Evidence map›Paper›PMID 38024117›Full record

ArticleJournal of cardiology cases2023

A case of atrial septal defect with right-to-left shunting without pulmonary hypertension.

Yusuke Yamazaki, Yohei Numasawa, Taro Mase, Miona Arai, Takashi Maeda, Yuhei Shinoda, Kosuke Watabe, Shoya Ono, Ryota Hashimoto, Souichi Yokokura and 4 more

Open access · greenAbstract readCase Reports
In one paragraph

Article in Journal of cardiology cases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.3field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 1 institution in 1 country.

Yusuke YamazakiDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Yohei NumasawaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Taro MaseDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Miona AraiDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Takashi MaedaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Yuhei ShinodaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Kosuke WatabeDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Shoya OnoDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Ryota HashimotoDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Souichi YokokuraDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Sho HaginiwaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Hidenori KojimaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Makoto TanakaDepartment of Cardiology, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Kiyoshi KoizumiDepartment of Cardiovascular Surgery, Japanese Red Cross Ashikaga Hospital, Ashikaga, Japan.
Ashikaga Red Cross Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

We report a case of a 54-year-old man with atrial septal defect who presented with oxygen desaturation on pulse oximetry. Cardiac magnetic resonance imaging and transesophageal echocardiography showed right-to-left shunting through an atrial septal defect, which was confirmed by superior vena cavography and suggested Eisenmenger syndrome. However, cardiac catheterization revealed a normal pulmonary arterial pressure. Simultaneous measurement of interatrial pressure identified two transient interatrial pressure gradient points, where the right atrial pressure was higher than the left atrial pressure. The patient was finally diagnosed with atrial septal defect without pulmonary hypertension. Right-to-left shunting was primarily caused by a transient interatrial pressure gradient due to a time delay in both initial atrial contraction and completion of passive ventricular filling between the right and left sides of the heart. Surgical closure of the atrial septal defect was performed, and hypoxemia improved. This is the first report of right-to-left shunting without pulmonary hypertension caused by a transient interatrial pressure gradient due to a time delay between the right and left cardiac cycles. Precise assessment of the simultaneous interatrial pressure in addition to diagnostic imaging played a pivotal role in clarifying the etiology of this rare condition. Learning objective: Atrial septal defect with right-to-left shunting without Eisenmenger syndrome is a rare condition. We identified transient interatrial pressure gradients associated with a time delay in both initial atrial contraction and completion of the passive ventricular filling phase, which we considered as the primary mechanism underpinning right-to-left shunting. Simultaneous measurement of interatrial pressure played a pivotal role in elucidating the hemodynamics and abnormal shunt flow mechanism.

Indexed as

Atrial septal defectCongenital heart diseaseEisenmenger syndromePulmonary hypertension

Identifiers

PMID38024117
PMCPMC10658296
OpenAlexW4385879464

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.