Abstract
Arterial vasculopathy and residual aortic obstruction can lead to left ventricular (LV) dysfunction in patients with coarctation of the aorta (CoA) related to adverse ventriculo-arterial coupling. This study aimed to investigate potential differences in LV myocardial deformation indices between repaired CoA patients and healthy controls. Twenty-two CoA patients (age 30 ± 10.6 years) after surgical repair (n = 12) or balloon angioplasty (BA) (n = 10) without residual stenosis, between 3 months and 16 years of age with > 10 years follow-up were compared to 22 healthy age- and gender-matched controls (age 30 ± 3.8 years). Cardiac magnetic resonance feature tracking (CMR-FT) was used for LV longitudinal-, circumferential-, and rotational deformation indices. Global systolic LV function was preserved in CoA patients (LV ejection fraction 58 ± 4.8 vs. 60 ± 6.8%, p = 0.56) when compared to controls, with normal LV dimensions and mass (p > 0.05). Twelve CoA patients (55%) were hypertensive, of whom 4 were on anti-hypertensive medication. LV global longitudinal strain was preserved in the four-chamber (− 18 ± 4.4 vs. − 16 ± 4.7%, p = 0.06) and two-chamber (− 22 ± 5.1 vs. − 20 ± 6.0%, p = 0.22) orientations in CoA patients. Global circumferential strain was preserved at basal (− 29 ± 4.1 vs. − 28 ± 4.8%, p = 0.43), mid-ventricular (− 27 ± 4.2 vs. − 25 ± 3.0%, p = 0.09), and apical levels (− 35 ± 7.8 vs. − 32 ± 34.9%, p = 0.32). No differences were found in global torsion (2.4 ± 1.3° vs. 2.0 ± 1.4°/cm, p = 0.28), twist (14 ± 5.8° vs. 12 ± 6.3°, p = 0.34), and recoil rate (− 17 ± 9.7° vs. − 17 ± 7.1°/cm s, p = 0.97). Analysis of intra-observer variability demonstrated good reproducibility for all CMR deformation indices. Global and rotational myocardial deformation indices are preserved in CoA patients long-term after repair without residual stenosis, despite a high incidence of hypertension.
Highlights
Coarctation of the aorta (CoA) is defined as a localized narrowing of the aorta, which can be repaired through endovascular and/or surgical treatment [1, 2]
The study population consisted of 22 patients who were successfully treated for CoA with surgery or balloon angioplasty (BA) and had a follow-up of at least 10 years
The study population consisted of 22 CoA patients and 22 healthy controls
Summary
Coarctation of the aorta (CoA) is defined as a localized narrowing of the aorta, which can be repaired through endovascular and/or surgical treatment [1, 2]. Despite adequate relief of the stenosis, CoA patients still have a reduced life expectancy and an increased risk for cardiovascular complications including hypertension, left ventricular (LV) dysfunction, Previous studies have demonstrated preserved or even increased global cardiac function, e.g., LV ejection fraction (LVEF), in patients treated for CoA [6, 11]. Recent reports indicate that quantification of myocardial deformation. Developed CMR feature-tracking (CMR-FT) software provides fast and accessible analysis of myocardial deformation of standard CMR cine images [17,18,19]. This study aimed to investigate CMR-FT myocardial deformation indices of the LV in CoA patients long-term after repair without residual stenosis, with comparison between two treatment strategies: surgical repair and balloon angioplasty (BA)
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