Persistent reduced myocardial deformation in neonates after CoA repair

Area of Science:

• Cardiology
• Pediatric Cardiology
• Echocardiography

Background:

• Coarctation of the aorta (CoA) repair in children is safe but associated with potential recurrence and complications.
• Abnormal aortic properties in CoA suggest persistent effects on left ventricular (LV) function post-repair.
• Two-dimensional speckle tracking echocardiography (STE) can assess LV myocardial mechanics.

Purpose of the Study:

• To evaluate LV myocardial mechanics in neonates with corrected CoA using 2D STE.
• To understand the impact of CoA repair on LV function over time.
• To identify factors associated with persistent LV dysfunction.

Main Methods:

• Retrospective study of 21 neonates with corrected CoA.
• STE analysis performed at three time points: pre-intervention, short-term, and medium-term follow-up.
• Comparison with normal LV function values.

Main Results:

• LV function significantly improved post-intervention but did not reach normal values at medium-term follow-up.
• Medium-term longitudinal strain correlated with pre-intervention ejection fraction.
• Subnormal LV function was more common in patients with bicuspid aortic valve.

Conclusions:

• 2D STE is feasible for evaluating and monitoring LV myocardial function in neonates with CoA.
• Subendocardial dysfunction persists in infants with corrected CoA long after surgical repair.
• Long-term follow-up with myocardial deformation measurements is crucial for understanding CoA's natural history.