TY - JOUR
T1 - Impact of Transcatheter Intervention on Myocardial Deformation in Patients with Coarctation of the Aorta
AU - Kheiwa, Ahmed
AU - Aggarwal, Sanjeev
AU - Forbes, Thomas J.
AU - Turner, Daniel R.
AU - Kobayashi, Daisuke
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Myocardial deformation measured by speckle tracking echocardiography can detect subtle abnormalities of left ventricular function before an obvious abnormality in traditional echocardiographic parameters such as ejection fraction is seen. We hypothesized that patients with coarctation of the aorta (CoA) may have impaired myocardial deformation that may persist even after successful transcatheter intervention. This is a retrospective study to assess the myocardial deformation in patients undergoing transcatheter intervention of CoA. The data were compared with age-matched normal controls. Echocardiographic parameters were obtained before, immediately and at median 6 months (range 3–8 months) after transcatheter intervention. Myocardial deformation indices were obtained off-line using Tomtec 2D Cardiac Performance Analysis Software. Repeated measure ANOVA was used to compare the indices between three time points. Independent sample t test or Chi-square test was used to compare data between groups. Twenty-four patients (age 13.5 ± 7.7 years) underwent successful transcatheter CoA intervention (stent 19, balloon angioplasty five) improving CoA peak gradient in the catheterization laboratory from 27.1 ± 11.3 to 4.5 ± 3.0 mmHg (p < 0.001). To compare with normal controls (n = 25, age 14.5 ± 1.9 years), fraction shortening was significantly higher in pre-intervention CoA patients (40.4 ± 7.1 vs. 33.8 ± 2.4 %, p < 0.001). In contrast, CoA patients had significantly abnormal left ventricular longitudinal strain compared to normal controls (−14.9 ± 2.6 vs. −20.5 ± 1.8 %, p < 0.001). In CoA patients, left ventricular longitudinal strain improved immediately and 3–8 months after intervention (−18.0 ± 2.9 and −17.6 ± 2.9 %, p < 0.007) but continued to be abnormal compared to normal controls. Patients with CoA had impaired myocardial deformation compared to normal controls. Myocardial mechanics improved but did not normalize even after successful transcatheter intervention on CoA in the short term.
AB - Myocardial deformation measured by speckle tracking echocardiography can detect subtle abnormalities of left ventricular function before an obvious abnormality in traditional echocardiographic parameters such as ejection fraction is seen. We hypothesized that patients with coarctation of the aorta (CoA) may have impaired myocardial deformation that may persist even after successful transcatheter intervention. This is a retrospective study to assess the myocardial deformation in patients undergoing transcatheter intervention of CoA. The data were compared with age-matched normal controls. Echocardiographic parameters were obtained before, immediately and at median 6 months (range 3–8 months) after transcatheter intervention. Myocardial deformation indices were obtained off-line using Tomtec 2D Cardiac Performance Analysis Software. Repeated measure ANOVA was used to compare the indices between three time points. Independent sample t test or Chi-square test was used to compare data between groups. Twenty-four patients (age 13.5 ± 7.7 years) underwent successful transcatheter CoA intervention (stent 19, balloon angioplasty five) improving CoA peak gradient in the catheterization laboratory from 27.1 ± 11.3 to 4.5 ± 3.0 mmHg (p < 0.001). To compare with normal controls (n = 25, age 14.5 ± 1.9 years), fraction shortening was significantly higher in pre-intervention CoA patients (40.4 ± 7.1 vs. 33.8 ± 2.4 %, p < 0.001). In contrast, CoA patients had significantly abnormal left ventricular longitudinal strain compared to normal controls (−14.9 ± 2.6 vs. −20.5 ± 1.8 %, p < 0.001). In CoA patients, left ventricular longitudinal strain improved immediately and 3–8 months after intervention (−18.0 ± 2.9 and −17.6 ± 2.9 %, p < 0.007) but continued to be abnormal compared to normal controls. Patients with CoA had impaired myocardial deformation compared to normal controls. Myocardial mechanics improved but did not normalize even after successful transcatheter intervention on CoA in the short term.
KW - Coarctation of the aorta
KW - Myocardial deformation
KW - Speckle tracking
KW - Transcatheter intervention
UR - http://www.scopus.com/inward/record.url?scp=84986301167&partnerID=8YFLogxK
U2 - 10.1007/s00246-016-1474-8
DO - 10.1007/s00246-016-1474-8
M3 - Article
C2 - 27638781
AN - SCOPUS:84986301167
SN - 0172-0643
VL - 37
SP - 1590
EP - 1597
JO - Pediatric Cardiology
JF - Pediatric Cardiology
IS - 8
ER -