title: Insights from Cardiac Mechanics after Three Decades from Successfully Repaired Aortic Coarctation.
abstract: OBJECTIVE
  Patients who underwent a successful repair of the aortic coarctation show chronic hyperdynamic state and normal left ventricular (LV) geometry; however, there are few data regarding the LV systolic function in the long term. Accordingly, we assessed LV systolic mechanics and factors associated with LV systolic dysfunction (LVSD) in patients with repaired CoA.
  
  
  METHODS
  Clinical and echocardiographic data from 19 repaired CoA were analyzed 28 ± 13 years after surgery. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S') were analyzed as indexes of LV circumferential and longitudinal systolic function, respectively. Echocardiographic data of CoA patients were compared with 19 patients matched for age and hypertension and 38 healthy controls. Sc-MS was considered impaired if <89%, S' if <8.5 cm/s (10th percentiles of healthy controls, respectively).
  
  
  RESULTS
  There were no statistical differences between study groups in LV volumes, mass and geometry. LV ejection fraction and Sc-MS were similar in all groups, however, CoA group had a significantly lower peak S' in comparison with matched and healthy controls (7.1 ± 1.3, 10.3 ± 1.9, and 11.1 ± 1.5, respectively; all P < 0.001). Prevalence of longitudinal LVSD defined as low S' was 84% in CoA, 13% in matched, and 5% in healthy control group (all P<0.05). Multivariate logistic regression analysis revealed that low peak S' was independently related to higher E/E' ratio and the presence of CoA.
  
  
  CONCLUSIONS
  Patients who underwent a successful repair of CoA commonly show asymptomatic longitudinal LVSD associated with worse LV diastolic function in the long-term follow-up.
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Faganello
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fisicaro
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Russo
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Anita
authors.initials: A
authors.lastname: Iorio
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Mazzone
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Eliana
authors.initials: E
authors.lastname: Grande
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Humar
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cherubini
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Pandullo
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.affiliation: Department of Cardiology, St. Martin Hospital, Belluno, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarantini
authors.affiliation: Institute for Maternal and Child Health-IRCCS, Burlo Garofolo, Trieste, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Benettoni
authors.affiliation: Pediatric and Congenital Cardiac Surgery and Cardiology, United Hospital, Ancona, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Cardiovascular Center, Health Authority n° 1, Trieste, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
authors.affiliation: Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioffi
mesh_terms: D000328:Adult; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007558:Italy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left; D055815:Young Adult
keywords: Aortic Coarctation; Cardiac Function; Left Ventricular Systolic Function