TY - JOUR
T1 - Headache and Left Ventricular Efficiency After Transcatheter Closure of Atrial Septal Defect
AU - Matsuoka, Ryohei
AU - Muneuchi, Jun
AU - Nagatomo, Yusaku
AU - Sugitani, Yuichiro
AU - Ezaki, Hiroki
AU - Doi, Hirohito
AU - Watanabe, Mamie
N1 - Funding Information:
We thank Dr. Kenichiro Yamamura, Kyushu University Hospital, for an insightful comment regarding statistical analysis. Public Partnership: This research is carried out with patients, carers, or members of the public, not on them. It encompasses the joint setting of research priorities, defining research questions and outcome measures, providing input into study design and conduct as well as the dissemination of results, and evaluation of studies.
Publisher Copyright:
© 2020 American Headache Society
PY - 2020/11/1
Y1 - 2020/11/1
N2 - Objective/Background: This study aimed to clarify the relationship between migraine-like headache and ventriculo-arterial coupling after transcatheter closure of the atrial septal defect in children. We hypothesized that migraine headache after defect closure would be related to an abnormal hemodynamic response against an increased left ventricular filling. Design: A retrospective cohort study. Methods: We calculated the end-ventricular systolic elastance (Ees), effective arterial elastance (Ea), and ventricular energy efficiency approximated based on echocardiography before and after defect closure, and compared these parameters between the subjects with and without headache after defect closure. Results: A total of 167 subjects were studied. Age at the procedure, defect diameter, and pulmonary to systemic blood flow ratio were 11 (9-17) years, 12.8 (9.2-16.0) mm, and 1.8 (1.6-2.3), respectively. We identified 47 (28%) subjects with migraine headache after defect closure. Although there was no significant difference in the Ees, Ea, and ventricular energy efficiency before defect closure between the groups, the Ees (4.0 [3.4-4.9] vs 4.8 [3.7-6.1], P =.014) and ventricular energy efficiency (0.79 [0.76-0.82] vs 0.83 [0.79-0.85], P =.001) after defect closure in subjects with headache were significantly lower than those in subjects without headache. Migraine headache after defect closure was significantly associated with age (odds ratio: 0.97, 95% confidential interval: 0.94-1.00, P =.036) and a decrease in the ventricular energy efficiency after defect closure (odds ratio: 6.42, 95% confidential interval: 2.76-14.90, P <.001). Conclusion: A loss of ventricular energy efficiency was common in pediatric subjects with migraine-like headache after transcatheter closure of the atrial septal defect, which suggested that the left ventricular function maladaptation was related to headache development after defect closure. We advocate that an impaired ventriculo-arterial coupling may be one of the mechanisms for developing attacks in not only this population but also in other patients with migraine.
AB - Objective/Background: This study aimed to clarify the relationship between migraine-like headache and ventriculo-arterial coupling after transcatheter closure of the atrial septal defect in children. We hypothesized that migraine headache after defect closure would be related to an abnormal hemodynamic response against an increased left ventricular filling. Design: A retrospective cohort study. Methods: We calculated the end-ventricular systolic elastance (Ees), effective arterial elastance (Ea), and ventricular energy efficiency approximated based on echocardiography before and after defect closure, and compared these parameters between the subjects with and without headache after defect closure. Results: A total of 167 subjects were studied. Age at the procedure, defect diameter, and pulmonary to systemic blood flow ratio were 11 (9-17) years, 12.8 (9.2-16.0) mm, and 1.8 (1.6-2.3), respectively. We identified 47 (28%) subjects with migraine headache after defect closure. Although there was no significant difference in the Ees, Ea, and ventricular energy efficiency before defect closure between the groups, the Ees (4.0 [3.4-4.9] vs 4.8 [3.7-6.1], P =.014) and ventricular energy efficiency (0.79 [0.76-0.82] vs 0.83 [0.79-0.85], P =.001) after defect closure in subjects with headache were significantly lower than those in subjects without headache. Migraine headache after defect closure was significantly associated with age (odds ratio: 0.97, 95% confidential interval: 0.94-1.00, P =.036) and a decrease in the ventricular energy efficiency after defect closure (odds ratio: 6.42, 95% confidential interval: 2.76-14.90, P <.001). Conclusion: A loss of ventricular energy efficiency was common in pediatric subjects with migraine-like headache after transcatheter closure of the atrial septal defect, which suggested that the left ventricular function maladaptation was related to headache development after defect closure. We advocate that an impaired ventriculo-arterial coupling may be one of the mechanisms for developing attacks in not only this population but also in other patients with migraine.
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U2 - 10.1111/head.13990
DO - 10.1111/head.13990
M3 - Article
C2 - 33045096
AN - SCOPUS:85092292235
SN - 0017-8748
VL - 60
SP - 2421
EP - 2430
JO - Headache
JF - Headache
IS - 10
ER -
