February 1, 2020Circulation Cardiovascular Imaging
Surveillance of Repaired Aortic Coarctation
Why the study?
Do Doppler-derived arterial load indices better predict left ventricular hypertrophy than systolic blood pressure in patients with repaired coarctation of the aorta?
Population
Patients with repaired coarctation of the aorta and healthy controls from a single-center database…
Comparison
Doppler-derived arterial load indices measured… vs Systolic blood pressure (SBP)
Design
Editorial
Authors
Discussion
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Implication
Doppler-derived arterial elastance index may be a more sensitive marker of increased left ventricular afterload and predictor of LV hypertrophy than systolic blood pressure in patients with repaired aortic coarctation.
Structured PICO
Do Doppler-derived arterial load indices better predict left ventricular hypertrophy than systolic blood pressure in patients with repaired coarctation of the aorta?
P
Population
Patients with repaired coarctation of the aorta (CoA) and healthy controls from a single-center database (1985-2018). Exploratory analysis included n=112 patients. Excluded: hemodynamically significant coarctation or associated aortic or mitral valve disease.
I
Intervention
Doppler-derived arterial load indices (effective arterial elastance index, total arterial compliance index, and systemic vascular resistance index) measured by echocardiography
C
Comparator
Systolic blood pressure (SBP)
O
Outcome
Prediction of left ventricular hypertrophy (LVH) and increase in indexed LV mass on follow-up echocardiogramsurrogate
Doppler-derived arterial elastance index may be a more sensitive marker of increased left ventricular afterload and predictor of LV hypertrophy than systolic blood pressure in patients with repaired aortic coarctation.
Limitations
- Low-risk patients chosen based on study end points
- Cardiovascular events were rare in the CoA group and absent in controls, preventing comparative analysis
- Considerable heterogeneity within the group (63% bicuspid aortic valve, variable treatment modalities)
- Propensity score matching followed by stratification by blood pressure may reintroduce bias
Cite This Study
Gaur et al. (2020) studied this question.