI":"10.1016\/j.jcin.2022.08.034","article-title":"Evaluation of Multimodality LAA Leak Closure Methods Following Incomplete Occlusion: The LAA Leak Study","volume":"15","author":"Charate","year":"2022","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e2445084","DOI":"10.1001\/jamanetworkopen.2024.45084","article-title":"Strategy Optimization for a Combined Procedure in Patients with Atrial Fibrillation: The COMBINATION Randomized Clinical Trial","volume":"7","author":"Du","year":"2024","journal-title":"JAMA Netw. Open"}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/9\/425\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:41:11Z","timestamp":1788410471000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/13\/9\/425"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcdd13090425"],"URL":"https:\/\/doi.org\/10.3390\/jcdd13090425","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}