title: Persistent reduced myocardial deformation in neonates after CoA repair.
abstract: BACKGROUND
  Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE.
  
  
  RESULTS
  We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05).
  
  
  CONCLUSIONS
  LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Haki
authors.initials: H
authors.lastname: Jashari
authors.affiliation: Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Lannering
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Pranvera
authors.initials: P
authors.lastname: Ibrahimi
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors.forename: Demir
authors.initials: D
authors.lastname: Djekic
authors.affiliation: Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Mellander
authors.affiliation: Department of Clinical Sciences, Umeå University, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Rydberg
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Sweden. Electronic address: michael.henein@umu.se.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Henein
mesh_terms: D001017:Aortic Coarctation / Q000000981:diagnostic imaging* / Q000601:surgery*; D004452:Echocardiography / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging* / Q000601:surgery*
keywords: Children; Coarctation of the aorta,; Longitudinal strain,; Neonates,; Speckle tracking echocardiography,