Diastolic Function and Left Atrial Strain in Young Patients with History of Aortic Coarctation Repair

This study aims to describe these parameters in AoCo patients and define their association with severity measures. 53 AoCo patients and 31 healthy controls, aged 12 –40 years, were evaluated. Effectively corrected AoCo (cAoCo) was defined as aortic trans-isthmic corrected Doppler gradient (Dgrad) ≤ 20 mmHg (n = 36), and recoarctation (rAoCo) as Dgrad >  20 mmHg (n = 17). Dependent variables were: E/E’; atrial reservoir strain (Ares); and atrial conduit strain (Acd). T-tests/Mann–Whitney U tests were used to compare these among groups. Multivariable regression was used to test correlation with systolic blood pressure (SBP), indexed LV mass (ILVM), Dgr ad, and the ratio between the narrowest diameter of aortic arch and aorta at diaphragm level (Aoratio). In cAoCo and rAoCo patients, E/E’ was higher (p <  0.001), Ares, and Acd were lower (p <  0.001 for both) comparing with controls. Acd was higher in cAoCo than rAoCo (p = 0.045). Higher Ares was associated with higher Aoratio (p = 0.002), and lower Acd with higher Dgrad (0.014). EF and GLS were not different among groups. Young patients with effectively corrected aortic coarctation have persistent changes in diastolic function parameters (E/E’ and atrial strain), and these are affected by anatomical sequelae. These p atients’ physiology is closer to patients with recoarctation, than to healthy individuals. This provides rationale for a stronger prevention, and treatment,...
Source: Mammalian Genome - Category: Genetics & Stem Cells Source Type: research