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Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation

Lombardi, Kristin C; Northrup, Veronika; McNamara, Robert L; Sugeng, Lissa and Weismann, Constance G LU (2013) In American Journal of Cardiology 112(11). p.33-1828
Abstract

Aortic stiffness and diastolic function are abnormal in adults with repaired coarctation of the aorta (CoA). The goal of this study was to determine the relation between aortic stiffness and left ventricular (LV) diastolic impairment in children who had undergone CoA repair very early in life. This is a retrospective review of echocardiograms in children with isolated repaired CoA (group CoA; n = 24) and healthy matched controls (group Normal; n = 24). We analyzed systolic and LV diastolic functions, proximal and distal ascending aortic stiffness indices (SIs), distensibility, and strain. Age range was 0.3 to 21 (median 9) years. Age at time of CoA repair was 0 to 24 (median 0.5) months. Median time since CoA repair was 6 years. There... (More)

Aortic stiffness and diastolic function are abnormal in adults with repaired coarctation of the aorta (CoA). The goal of this study was to determine the relation between aortic stiffness and left ventricular (LV) diastolic impairment in children who had undergone CoA repair very early in life. This is a retrospective review of echocardiograms in children with isolated repaired CoA (group CoA; n = 24) and healthy matched controls (group Normal; n = 24). We analyzed systolic and LV diastolic functions, proximal and distal ascending aortic stiffness indices (SIs), distensibility, and strain. Age range was 0.3 to 21 (median 9) years. Age at time of CoA repair was 0 to 24 (median 0.5) months. Median time since CoA repair was 6 years. There was no significant difference in blood pressure, LV size, and systolic function between the groups. LV diastolic function was impaired in group CoA compared with group Normal (septal E': CoA 10.3 ± 1.6 cm/s and Normal 13.4 ± 1.9 cm/s, p <0.001). All parameters of proximal and distal ascending aortic elasticities were abnormal in group CoA versus Normal (SI of proximal ascending aorta: CoA 4.9 ± 1.6 and Normal 2.7 ± 0.6, p <0.001). Across all patients, there was a strong correlation between septal E' and proximal ascending aortic SI (r = -0.72, p <0.001). In conclusion, even children who underwent CoA repair at a very young age have abnormal LV diastolic function and aortic elasticity compared with controls and there is a linear relation between the 2. LV diastolic dysfunction in patients with repaired CoA may be due to chronically increased afterload.

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author
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Contribution to journal
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published
subject
keywords
Adolescent, Aorta/diagnostic imaging, Aortic Coarctation/complications, Case-Control Studies, Child, Child, Preschool, Diastole/physiology, Echocardiography, Doppler, Female, Humans, Infant, Male, Retrospective Studies, Vascular Stiffness/physiology, Ventricular Dysfunction, Left/diagnostic imaging, Ventricular Function, Left, Young Adult
in
American Journal of Cardiology
volume
112
issue
11
pages
6 pages
publisher
Excerpta Medica
external identifiers
  • scopus:84887999465
ISSN
1879-1913
DOI
10.1016/j.amjcard.2013.07.052
language
English
LU publication?
no
id
b1aafc8b-f8aa-42c3-bbd9-b54c66b2c408
date added to LUP
2019-01-25 14:48:39
date last changed
2019-10-15 06:57:03
@article{b1aafc8b-f8aa-42c3-bbd9-b54c66b2c408,
  abstract     = {<p>Aortic stiffness and diastolic function are abnormal in adults with repaired coarctation of the aorta (CoA). The goal of this study was to determine the relation between aortic stiffness and left ventricular (LV) diastolic impairment in children who had undergone CoA repair very early in life. This is a retrospective review of echocardiograms in children with isolated repaired CoA (group CoA; n = 24) and healthy matched controls (group Normal; n = 24). We analyzed systolic and LV diastolic functions, proximal and distal ascending aortic stiffness indices (SIs), distensibility, and strain. Age range was 0.3 to 21 (median 9) years. Age at time of CoA repair was 0 to 24 (median 0.5) months. Median time since CoA repair was 6 years. There was no significant difference in blood pressure, LV size, and systolic function between the groups. LV diastolic function was impaired in group CoA compared with group Normal (septal E': CoA 10.3 ± 1.6 cm/s and Normal 13.4 ± 1.9 cm/s, p &lt;0.001). All parameters of proximal and distal ascending aortic elasticities were abnormal in group CoA versus Normal (SI of proximal ascending aorta: CoA 4.9 ± 1.6 and Normal 2.7 ± 0.6, p &lt;0.001). Across all patients, there was a strong correlation between septal E' and proximal ascending aortic SI (r = -0.72, p &lt;0.001). In conclusion, even children who underwent CoA repair at a very young age have abnormal LV diastolic function and aortic elasticity compared with controls and there is a linear relation between the 2. LV diastolic dysfunction in patients with repaired CoA may be due to chronically increased afterload. </p>},
  author       = {Lombardi, Kristin C and Northrup, Veronika and McNamara, Robert L and Sugeng, Lissa and Weismann, Constance G},
  issn         = {1879-1913},
  keyword      = {Adolescent,Aorta/diagnostic imaging,Aortic Coarctation/complications,Case-Control Studies,Child,Child, Preschool,Diastole/physiology,Echocardiography, Doppler,Female,Humans,Infant,Male,Retrospective Studies,Vascular Stiffness/physiology,Ventricular Dysfunction, Left/diagnostic imaging,Ventricular Function, Left,Young Adult},
  language     = {eng},
  month        = {12},
  number       = {11},
  pages        = {33--1828},
  publisher    = {Excerpta Medica},
  series       = {American Journal of Cardiology},
  title        = {Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation},
  url          = {http://dx.doi.org/10.1016/j.amjcard.2013.07.052},
  volume       = {112},
  year         = {2013},
}