Key result
Higher total arterial compliance index linked to ~31% lower odds of LVH after coarctation repair.
Why the study?
Coarctation of the aorta is associated with long-term arterial stiffness and remodeling of the left ventricle and left atrium in children after repair.
Are Doppler-derived indices of arterial load associated with left ventricular remodeling in children after successful coarctation of the aorta repair?
Cross-Sectional
Are Doppler-derived indices of arterial load associated with left ventricular remodeling in children after successful coarctation of the aorta repair?
Odds Ratio: 0.69 (95% CI 0.51–0.92)
p-value: p=0.012
Children after successful coarctation of the aorta repair demonstrate increased arterial stiffness which is independently associated with early left ventricular hypertrophy.
AIMS Coarctation of the aorta (COA) is associated with long-term arterial stiffness, and remodeling of the left ventricle (LV) and left atrium (LA). We hypothesized that Doppler-derived indices of arterial load would be associated with LV remodeling in children after successful COA repair. METHODS In this cross-sectional study, we retrospectively analyzed clinical and echocardiographic data from children after COA repair and age- and sex-matched healthy controls. Arterial load was assessed using Doppler-derived effective arterial elastance index (Eal) and total arterial compliance index (TACI). RESULTS The COA group had higher pulse pressure (55.5 (48 - 61) vs 48 (43 - 52) mmHg, p<0.001), lower TACI (0.49 (0.39 - 0.64) vs 0.84 (0.69 - 0.95) ml mmHg-1 m-2, p<0.001), higher Eal (3.49 (2.99 - 4.33) vs 2.51 (2.51 (2.29 - 2.9)) mmHg m2 ml-1, p<0.001), higher LV mass z-score (1.96 (0.99 - 3.13) vs 0.64 (-0.12 - 1.32), p < 0.001) and higher LA volume index (LAVI, 24.34 (21.67 - 31.33) vs 18.73 (15.36 - 24.31) ml m-2, p <0.001) than controls. Lower TACI and male sex were independently associated with LV hypertrophy in multivariate analysis (OR 0.69, 95% CI 0.51-0.92, p = 0.012; and OR 5.88, 95% CI 2.08-16.62, p = 0.001, respectively). Higher LAVI was associated with elevated RV systolic pressure in univariate analysis (OR 1.72, 95% CI 1.07-2.78, p = 0.03). CONCLUSION Children after successful CoA repair demonstrate increased arterial stiffness and early LV and LA remodeling independent of hypertension. Doppler-derived indices of arterial load are readily obtained by standard echocardiography and may improve risk stratification in this population. However, our study design precludes establishing a temporal relationship between altered arterial load and LV remodeling, or demonstrating causality.
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Joye et al. (2026) conducted a cross-sectional in Coarctation of the aorta (COA). Lower total arterial compliance index (TACI) vs. Higher total arterial compliance index was evaluated on Left ventricular hypertrophy (OR 0.69, 95% CI 0.51-0.92, p=0.012). In children following coarctation of the aorta repair, lower total arterial compliance index was independently associated with left ventricular hypertrophy (OR 0.69; 95% CI 0.51-0.92; p=0.012).
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