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Doppler echocardiographic profile and indexes in the evaluation of aortic coarctation in patients before and after stenting.

Abstract：

OBJECTIVES:We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients. BACKGROUND:Doppler echocardiography demonstrates characteristic flow patterns in significant aortic coarctation. METHODS:We undertook retrospective echocardiographic analyses before and at six to nine months after coarctation stenting in consecutive patients from 2002 to 2003. Peak systolic pressure gradient (SPG), diastolic velocity (DV), end-diastolic tail velocity (EDTV), systolic velocity half-time index (SVHTi) and diastolic velocity half-time index (DVHTi), and systolic pressure half-time index (SPHTi) and diastolic pressure half-time index (DPHTi) were measured. The severity of aortic coarctation was compared with cardiovascular magnetic resonance (CMR) imaging using the coarctation index (CoAi). RESULTS:The patient cohort was divided into two groups: group 1 (13 patients; age 30 +/- 8 years), which consisted of patients with significant aortic coarctation treated with stenting, and group 2 (11 patients; age 39 +/- 16 years), which consisted of patients with previous surgical repair of aortic coarctation without evidence of re-coarctation. After stenting, there was significant reduction in SPG (p = 0.001), DV (p = 0.001), EDTV (p = 0.005), DVHTi (p = 0.001), and DPHTi (p = 0.001) values. In the patient group as a whole, there was a significant correlation between SPG and DV (r = 0.86; p < 0.001), EDTV (r = 0.80; p < 0.001), DVHTi (r = 0.56; p < 0.001), and DPHTi (r = 0.50; p = 0.002). In addition, DV >193 cm/s (100% sensitivity, 100% specificity) and diastolic/systolic velocity ratio >0.53 (100% sensitivity, 96% specificity) had high predictive values for severe aortic coarctation (CoAi <0.25). CONCLUSIONS:After stenting, peak SPG, DV, and pressure half-time indexes (i.e., DVHTi and DPHTi) decreased significantly. These findings can confidently be used in the follow-up of coarctation patients after stenting, particularly in those with limited two-dimensional images.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Tan JL,Babu-Narayan SV,Henein MY,Mullen M,Li W

doi

10.1016/j.jacc.2005.05.076

subject

Has Abstract

pub_date

2005-09-20 00:00:00

pages

1045-53

issue

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(05)01514-7

journal_volume

pub_type

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Doppler echocardiographic profile and indexes in the evaluation of aortic coarctation in patients before and after stenting.