title: Assessment of ventriculo-vascular properties in repaired coarctation using cardiac magnetic resonance-derived aortic, left atrial and left ventricular strain.
abstract: OBJECTIVE
  In patients with repaired coarctation of aorta (CoA), we assessed ventriculo-vascular characteristics using CMR-derived aortic area strain (AAS), left atrial (LA) and left ventricular (LV) longitudinal and circumferential strain (LS, CS).
  
  
  METHODS
  Seventy-five subjects including 50 with repaired CoA divided into hypertensive (n = 25), normotensive (n = 25) and 25 controls were studied. AAS was measured at 3 levels: ascending aorta, proximal descending and descending aorta. LA and LV LS were measured using CMR-feature tracking. LA and LV end-diastolic volumes, ejection fraction (EF) and mass were measured.
  
  
  RESULTS
  Mean patient age was 19.7 ± 6.7 and controls 23 ± 15 (years). All strains (LA, LV, ascending and descending aortic) were lower in CoA subgroups compared to controls except the AAS at diaphragm, which was not different. Comparisons between hypertensive and normotensive CoA showed no differences in LV mass, LV volumetric indices, and LA and LV strain indices; however, ascending AAS was lower in hypertensive subgroup (p = 0.02). Ascending AAS was correlated with LV mass (r = -0.4, p = 0.005), LVEF (r = -0.4, p = 0.004), systolic blood pressure (r = -0.5, p = 0.0001) and LVLS (r = 0.5, p = 0.001).
  
  
  CONCLUSIONS
  Ascending AAS correlated with LV mass, EF and LVLS. In hypertensive CoA, ascending AAS was reduced compared to normotensive CoA and controls, indicating vascular remodelling differences influenced by ongoing hypertension.
  
  
  CONCLUSIONS
  • Impaired arterial strain is a measure of increased stiffness in arteries • Ascending aorta strain correlates with left ventricular mass and longitudinal strain • Ascending aorta strain is significantly lower in hypertensive coarctation patients • Hypertension may be a consequence of vascular pathology persisting despite repair.
authors.affiliation: Division of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, 8200, Dodge Street, Omaha, NE, 68114, USA.|Department of Radiology, Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China.
authors.forename: Quanliang
authors.initials: Q
authors.lastname: Shang
authors.affiliation: Hannover Medical School, Hannover, Germany.
authors.forename: Samir
authors.initials: S
authors.lastname: Sarikouch
authors.affiliation: Division of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, 8200, Dodge Street, Omaha, NE, 68114, USA.
authors.forename: Shivani
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Cardiology and Pneumonology, Georg-August-University and German Center for Cardiovascular Research (DZHK, Partner Site), Göttingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schuster
authors.affiliation: Department of Pediatric Cardiology, Georg-August-University and German Center for Cardiovascular Research (DZHK, Partner Site), Göttingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Steinmetz
authors.affiliation: University Paris Diderot, Department of Radiology, Hospital Bichat, APHP, Paris, France.
authors.forename: Phalla
authors.initials: P
authors.lastname: Ou
authors.affiliation: Division of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, 8200, Dodge Street, Omaha, NE, 68114, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Danford
authors.affiliation: Hannover Medical School, Hannover, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Beerbaum
authors.affiliation: Division of Pediatric Cardiology, University of Nebraska College of Medicine and Children's Hospital and Medical Center, 8200, Dodge Street, Omaha, NE, 68114, USA. skutty@unmc.edu.
authors.forename: Shelby
authors.initials: S
authors.lastname: Kutty
mesh_terms: D000293:Adolescent; D001011:Aorta / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D001017:Aortic Coarctation / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001794:Blood Pressure; D002648:Child; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D011184:Postoperative Period; D059289:Vascular Stiffness / Q000502:physiology*; D014656:Vascular Surgical Procedures; D016277:Ventricular Function, Left / Q000502:physiology*; D055815:Young Adult
keywords: Adult congenital heart disease; Aortic strain; Cardiovascular magnetic resonance; Coarctation of the aorta; Paediatric cardiology