title: Doppler echocardiographic profile and indexes in the evaluation of aortic coarctation in patients before and after stenting.
abstract: OBJECTIVE
  We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients.
  
  
  BACKGROUND
  Doppler echocardiography demonstrates characteristic flow patterns in significant aortic coarctation.
  
  
  METHODS
  We undertook retrospective echocardiographic analyses before and at six to nine months after coarctation stenting in consecutive patients from 2002 to 2003. Peak systolic pressure gradient (SPG), diastolic velocity (DV), end-diastolic tail velocity (EDTV), systolic velocity half-time index (SVHTi) and diastolic velocity half-time index (DVHTi), and systolic pressure half-time index (SPHTi) and diastolic pressure half-time index (DPHTi) were measured. The severity of aortic coarctation was compared with cardiovascular magnetic resonance (CMR) imaging using the coarctation index (CoAi).
  
  
  RESULTS
  The patient cohort was divided into two groups: group 1 (13 patients; age 30 +/- 8 years), which consisted of patients with significant aortic coarctation treated with stenting, and group 2 (11 patients; age 39 +/- 16 years), which consisted of patients with previous surgical repair of aortic coarctation without evidence of re-coarctation. After stenting, there was significant reduction in SPG (p = 0.001), DV (p = 0.001), EDTV (p = 0.005), DVHTi (p = 0.001), and DPHTi (p = 0.001) values. In the patient group as a whole, there was a significant correlation between SPG and DV (r = 0.86; p < 0.001), EDTV (r = 0.80; p < 0.001), DVHTi (r = 0.56; p < 0.001), and DPHTi (r = 0.50; p = 0.002). In addition, DV >193 cm/s (100% sensitivity, 100% specificity) and diastolic/systolic velocity ratio >0.53 (100% sensitivity, 96% specificity) had high predictive values for severe aortic coarctation (CoAi <0.25).
  
  
  CONCLUSIONS
  After stenting, peak SPG, DV, and pressure half-time indexes (i.e., DVHTi and DPHTi) decreased significantly. These findings can confidently be used in the follow-up of coarctation patients after stenting, particularly in those with limited two-dimensional images.
authors.affiliation: Adult Congenital Heart Disease Unit, Royal Brompton Hospital, London, United Kingdom.
authors.forename: Ju-Le
authors.initials: JL
authors.lastname: Tan
authors.forename: Sonya V
authors.initials: SV
authors.lastname: Babu-Narayan
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Henein
authors.forename: Michael
authors.initials: M
authors.lastname: Mullen
authors.forename: Wei
authors.initials: W
authors.lastname: Li
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000601:surgery*; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors