Key result
Children with a history of successful surgical repair of aortic coarctation demonstrated significantly impaired left ventricular diastolic mechanics, including a higher E/E' ratio (8.30 vs. 6.95), compared to healthy controls.
Why the study?
Is left ventricular diastolic function impaired in children after successful repair of aortic coarctation compared to healthy controls?
Observational (n=66)
No
Is left ventricular diastolic function impaired in children after successful repair of aortic coarctation compared to healthy controls?
Absolute Event Rate: 8.3% vs 6.95%
p-value: p=<0.05
Children who have undergone successful surgical repair of aortic coarctation exhibit subclinical impairment of left ventricular active myocardial relaxation, regardless of their current blood pressure status.
Subclinical diastolic impairment after coarctation repair may warrant closer echocardiographic follow-up; leaves open prognostic implications in children.
The purpose of the study was an assessment of left ventricular diastolic function in children after the successful repair of aortic coarctation (CoA). The prospective study concerned 32 pediatric patients after the CoA surgery. Tissue Doppler imaging parameters including strain and strain rate and the conventional echocardiographic indexes were analyzed in patients and healthy controls. Analysis of mitral annulus velocities, E-E' ratio, strain, and strain rate of left ventricular mid-cavity segments and conventional indexes of mitral inflow showed the worsening of left ventricular diastolic mechanics in the study group compared to healthy controls. The E/E' ratio was significantly higher in the study group compared to the control group (8.30 ± 3.24 vs. 6.95 ± 1.36; p < 0.05). The early diastolic strain rate to late diastolic strain rate ratio as well as early to late diastolic strain ratio of the left ventricular mid-cavity segments were significantly lower in the study group compared to healthy controls (1.81 ± 0.63 vs. 3.74 ± 1.53; p < 0.001 and 1.20 ± 0.49 vs. 3.41 ± 1.26; p < 0.001). No differences of the pulmonary venous flow parameters between those two groups were observed. The left ventricular diastolic mechanics in hypertensive patients after CoA repair did not differ from normotensive subjects. Hypertensive and normotensive children after surgical repair of CoA are found to have worsening of the left ventricular diastolic mechanics suggesting the impairment of the active myocardial relaxation.
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Floriańczyk et al. (2010) conducted an observational in Aortic coarctation (post-repair) (n=66). Successful surgical repair of aortic coarctation vs. Healthy matched controls was evaluated on E/E' ratio (Left ventricular diastolic function) (p=<0.05). Children with a history of successful surgical repair of aortic coarctation demonstrated significantly impaired left ventricular diastolic mechanics, including a higher E/E' ratio (8.30 vs. 6.95), compared to healthy controls.
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