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

Giorgio Faganello1, Maurizio Fisicaro1, Giulia Russo1

  • 1Cardiovascular Center, Health Authority n° 1, Trieste, Italy.

Congenital Heart Disease
|November 12, 2015
PubMed

Insights

Long-term repair of aortic coarctation (CoA) often leads to asymptomatic longitudinal left ventricular systolic dysfunction (LVSD), impacting diastolic function. This highlights the need for ongoing monitoring in repaired CoA patients.

Area of Science:

  • Cardiology
  • Echocardiography
  • Cardiovascular Surgery

Background:

  • Successful repair of aortic coarctation (CoA) can result in a chronic hyperdynamic state.
  • Long-term data on left ventricular (LV) systolic function post-CoA repair are limited.
  • Assessing LV mechanics and identifying factors for LV systolic dysfunction (LVSD) in repaired CoA patients is crucial.

Purpose of the Study:

  • To evaluate long-term LV systolic mechanics in patients with repaired aortic coarctation (CoA).
  • To identify factors associated with LV systolic dysfunction (LVSD) after CoA repair.

Main Methods:

  • Analyzed clinical and echocardiographic data from 19 repaired CoA patients (28 ± 13 years post-surgery).
  • Assessed LV circumferential (sc-MS) and longitudinal (S') systolic function.
  • Compared CoA patients with age/hypertension-matched controls and healthy controls.

Main Results:

  • No significant differences in LV volumes, mass, or geometry were observed between groups.
  • LV ejection fraction and sc-MS were similar across groups.
  • CoA patients exhibited significantly lower peak S' (7.1 ± 1.3 cm/s) compared to controls (10.3 ± 1.9 and 11.1 ± 1.5 cm/s; P < 0.001).
  • Prevalence of longitudinal LVSD (low S') was 84% in CoA patients versus 13% in matched and 5% in healthy controls (P < 0.05).
  • Low peak S' was independently associated with a higher E/E' ratio and the presence of CoA.

Conclusions:

  • Repaired aortic coarctation (CoA) patients frequently develop asymptomatic longitudinal LVSD.
  • This dysfunction is linked to impaired LV diastolic function in the long term.
  • Findings underscore the importance of monitoring LV function post-CoA repair.
Abstract

Keywords:
Aortic CoarctationCardiac FunctionLeft Ventricular Systolic Function

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