Insights from Cardiac Mechanics after Three Decades from Successfully Repaired Aortic Coarctation.

Abstract:

BACKGROUND AND AIMS:Patients who underwent a successful repair of the aortic coarctation show chronic hyperdynamic state and normal left ventricular (LV) geometry; however, there are few data regarding the LV systolic function in the long term. Accordingly, we assessed LV systolic mechanics and factors associated with LV systolic dysfunction (LVSD) in patients with repaired CoA. METHODS:Clinical and echocardiographic data from 19 repaired CoA were analyzed 28 ± 13 years after surgery. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S') were analyzed as indexes of LV circumferential and longitudinal systolic function, respectively. Echocardiographic data of CoA patients were compared with 19 patients matched for age and hypertension and 38 healthy controls. Sc-MS was considered impaired if <89%, S' if <8.5 cm/s (10th percentiles of healthy controls, respectively). RESULTS:There were no statistical differences between study groups in LV volumes, mass and geometry. LV ejection fraction and Sc-MS were similar in all groups, however, CoA group had a significantly lower peak S' in comparison with matched and healthy controls (7.1 ± 1.3, 10.3 ± 1.9, and 11.1 ± 1.5, respectively; all P < 0.001). Prevalence of longitudinal LVSD defined as low S' was 84% in CoA, 13% in matched, and 5% in healthy control group (all P<0.05). Multivariate logistic regression analysis revealed that low peak S' was independently related to higher E/E' ratio and the presence of CoA. CONCLUSIONS:Patients who underwent a successful repair of CoA commonly show asymptomatic longitudinal LVSD associated with worse LV diastolic function in the long-term follow-up.

journal_name

Congenit Heart Dis

journal_title

Congenital heart disease

authors

Faganello G,Fisicaro M,Russo G,Iorio A,Mazzone C,Grande E,Humar F,Cherubini A,Pandullo C,Barbati G,Tarantini L,Benettoni A,Pozzi M,Di Lenarda A,Cioffi G

doi

10.1111/chd.12310

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

254-61

issue

3

eissn

1747-079X

issn

1747-0803

journal_volume

11

pub_type

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