title: Coarctation repair normalizes left ventricular function and aorto-septal angle in neonates.
abstract: OBJECTIVE
  Patients with coarctation of the aorta (CoA) have increased left ventricular (LV) afterload that has been shown to impact the LV and ascending aortic function. We aimed to examine the effect of coarctation on LV function and aorto-septal angle (AoSA) before and after surgical repair.
  
  
  METHODS
  We retrospectively studied 21 patients with surgically repaired 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. AoSA was measured from the parasternal long axis view, at three time points during the cardiac cycle: (1) end diastole, (2) beginning of systole, and (3) at peak ejection in the descending aorta. In addition to conventional LV structure and function, global longitudinal strain, and strain rate were measured using STE technique and Tomtec software. Three groups of age matched healthy children served as controls at each time point.
  
  
  RESULTS
  AoSA was significantly wider before intervention, in particular at peak ejection in the descending aorta (144° ± 6.4° vs. 136° ± 4.1°; P < .0001), and correlated with CoA pressure gradient. After intervention, AoSA normalized and significantly correlated with the increase of LV cavity function and overall LV deformation parameters.
  
  
  CONCLUSIONS
  AoSA is abnormally wide in neonates with CoA and is associated with severity of obstruction, LV dysfunction and compromised LV global deformation.
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Haki
authors.initials: H
authors.lastname: Jashari
authors.affiliation: Department of Pediatric Cardiology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Lannering
authors.affiliation: Department of Pediatric Cardiology, Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Mellander
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Pranvera
authors.initials: P
authors.lastname: Ibrahimi
authors.affiliation: Department of Clinical Sciences, Umeå University, Umeå, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Rydberg
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Henein
mesh_terms: D001017:Aortic Coarctation / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009200:Myocardial Contraction; D011237:Predictive Value of Tests; D020127:Recovery of Function; D012189:Retrospective Studies; D013314:Stress, Mechanical; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology*; D016277:Ventricular Function, Left
keywords: aorto-septal angle; coarctation of the aorta; left ventricular function; neonate