Key result
Aortic valve disease (OR 15.1; 95% CI 2.50-48.4) and higher systolic blood pressure were associated with increased left ventricular mass in adults with surgically repaired aortic coarctation.
Why the study?
What factors are associated with increased left ventricular mass in adults with surgically repaired coarctation of the aorta?
Observational (n=51)
What factors are associated with increased left ventricular mass in adults with surgically repaired coarctation of the aorta?
In adults with surgically repaired coarctation of the aorta, increased left ventricular mass is common and independently associated with higher systolic blood pressure and aortic valve disease, highlighting the need for strict blood pressure control.
Higher SBP and aortic valve disease may warrant closer monitoring in repaired coarctation; hypothesis-generating and should not yet change practice.
Introduction: Most patients with repaired coarctation of the aorta (CoA) live normal lives and have good physical performance. However, even after a successful surgical intervention, long-term cardiovascular risks including left ventricular hypertrophy remain. The aim of the study was to identify factors associated with increased left ventricular mass (LVM) in patients with surgically repaired CoA. Methods: Consecutive cardiovascular magnetic resonance investigations in 51 patients with surgically repaired CoA (age 37+/-15 years, age at intervention 9.7 ± 6.8 years, 45% female) were reviewed. LVM was measured and indexed to body surface area. The association between increased LVM index and clinical, anatomic and functional variables was investigated with logistic regression analysis. Results: In this population, 14/51 (27%) patients had a LVM index above normal limits. Factors associated with an increased LVM index in univariate analysis were higher systolic blood pressure (odds ratio (OR) = 1.04, 95 % confidence interval (CI) 1.00-1.08, p = 0.03), descending aortic diameter (OR = 1.48, CI 1.14-1.90, p = 0.003) and more than mild aortic valve disease or previous aortic valve intervention (OR = 15.1, CI 2.50-48.4, p=0.002), but not diastolic blood pressure, diameter of ascending aorta, diameter or ratio of CoA, velocity in descending aorta, smoking or bicuspid aortic valve (p > 0.05 for all). In multivariate analysis, only systolic blood pressure (p = 0.05) and aortic valve disease (p = 0.006) remained significant, yielding R2 = 0.47, p = 0.002 for the model. Conclusion: Increased LVM is a common late finding after surgically repaired CoA. This study showed that LVM was associated with modifiable factors; systolic blood pressure and aortic valve disease. As most patients are young, and increased LVM will eventually affect ventricular function, close attention to blood pressure optimization may be of particular importance in the surgically repaired CoA population.
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Rinnström et al. (2015) conducted an observational in Surgically repaired coarctation of the aorta (n=51). Aortic valve disease and higher systolic blood pressure was evaluated on Increased left ventricular mass (LVM) index (OR 15.1, 95% CI 2.50-48.4, p=0.002). Aortic valve disease (OR 15.1; 95% CI 2.50-48.4) and higher systolic blood pressure were associated with increased left ventricular mass in adults with surgically repaired aortic coarctation.
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