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Persistent reduced myocardial deformation in neonates after CoA repair
Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Department of Pediatric Cardiology, Queen Silvia Children's Hospital at the Sahlgrenska University Hospital, Götenborg, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Sweden.
Department of Public Health and Clinical Medicine, Umeå University, Sweden.ORCID iD: 0000-0002-2957-9904
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 221, 886-891 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Surgical repair of coarctation of the aorta (CoA) is a safe procedure in children, however the condition is known for its potential recurrence and other related complications. The available evidence shows abnormal intrinsic properties of the aorta in CoA, thus suggesting additional effect, even after CoA repair, on left ventricular (LV) function. Accordingly, we sought to obtain a better understanding of LV myocardial mechanics in very early-corrected CoA using two-dimensional STE.

METHODS AND RESULTS: We retrospectively studied 21 patients with corrected CoA at a median age of 9 (2-53) days at three time points: 1) just before intervention, 2) at short-term follow-up and 3) at medium-term follow-up after intervention and compared them with normal values. Speckle tracking analysis was conducted via vendor independent software, Tomtec. After intervention, LV function significantly improved (from -12.8±3.9 to -16.7±1.7; p<0.001), however normal values were not reached even at medium term follow-up (-18.3±1.7 vs. -20±1.6; p=0.002). Medium term longitudinal strain correlated with pre intervention EF (r=0.58, p=0.006). Moreover, medium term subnormal values were more frequently associated with bicuspid aortic valve (33.3% vs. 66.6%; p<0.05).

CONCLUSION: LV myocardial function in neonates with CoA can be feasibly evaluated and followed up by speckle tracking echocardiography. LV subendocardial dysfunction however, remains in early infancy coarctation long after repair. Long-term follow-up through adulthood using myocardial deformation measurements should shed light on the natural history and consequences of this anomaly.

Place, publisher, year, edition, pages
Elsevier , 2016. Vol. 221, 886-891 p.
Keyword [en]
Coarctation of the aorta, Speckle tracking echocardiography, Longitudinal strain, Neonates, Children
National Category
Pediatrics Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
URN: urn:nbn:se:oru:diva-57885DOI: 10.1016/j.ijcard.2016.07.114ISI: 000384692600169PubMedID: 27434366Scopus ID: 2-s2.0-84978204339OAI: oai:DiVA.org:oru-57885DiVA: diva2:1104819
Available from: 2016-10-24 Created: 2017-06-01 Last updated: 2017-06-12Bibliographically approved

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