Haki Jashari1, Katarina Lannering2, Pranvera Ibrahimi1, Demir Djekic1, Mats Mellander2, Annika Rydberg3, Michael Y Henein4. 1. Department of Public Health and Clinical Medicine, Umeå University, Sweden. 2. Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden. 3. Department of Clinical Sciences, Umeå University, Sweden. 4. Department of Public Health and Clinical Medicine, Umeå University, Sweden. Electronic address: michael.henein@umu.se.
Abstract
INTRODUCTION: Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. METHODS AND RESULTS: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05). CONCLUSION: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.
INTRODUCTION: Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE. METHODS AND RESULTS: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05). CONCLUSION: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.
Authors: Katie L Skeffington; Andrew R Bond; M Giulia Bigotti; Safa AbdulGhani; Dominga Iacobazzi; Sok-Leng Kang; Kate J Heesom; Marieangela C Wilson; Serban Stoica; Robin Martin; Massimo Caputo; M Saadeh Suleiman; Mohamed T Ghorbel Journal: Exp Ther Med Date: 2020-09-03 Impact factor: 2.447
Authors: Elles J Dijkema; Martijn G Slieker; Johannes M P J Breur; Tim Leiner; Heynric B Grotenhuis Journal: Pediatr Cardiol Date: 2017-12-05 Impact factor: 1.655
Authors: Katie L Skeffington; Andrew R Bond; Safa Abdul-Ghani; Dominga Iacobazzi; Sok-Leng Kang; Kate J Heesom; Marieangela C Wilson; Mohamed Ghorbel; Serban Stoica; Robin Martin; M Saadeh Suleiman; Massimo Caputo Journal: J Clin Med Date: 2019-04-16 Impact factor: 4.241