@article {10758, title = {Are aortic coarctation and rheumatoid arthritis different models of aortic stiffness? Data from an echocardiographic study.}, journal = {Cardiovasc Ultrasound}, volume = {16}, year = {2018}, month = {2018 Jun 26}, pages = {9}, abstract = {

BACKGROUND: Patients who underwent a successful repair of the aortic coarctation (CoA) show high risk for cardiovascular (CV) events. Mechanical and structural abnormalities in the ascending aorta (Ao) might have a role in the prognosis of CoA patients. We analyzed the elastic properties of Ao measured as aortic stiffness index (AoSI) in CoA patients in the long-term period and we compared AoSI with a cohort of 38 patients with rheumatoid arthritis (RA) and 38 non-RA matched controls.

METHODS: Data from 19 CoA patients were analyzed 28 {\textpm} 13~years after surgery. Abnormally high AoSI was diagnosed if AoSI > 6.07\% (95th percentile of the AoSI detected in our reference healthy population). AoSI was assessed at the level of the aortic root by two-dimensional guided M-mode evaluation.

RESULTS: CoA patients showed more than two-fold higher AoSI compared to RA and controls (9.8 {\textpm} 12.6 vs 4.8 {\textpm} 2.5\% and 3.1 {\textpm} 2.0\%, respectively; all p < 0.05 and in 5 of 19 patients with CoA (26\%) AoSI was exceptionally high. The 5 patients with abnormally high AoSI were older with higher BP, LV mass and prevalence of LV diastolic dysfunction. Multiple linear regression analysis revealed that AoSI was independently related to the presence of LV hypertrophy and higher LV relative wall thickness.

CONCLUSIONS: CoA patients have higher AoSI levels than RA patients and non-RA matched controls. AoSI levels are abnormally high in a small sub-group of CoA patients who show a very high-risk clinical profile for adverse CV events.

}, keywords = {Aorta, Aortic Coarctation, Arthritis, Rheumatoid, Humans, Prognosis, Vascular Stiffness}, issn = {1476-7120}, doi = {10.1186/s12947-018-0126-y}, author = {Faganello, Giorgio and Cioffi, Giovanni and Rossini, Maurizio and Ognibeni, Federica and Giollo, Alessandro and Fisicaro, Maurizio and Russo, Giulia and Di Nora, Concetta and Doimo, Sara and Tarantini, Luigi and Mazzone, Carmine and Cherubini, Antonella and D{\textquoteright}Agata Mottolesi, Biancamaria and Pandullo, Claudio and Di Lenarda, Andrea and Sinagra, Gianfranco and Viapiana, Ombretta} } @article {8077, title = {Insights from Cardiac Mechanics after Three Decades from Successfully Repaired Aortic Coarctation.}, journal = {Congenit Heart Dis}, year = {2015}, month = {2015 Nov 11}, abstract = {

BACKGROUND AND AIMS: Patients who underwent a successful repair of the aortic coarctation show chronic hyperdynamic state and normal left ventricular (LV) geometry; however, there are few data regarding the LV systolic function in the long term. Accordingly, we assessed LV systolic mechanics and factors associated with LV systolic dysfunction (LVSD) in patients with repaired CoA.

METHODS: Clinical and echocardiographic data from 19 repaired CoA were analyzed 28 {\textpm} 13 years after surgery. Stress-corrected midwall shortening (sc-MS) and mitral annular peak systolic velocity (S{\textquoteright}) were analyzed as indexes of LV circumferential and longitudinal systolic function, respectively. Echocardiographic data of CoA patients were compared with 19 patients matched for age and hypertension and 38 healthy controls. Sc-MS was considered impaired if <89\%, S{\textquoteright} if <8.5 cm/s (10th percentiles of healthy controls, respectively).

RESULTS: There were no statistical differences between study groups in LV volumes, mass and geometry. LV ejection fraction and Sc-MS were similar in all groups, however, CoA group had a significantly lower peak S{\textquoteright} in comparison with matched and healthy controls (7.1 {\textpm} 1.3, 10.3 {\textpm} 1.9, and 11.1 {\textpm} 1.5, respectively; all P < 0.001). Prevalence of longitudinal LVSD defined as low S{\textquoteright} was 84\% in CoA, 13\% in matched, and 5\% in healthy control group (all P<0.05). Multivariate logistic regression analysis revealed that low peak S{\textquoteright} was independently related to higher E/E{\textquoteright} ratio and the presence of CoA.

CONCLUSIONS: Patients who underwent a successful repair of CoA commonly show asymptomatic longitudinal LVSD associated with worse LV diastolic function in the long-term follow-up.

}, issn = {1747-0803}, doi = {10.1111/chd.12310}, author = {Faganello, Giorgio and Fisicaro, Maurizio and Russo, Giulia and Iorio, Anita and Mazzone, Carmine and Grande, Eliana and Humar, Franco and Cherubini, Antonella and Pandullo, Claudio and Barbati, Giulia and Tarantini, Luigi and Benettoni, Alessandra and Pozzi, Marco and Di Lenarda, Andrea and Cioffi, Giovanni} }