Increased central aortic stiffness and left ventricular mass in normotensive young subjects after successful coarctation repair.
BACKGROUND
Hypertension occurs in 20% to 40% of survivors of anatomically successful repair of aortic coarctation (CoA). The aim of the present study was to examine the role of central aortic function in this setting.


METHODS
Forty normotensive asymptomatic subjects with successful CoA repair (age 12 +/- 8 years) and 20 age- and sex-matched control subjects underwent detailed magnetic resonance imaging investigation of the thoracic aorta and left ventricle. Aortic distensibility, compliance, and stiffness beta index were calculated in the central (precoarctation) and descending (postcoarctation) aorta. Aortic pulse wave velocity was measured and left ventricular mass was calculated.


RESULTS
Compared to control subjects, CoA subjects had markedly decreased central aortic distensibility (2.8 +/- 0.7 vs 4.2 +/- 0.5 mm Hg(-1) x 10(-3), P < .001) and compliance (1.7 +/- 0.3 vs 2.5 +/- 0.6 mm2 mm Hg(-1), P < .001) and increased stiffness beta index (5.2 +/- 1 vs 2.5 +/- 0.6, P < .001). Pulse wave velocity was also significantly increased in the CoA subjects (4.7 +/- 1.3 vs 3.3 +/- 0.6 m/sec, P < .001). Left ventricular mass index was higher in the CoA subjects (84 +/-11 vs 73 +/-10 g/m2, P = .01) and correlated significantly with aortic stiffness beta index (r2 = 0.8, P < .0001). By contrast, descending aortic characteristics were similar in the CoA and control subjects.


CONCLUSIONS
Central aortic stiffness is markedly increased and associated with increased left ventricular mass in normotensive young subjects after successful early repair of CoA.
Ou
Phalla
P
Department of Pediatric Radiology, Hôpital Necker-Enfants Malades, University Rene Descartes-Paris 5, Paris, France. phalla.ou@nck.ap-hop-paris.fr
Celermajer
David S
DS
Jolivet
Odile
O
Buyens
Fanny
F
Herment
Alain
A
Sidi
Daniel
D
Bonnet
Damien
D
Mousseaux
Elie
E
D000293:Adolescent; D001011:Aorta / Q000473:pathology*; D001017:Aortic Coarctation / Q000175:diagnosis* / Q000601:surgery*; D001795:Blood Pressure Determination; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis; D011336:Probability; D011673:Pulsatile Flow; D012016:Reference Values; D018570:Risk Assessment; D014655:Vascular Resistance