The Impact of Transcatheter or Surgical Defect Closure on Self-Reported Sleep Quality in Adults with Atrial Septal Defect.

OBJECTIVE: Sleep quality in those with cardiovascular disease is significantly lower than in the general population. This study aimed to explore the effect of transcatheter or surgical closure of atrial septal defect (ASD) on sleep quality. METHODS: One hundred nineteen adult patients with ASD who underwent transcatheter or surgical closure were included in the study. Sleep quality was investigated prospectively just before defect closure and six months after defect closure. Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality of these patients. RESULTS: PSQI scores were similar in both groups before the procedure in patients who underwent both transcatheter and surgical closure. The PSQI scores six months after transcatheter closure was significantly improved compared to the PSQI score before transcatheter ASD closure (3.5 ± 2.0 vs. 6.9 ± 3.4, respectively; P<0.001). The PSQI scores six months after surgical ASD closure was significantly improved compared to the PSQI score before surgical closure (4.8 ± 2.1 vs. 7.1 ± 2.0, respectively; P<0.001). Total PSQI scores were also statistically different at six months after transcatheter and surgical closure (3.5 ± 2.0 vs. 4.8 ± 2.1, P=0.014). However, six months after both transcatheter and surgical closure, PSQI scores were significantly decreased in both groups which was more pronounced in patients who underwent transcatheter closure. CONCLUSION: Transcatheter or surgical closure of the defect may be beneficial in improving the sleep quality of adult patients with ASD. Delayed improvement of sleep quality after surgical closure may be an important advantage for transcatheter closure.

Investigation of ocular microstructural changes according to disease severity in patients with chronic obstructive pulmonary disease.

OBJECTIVE: To investigate retinal nerve fibre layer (RNFL) thickness and vascular density alterations in the retina and optic disc in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 66 COPD patients and 54 age- and sex-matched healthy individuals were enrolled in this prospective cross-sectional study. The COPD patients were divided into 3 subgroups (mild, moderate, and severe COPD) based on spirometric parameters as per the Global Initiative for Chronic Obstructive Lung Disease guideline. RNFL thickness, foveal avascular zone area, and vessel density in the superficial capillary plexus, deep capillary plexus, and radial peripapillary capillary plexus were measured by optical coherence angiography and compared among groups. RESULTS: There was no significant difference between COPD patients and control individuals in terms of foveal avascular zone area or RNFL thickness (p = 0.891 and p = 0.896, respectively). Patients with severe COPD showed lower vessel density in the superficial capillary plexus compared with the other groups, but the difference was not significant (p > 0.05). In the deep capillary plexus, vessel density did not differ significantly among groups in the foveal region (p > 0.05) but was significantly lower in all parafoveal quadrants in the severe COPD group. Radial peripapillary capillary plexus vessel density also was lower in the severe COPD group, especially the peripapillary region (p = 0.044). CONCLUSION: Although COPD is primarily a lung disease, the eye seems to be among the tissues affected in its natural course. The effects are more pronounced in patients with severe COPD and in the deep capillary plexus and radial peripapillary capillary plexus.