PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
May 18, 2020IJC Heart & VasculatureOpen Access

Increased prevalence of left ventricular diastolic dysfunction in adults with repaired coarctation of aorta

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Patients with repaired COA may have aortic vasculopathy causing LV pressure overload, leading to hypothesized higher LV diastolic dysfunction even without hemodynamically significant COA.

Does repaired coarctation of aorta without significant re-coarctation increase the prevalence of left ventricular diastolic dysfunction compared to matched controls?

Population

Adult patients with mild COA (Doppler peak velocity < 2.5 m/s) and matched controls

Comparison

Adults with repaired mild COA vs controls without structural heart disease

Design

Propensity score-matched study

Key result

Adults with repaired, mild coarctation of the aorta had significantly worse left ventricular diastolic function, including a higher lateral E/e' ratio (10 vs 7, p<0.001), compared to matched controls.

Authors

AEAlexander C. EgbeWMWilliam R. MirandaHCHeidi M. Connolly

Discussion

Loading...

Member takes

Overview

Supports closer LV diastolic surveillance post-repair; leaves open impact on outcomes and management.

Study Design

Type

Observational (n=408)

Multicenter

No

Structured PICO

Does repaired coarctation of aorta without significant re-coarctation increase the prevalence of left ventricular diastolic dysfunction compared to matched controls?

P
Population
408 adults (204 with repaired coarctation of aorta without hemodynamically significant re-coarctation, 204 propensity-matched controls without structural heart disease), mean age 35, 57% male, US-based (Mayo Clinic). Key inclusion for COA: Doppler peak velocity < 2.5 m/s at COA site, no significant aortic or mitral valve disease, sinus rhythm.
I
Intervention
History of repaired coarctation of aorta (observational exposure)
C
Comparator
Propensity-matched controls without structural heart disease (matched 1:1 based on age, sex, BMI, history of hypertension, and systolic blood pressure)
O
Outcome
Left ventricular diastolic function indices and the prevalence of LV diastolic dysfunction (defined as E/e' > 2 standard deviations above age-specific normative values)surrogate

Main Result

Effect estimate: Mean difference 3 (95% CI 2-4)

Absolute Event Rate: 10% vs 7%

p-value: p=<0.001

Adults with repaired coarctation of the aorta have a significantly higher prevalence of LV diastolic dysfunction and LV hypertrophy compared to matched controls, suggesting ongoing LV pressure overload even without hemodynamically significant re-coarctation.

Limitations

  • Study design does not provide proof of causality
  • No standardized diagnostic criteria for hypertension and coronary artery disease, relying instead on clinical notes
  • Risk of residual confounders despite propensity score matching
  • No standardized diagnostic criteria for hypertension and coronary artery disease (relied on clinical notes)
  • Potential for residual confounders despite propensity matching

Cite This Study

Egbe et al. (2020) conducted an observational in Repaired coarctation of aorta (n=408). Repaired coarctation of aorta vs. Propensity-matched controls without structural heart disease was evaluated on Lateral E/e' ratio (Mean difference 3, 95% CI 2-4, p=<0.001). Adults with repaired, mild coarctation of the aorta had significantly worse left ventricular diastolic function, including a higher lateral E/e' ratio (10 vs 7, p<0.001), compared to matched controls.

synapsesocial.com/papers/6a1d59f61e7099f691054ba0https://doi.org/10.1016/j.ijcha.2020.100530
View Full Paper
Ask AI
Bookmark
Share