Key result
Adults with repaired, mild coarctation of the aorta had worse left ventricular diastolic function, including a higher lateral E/e' ratio, compared to matched controls.
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?
Observational (n=408)
No
Does repaired coarctation of aorta without significant re-coarctation increase the prevalence of left ventricular diastolic dysfunction compared to matched controls?
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.
Answers are grounded in this paper and cite their sources.
Supports closer LV diastolic surveillance post-repair; leaves open impact on outcomes and management.
BACKGROUND: Left ventricular (LV) pressure overload and coronary artery disease are common in patients with coarctation of aorta (COA), and they are risk factors for LV diastolic dysfunction. Patients with COA may have aortic vasculopathy that can result in LV pressure overload even in the absence of hemodynamically significant COA. We therefore hypothesized that patients with mild COA (without hemodynamically significant COA) will have more LV diastolic dysfunction compared to controls. METHODS: Adult patients with mild COA (Doppler peak velocity < 2.5 m/s) were matched 1:1 to patients without structural heart disease using propensity score method based on age, sex, body mass index, hypertension and blood pressure. The objective was to compare LV diastolic dysfunction (defined as E/e' > 2 standard deviations above age-specific normative values) between adults with repaired COA and controls. CONCLUSION: LV diastolic dysfunction was common in patients with COA, and the association with LVMI suggests that patients with COA may have ongoing LV pressure overload in the absence of hemodynamically significant re-coarctation.
No takes yet. Share an insight, caveat, or question.
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 worse left ventricular diastolic function, including a higher lateral E/e' ratio, compared to matched controls.
Synapse has enriched 10 related papers. Consider them for comparative context: