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Are aortic coarctation and rheumatoid arthritis different models of aortic stiffness? Data from an echocardiographic

Giorgio Faganello1, Giovanni Cioffi2, Maurizio Rossini3

  • 1Cardiovascular Centre, Department of Cardiology, Azienda Sanitaria Universitaria Integrata di Trieste, via Slataper n°9, 34134, Trieste, Italy. giorgio.faganello@asuits.sanita.fvg.it.

Cardiovascular Ultrasound
|June 27, 2018
PubMed

Insights

Patients with repaired aortic coarctation (CoA) have increased aortic stiffness. This aortic stiffness index (AoSI) is higher than in rheumatoid arthritis (RA) patients and controls, indicating a higher cardiovascular event risk in a CoA subgroup.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Medical Imaging

Background:

  • Patients with repaired aortic coarctation (CoA) face a significant risk of cardiovascular events.
  • Ascending aorta (Ao) mechanical and structural abnormalities may influence CoA patient prognosis.
  • Aortic stiffness, measured by aortic stiffness index (AoSI), is a potential marker for cardiovascular risk.

Purpose of the Study:

  • To analyze the elastic properties of the ascending aorta (Ao) in patients with repaired aortic coarctation (CoA).
  • To compare aortic stiffness index (AoSI) in CoA patients with rheumatoid arthritis (RA) patients and healthy controls.
  • To identify factors associated with elevated AoSI in CoA patients.

Main Methods:

  • Analysis of data from 19 CoA patients, 28 ± 13 years post-surgery.
  • Assessment of aortic stiffness index (AoSI) at the aortic root using 2D-guided M-mode echocardiography.
  • Comparison of AoSI between CoA patients, 38 RA patients, and 38 matched controls.

Main Results:

  • CoA patients exhibited more than double the AoSI compared to RA patients and controls (9.8 ± 12.6% vs. 4.8 ± 2.5% and 3.1 ± 2.0%, respectively; p < 0.05).
  • Abnormally high AoSI (>6.07%) was observed in 26% of CoA patients.
  • High AoSI in a subgroup of CoA patients was associated with older age, higher blood pressure, increased left ventricular (LV) mass, and LV diastolic dysfunction.

Conclusions:

  • Repaired aortic coarctation (CoA) patients demonstrate significantly higher aortic stiffness index (AoSI) levels compared to rheumatoid arthritis (RA) patients and controls.
  • A subset of CoA patients presents with abnormally high AoSI, signifying a high-risk clinical profile for adverse cardiovascular events.
  • Elevated AoSI is independently associated with left ventricular hypertrophy and increased relative wall thickness in CoA patients.
Abstract

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