Doppler Flow Pattern and Arterial Stiffness in Patients with Aortic Coarctation

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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
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Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness

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Susana Cordeiro1, João Gomes2, Inês Carmo Mendes3

  • 1Hospital de Santa Cruz, Centro Hospitalar Lisboa Ocidental, Av. Prof. Reinaldo dos Santos, 2799-523, Carnaxide, Portugal. susanacordeiromendes@gmail.com.

Pediatric Cardiology
|August 26, 2016
PubMed

Insights

Diastolic flow in the descending aorta in patients with aortic coarctation (CoAo) is linked to arterial stiffness. Lower aortic stiffness may contribute to persistent diastolic flow, aiding CoAo treatment decisions.

Area of Science:

  • Cardiovascular Medicine
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Aortic coarctation (CoAo) is a congenital heart defect characterized by narrowing of the aorta.
  • Patients with CoAo often exhibit diastolic flow in the descending aorta, a phenomenon not fully understood.
  • Arterial stiffness is a known factor influencing hemodynamic patterns, but its specific role in CoAo flow dynamics requires further elucidation.

Purpose of the Study:

  • To investigate the relationship between arterial stiffness and Doppler flow patterns in patients with aortic coarctation.
  • To determine if arterial stiffness influences the presence of diastolic flow in the descending aorta in CoAo patients.
  • To provide data supporting treatment decisions for CoAo by correlating flow patterns and arterial stiffness.

Main Methods:

  • Fifty studies were analyzed from 31 patients with CoAo, including pre- and post-intervention assessments in 19 patients.
  • Invasive systolic gradients (Sgrad) and Doppler parameters (Dgrad, DVT, DVQ, SHPTc, DHPTc, VRc) were measured.
  • Arterial stiffness was assessed using pulse wave velocity (PWV) between the carotid and radial arteries in 19 patients.

Main Results:

  • Systolic invasive gradients (Sgrad) significantly correlated with all measured Doppler parameters (p < 0.01).
  • Multiple regression analysis identified Dgrad and DHPTc as key predictors of Sgrad variability (R² = 0.766).
  • In patients with Sgrad < 30 mmHg, lower arterial stiffness (PWV) was associated with persistent diastolic flow (DTail=1, p=0.024), particularly in mild to moderate CoAo.

Conclusions:

  • Doppler-derived systolic and diastolic parameters effectively correlate with the severity of aortic coarctation.
  • Lower arterial stiffness is a significant factor contributing to the presence of diastolic flow in the descending aorta in patients with mild to moderate CoAo.
  • Understanding the interplay between arterial stiffness and flow dynamics can inform therapeutic strategies for aortic coarctation.

Keywords:
Arterial stiffnessCoarctationInvasive gradients

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