Regional left ventricular myocardial shortening in normotensive patients late after aortic coarctation repair - normal or impaired?

Despite successful repair of aortic coarctation (AoC), changes in the left ventricular (LV) regional myocardial function are reported. The aims of this study were (i) to determine LV regional longitudinal deformation in patients who underwent a repair of AoC, who were normotensive and who had normal LV global function; and (ii) to establish a potential correlation between the degree of residual narrowing in the descending aorta and the extent of LV regional deformation. We studied 22 normotensive patients aged 19-58 y (mean 32.6; SD+/-11.3). Maximal strain, epsilon (%), as well as peak systolic and early and late diastolic strain rates (SRs; s(-1)), were obtained on the basis of speckle tracking. The data were compared with those obtained from sex and age-matched controls. Regional SRs were significantly reduced for the LV anterior wall during systole and early diastole -1.1 vs. -1.39; 1.41 vs. 1.86 s(-1), respectively; p<0.05. Transaortic maximal and mean gradients across the coarctation site correlated with epsilon and systolic SR obtained from the midsegment of the LV anterior wall. Despite a successful repair, absence of systemic hypertension and normal global LV function, regional deformation properties of the anterior LV wall were impaired. The degree of longitudinal impairment in this anatomical region correlated with the extent of residual narrowing.