title: Global area strain is a sensitive marker of subendocardial damage in adults after optimal repair of aortic coarctation: three-dimensional speckle-tracking echocardiography data.
abstract: Aortic coarctation (CoA) in adults is associated with reduced survival. Despite successful repair, some unfavorable changes in the left ventricular (LV) myocardial function are reported. Three-dimensional speckle-tracking imaging (3D-STE) is a novel method that allows to assess regional myocardial function in all directions simultaneously and to calculate global area strain which integrates longitudinal and circumferential deformation. The aim of our study was to assess whether 3-D STE provides any new characteristics of LV deformation in patients with optimal CoA repair. Adults after CoA correction underwent transthoracic echocardiographic examinations. Patients with significant concomitant lesions were ruled out. Global longitudinal strain (GLS), global circumferential strain (GCS), global area strain (GAS), and global radial strain (GRS) were assessed using 3D-STE (Echopac Software, GE). The data were compared with those obtained from healthy subjects. 26 adults (9F/17M; mean age 24.4 years) with repaired CoA were studied. Despite preserved LVEFs, patients with repaired CoA had decreased GAS compared with controls (-28.8 vs. -31.7 %; p = 0.007). No differences between patients and healthy subjects in terms of GLS, GCS and GRS were observed. We found a significant correlation between mean blood pressure and GAS (R = 0.39; p < 0.05). No significant influence of age at repair, CoA correction method or LV mass on three-dimensional deformation was observed. Summarizing, global area strain derived from 3D-STE may be a sensitive indicator of subclinical LV dysfunction in patients after optimal repair of CoA. Mean blood pressure, but not age at correction seems to determine LV deformation.
authors: Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland. ewa.kowalik@gmail.com.
authors: Ewa
authors: E
authors: Kowalik
authors: Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
authors: Mirosław
authors: M
authors: Kowalski
authors: Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
authors: Anna
authors: A
authors: Klisiewicz
authors: Department of Congenital Heart Disease, Institute of Cardiology, Alpejska 42, 04-628, Warsaw, Poland.
authors: Piotr
authors: P
authors: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D016022:Case-Control Studies; D015150:Echocardiography, Doppler; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D009200:Myocardial Contraction; D015588:Observer Variation; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D013314:Stress, Mechanical; 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; Area strain; Left ventricular function; Speckle-tracking echocardiography; Three-dimensional imaging