Abstract
Objective
To evaluate the application of four-dimensional auto left atrial quantification (4D Auto LAQ) technology in assessing left atrial (LA) function following transcatheter closure of a patent foramen ovale (PFO).
Methods
In this prospective study, patients diagnosed with a PFO and scheduled for transcatheter closure at the First Affiliated Hospital of Xinxiang Medical University underwent transthoracic echocardiography and 4D Auto LAQ examinations before the procedure and at 1 day and 1, 3, 6 and 12 months after procedure. Left atrial structural parameters, volumetric parameters and strain parameters were measured. Repeated measures analysis of variance was used to analyse parameter changes over time.
Results
Thirty-two patients (13 men, 19 women; mean age: 44.0 ± 9.5 years) were included in the final analysis. Left atrial volume minimum increased significantly following closure (P = 0.007), whereas total LA ejection fraction (LAEF) and active LAEF decreased (P < 0.001 and P = 0.019, respectively). Several LA strain indices, including reservoir strain (LASr) and circumferential reservoir/conduit/contraction strains (LASr_c, LAScd_c and LASct_c), showed significant postoperative reductions (all P < 0.010). No significant differences were observed in other tracked measurements over time (all P > 0.050). The observed changes occurred early after closure and appeared to stabilise during subsequent follow-up.
Conclusion
Four-dimensional auto left atrial quantification could provide a sensitive and non-invasive approach to evaluate LA volume and strain changes following PFO closure. Given the observational, non-comparative design, causal inference cannot be made; the detected alterations should be interpreted as hypothesis generating. Larger controlled studies incorporating clinical endpoints are warranted to determine the mechanisms and clinical relevance of these imaging changes.
Data availability
The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
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Funding
1. Study on the value of ultrasound four-dimensional left atrial quantitative analysis technology in evaluating left atrial function in patients undergoing patent foramen ovale closure; No. LHGJ20220630.
2. Analysis of the application value of ultrasound in common acute abdomen in children; No. ON-2022-B14.
This study was directly supported by the project Grant No.: LHGJ20220630. An additional departmental grant provided general institutional support for equipment and training but did not directly fund the present study.
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Conception and design of the research: Lv FH, Zhou WY. Acquisition of data: Li R, Shang J. Analysis and interpretation of the data: Guo LJ, Wang Z. Statistical analysis: Fan HJ, Zhang PY. Obtaining financing: None. Writing of the manuscript: Zhou WY, Li R. Critical revision of the manuscript for intellectual content: Lv FH.All authors reviewed and approved of the final manuscript.
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This study was conducted in accordance with the Declaration of Helsinki and approved by the Research Ethics Committee of The First Affiliated Hospital of Xinxiang Medical University (No. EC-025-438, Date: 2022. 04. 01), and written informed consent was obtained from all participants. All methods were carried out in accordance with relevant guidelines and regulations. Written informed consent was obtained from all participants. All methods were carried out in accordance with relevant guidelines and regulations.
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Zhou, W., Li, R., Shang, J. et al. Assessment of left atrial function following patent foramen ovale closure using four-dimensional auto left atrial quantification. BMC Cardiovasc Disord (2026). https://doi.org/10.1186/s12872-026-05614-1
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DOI: https://doi.org/10.1186/s12872-026-05614-1