Key result
Aortic coarctation was associated with a more spherical left ventricle compared to healthy controls (sphericity index 0.62 vs 0.57), which significantly correlated with reduced myocardial strain.
Why the study?
The functional implications of left ventricular morphological characterization in congenital heart disease are not widely explored.
How does left ventricular morphology correlate with left ventricular function and thoracic aortic morphology in patients with aortic coarctation and bicuspid aortic valve?
Observational (n=110)
No
How does left ventricular morphology correlate with left ventricular function and thoracic aortic morphology in patients with aortic coarctation and bicuspid aortic valve?
Increased left ventricular sphericity in patients with aortic coarctation is associated with reduced myocardial strain, independent of functional aortic valve disease.
Greater LV sphericity was associated with reduced strain in CoA; leaves open whether shape modeling aids risk stratification in CHD.
Background The functional implications of left ventricular (LV) morphological characterization in congenital heart disease (CHD) are not widely explored. This study qualitatively and quantitatively assessed LV shape associations with a) LV function and b) thoracic aortic morphology in patients with aortic coarctation (CoA) with/without bicuspid aortic valve (BAV). Methods A statistical shape modelling (SSM) framework was employed to analyse three-dimensional (3D) LV shapes from cardiac magnetic resonance (CMR) data in isolated CoA (n=25), CoA+BAV (n=30), isolated BAV (n=30), and age-matched healthy controls (n=25). Average 3D templates and deformations were computed. Correlations between shape data and CMR-derived morphometric parameters (i.e. sphericity, conicity) or global and apical strain values were assessed to elucidate possible functional implications. The relationship between LV shape features and arch architecture was also explored. Results The LV template was shorter and more spherical in CoA patient and LV sphericity was associated (p≤0.04) with lower global longitudinal, radial and circumferential strain, irrespective of the presence of aortic stenosis and/or regurgitation. Conversely, LV strain was not associated with arch architecture. Conclusions Differences in LV morphology were observed between CoA and BAV patients. Increasing LV sphericity was associated with reduced strain, independent of aortic arch architecture and functional aortic valve disease.
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Sophocleous et al. (2022) conducted an observational in Aortic Coarctation and Bicuspid Aortic Valve (n=110). Aortic coarctation vs. Healthy controls was evaluated on Left ventricular sphericity index (p=0.02). Aortic coarctation was associated with a more spherical left ventricle compared to healthy controls (sphericity index 0.62 vs 0.57), which significantly correlated with reduced myocardial strain.
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