title: Arterial-left ventricular-left atrial coupling late after repair of aortic coarctation and interruption.
abstract: OBJECTIVE
  This study aimed to explore the arterial-left ventricular (LV)-left atrial (LA) interaction in adolescents and young adults late after intervention for coarctation of the aorta (CoA) and interrupted aortic arch (IAA).
  
  
  RESULTS
  Thirty-one (16 males) patients aged 23.4 ± 6.3, at 20.6 ± 5.2 years after intervention, and 31 controls were studied. Carotid arterial stiffness and intima-media thickness (IMT) and brachial-ankle pulse wave velocity were determined by radiofrequency-based echocardiography and oscillometry, respectively. Tissue Doppler and speckle tracking echocardiography (STE) were performed to assess, respectively, LV myocardial tissue velocities and linear and torsional deformation. Left atrial positive, negative, and total strain and strain rate at ventricular systole (aSRs), early diastole (aSRed), and atrial contraction (aSRac) were also determined using STE. Patients had significantly greater arterial stiffness and IMT than controls (all P < 0.05). Mitral annular systolic and diastolic velocities, LV longitudinal and radial strain and early diastolic strain rates, peak torsion and untwisting velocity, and LA peak positive and total strain, aSRs, aSRed, and aSRac were significantly lower in patients than in controls (all P < 0.05). Arterial stiffness correlated inversely with LV longitudinal strain and systolic and early diastolic strain rate (all P < 0.05), while LA total strain and aSRed were associated positively with LV diastolic annular velocity, longitudinal SRe, and peak untwisting velocity (all P < 0.05). Multiple linear regression further revealed arterial stiffness as an independent determinant of LA total strain (β = -1.3, P = 0.034).
  
  
  CONCLUSIONS
  Our findings suggest impairment of arterial function and LV and LA mechanics in patients after CoA and IAA repair and implicate an abnormal arterial-LV-LA interaction.
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, 102 Pokfulam Road, Hong Kong, China.
authors.forename: Vivian Wing-yi
authors.initials: VW
authors.lastname: Li
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, University of Hong Kong, 102 Pokfulam Road, Hong Kong, China xfcheung@hkucc.hku.hk.
authors.forename: Yiu-fai
authors.initials: YF
authors.lastname: Cheung
mesh_terms: D000015:Abnormalities, Multiple / Q000000981:diagnostic imaging / Q000601:surgery; D000293:Adolescent; D000328:Adult; D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging; D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000601:surgery*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006330:Heart Defects, Congenital / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D059289:Vascular Stiffness; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: arteries; coarctation of the aorta; interrupted aortic arch; left atrium; left ventricular