title: Comparison by magnetic resonance phase contrast imaging of pulse-wave velocity in patients with single ventricle who have reconstructed aortas versus those without.
abstract: Pulse-wave velocity (PWV), a measure of arterial stiffness, is a known independent risk factor for cardiovascular events. Patients with single ventricle who undergo aortic to pulmonary anastomosis (recon) have noncompliant patch material inserted into the neoaorta, possibly increasing vessel stiffness and afterload. The purpose of this study is to determine if PWV in patients with single ventricle differed between those who did and those who did not undergo aortic reconstruction (nonrecon). We retrospectively reviewed cardiac magnetic resonance anatomic, cine, and phase contrast evaluations in the ascending aorta and descending aorta (DAo) at the level of the diaphragm data from 126 patients with single ventricle (8.6 ± 8.0 years) from January 2012 to May 2013. Significance = p <0.05. Seventy-five patients underwent recon and 51 did not. PWV in recon was significantly higher than in nonrecon (3.9 ± 0.9 m/s vs 3.2 ± 1.0 m/s, p = 0.008); in recon, patients >13 years old had a higher PWV than those <7 years (4.5 ± 0.6 vs 3.5 ± 0.7 m/s, p = 0.004). Whether <7 or >13 years old, PWV of those with recon was higher than nonrecon DAo distensibility was similar between both groups. There was no difference in age, body surface area, or cardiac index between recon and nonrecon. No correlations between various hemodynamic and ventricular function parameters with PWV were noted. In conclusion, PWV in recon is higher than in nonrecon with similar DAo distensibility implicating the aortic reconstruction as a possible cause of increased afterload; older recon patients have stiffer aortas than younger ones, possibly imposing an additional cardiovascular risk in the future. Other biomaterials may potentially moderate PWV if clinical outcome is adversely affected.
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: fogel@email.chop.edu.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Fogel
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Christine
authors.initials: C
authors.lastname: Li
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Susan C
authors.initials: SC
authors.lastname: Nicolson
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Spray
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: J William
authors.initials: JW
authors.lastname: Gaynor
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fuller
authors.affiliation: Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Marc S
authors.initials: MS
authors.lastname: Keller
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Harris
authors.affiliation: The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia.
authors.forename: Ajit P
authors.initials: AP
authors.lastname: Yoganathan
authors.affiliation: Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania; Department of Radiology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at The University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Whitehead
mesh_terms: D001013:Aorta, Thoracic / Q000503:physiopathology*; D002648:Child; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000503:physiopathology; D006352:Heart Ventricles / Q000002:abnormalities*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D063177:Pulse Wave Analysis / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D059289:Vascular Stiffness / Q000502:physiology
chemical_list: D003287:Contrast Media