Persistent reduced myocardial deformation in neonates after CoA repair

Jashari, Haki; Lannering, Katarina; Ibrahimi, Pranvera; Djekic, Demir; Mellander, Mats; Rydberg, Annika; Henein, Michael Y.

doi:10.1016/j.ijcard.2016.07.114

Cited by 11 publications

(17 citation statements)

References 34 publications

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“…Jashari et al reported more impaired longitudinal strain in CoA patients with LV hypertrophy, as confirmed by other studies [ 9 , 27 , 28 , 31 ]. The myofiber orientation changes throughout the myocardium, with a predominantly longitudinal orientation in the endomyocardium [ 10 , 27 ].…”

Section: Discussionsupporting

confidence: 72%

“…Myocardial deformation was preserved in our CoA patients when compared to healthy controls, in agreement with previous echocardiography and CMR-FT reports indicating preserved longitudinal and circumferential strain in CoA patients with preserved global LV systolic function and normal LV mass [ 9 , 11 ]. Jashari et al found reduced LV global longitudinal strain and strain rate prior to surgical CoA repair, with a further decrease shortly after intervention [ 28 ]. Interestingly, progressive normalization of strain was observed over 2 years after satisfactory repair, resulting in near-normal LV longitudinal strain values [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Jashari et al found reduced LV global longitudinal strain and strain rate prior to surgical CoA repair, with a further decrease shortly after intervention [ 28 ]. Interestingly, progressive normalization of strain was observed over 2 years after satisfactory repair, resulting in near-normal LV longitudinal strain values [ 28 ]. Kowalski et al also showed normal global LV function and LV longitudinal strain in CoA patients by 2D echocardiographic deformation 10 years after surgical repair, suggesting a full recovery of the myocardium at long-term follow-up [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

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Preserved Myocardial Deformation after Successful Coarctation Repair: A CMR Feature-Tracking Study

et al. 2017

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Arterial vasculopathy and residual aortic obstruction can lead to left ventricular (LV) dysfunction in patients with coarctation of the aorta (CoA) related to adverse ventriculo-arterial coupling. This study aimed to investigate potential differences in LV myocardial deformation indices between repaired CoA patients and healthy controls. Twenty-two CoA patients (age 30 ± 10.6 years) after surgical repair (n = 12) or balloon angioplasty (BA) (n = 10) without residual stenosis, between 3 months and 16 years of age with > 10 years follow-up were compared to 22 healthy age- and gender-matched controls (age 30 ± 3.8 years). Cardiac magnetic resonance feature tracking (CMR-FT) was used for LV longitudinal-, circumferential-, and rotational deformation indices. Global systolic LV function was preserved in CoA patients (LV ejection fraction 58 ± 4.8 vs. 60 ± 6.8%, p = 0.56) when compared to controls, with normal LV dimensions and mass (p > 0.05). Twelve CoA patients (55%) were hypertensive, of whom 4 were on anti-hypertensive medication. LV global longitudinal strain was preserved in the four-chamber (− 18 ± 4.4 vs. − 16 ± 4.7%, p = 0.06) and two-chamber (− 22 ± 5.1 vs. − 20 ± 6.0%, p = 0.22) orientations in CoA patients. Global circumferential strain was preserved at basal (− 29 ± 4.1 vs. − 28 ± 4.8%, p = 0.43), mid-ventricular (− 27 ± 4.2 vs. − 25 ± 3.0%, p = 0.09), and apical levels (− 35 ± 7.8 vs. − 32 ± 34.9%, p = 0.32). No differences were found in global torsion (2.4 ± 1.3° vs. 2.0 ± 1.4°/cm, p = 0.28), twist (14 ± 5.8° vs. 12 ± 6.3°, p = 0.34), and recoil rate (− 17 ± 9.7° vs. − 17 ± 7.1°/cm s, p = 0.97). Analysis of intra-observer variability demonstrated good reproducibility for all CMR deformation indices. Global and rotational myocardial deformation indices are preserved in CoA patients long-term after repair without residual stenosis, despite a high incidence of hypertension.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Preserved Myocardial Deformation after Successful Coarctation Repair: A CMR Feature-Tracking Study

et al. 2017

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“…Neonatal CoA patients with a bicuspid aortic valve show less improvement in ventricular function following repair and greater long-term cardiovascular risks compared to CoA patients with a normal, tricuspid aortic valve [4,5,6]. This study found significant differences in the aortic proteome of neonatal CoA patients dependent on the morphology of the aortic valve.…”

Section: Discussionmentioning

confidence: 71%

“…CoA is a known risk factor for aortic complications including aneurysm formation or aortic dissection [2,3], and the presence of BAV further increases the risks for CoA patients. Studies have demonstrated that CoA patients with BAV have increased risk of aortic aneurysm [4], suboptimal improvement in left ventricular function following repair [5] and greater long-term cardiovascular morbidity [6]. The coexistence of CoA and BAV has been demonstrated to significantly affect aortic blood flow haemodynamics, for example increasing turbulent flow and affecting indices of shear stress both upstream and downstream of the coarctation [7]; such haemodynamic changes may at least partly explain the heightened cardiovascular risks in these patients.…”

Section: Introductionmentioning

confidence: 99%

Bicuspid Aortic Valve Alters Aortic Protein Expression Profile in Neonatal Coarctation Patients

Skeffington

Bond

Abdul‐Ghani

et al. 2019

JCM

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Coarctation of the aorta is a form of left ventricular outflow tract obstruction in paediatric patients that can be presented with either bicuspid (BAV) or normal tricuspid (TAV) aortic valve. The congenital BAV is associated with hemodynamic changes and can therefore trigger different molecular remodelling in the coarctation area. This study investigated the proteomic and phosphoproteomic changes associated with BAV for the first time in neonatal coarctation patients. Aortic tissue was collected just proximal to the coarctation site from 23 neonates (BAV; n = 10, TAV; n = 13) that were matched for age (age range 4–22 days). Tissue from half of the patients was frozen and used for proteomic and phosphoproteomic analysis whilst the remaining tissue was formalin fixed and used for analysis of elastin content using Elastic Van-Gieson (EVG) staining. A total of 1796 protein and 75 phosphoprotein accession numbers were detected, of which 34 proteins and one phosphoprotein (SSH3) were differentially expressed in BAV patients compared to TAV patients. Ingenuity Pathway Analysis identified the formation of elastin fibres as a significantly enriched function (p = 1.12 × 10−4) due to the upregulation of EMILIN-1 and the downregulation of TNXB. Analysis of paraffin sections stained with EVG demonstrated increased elastin content in BAV patients. The proteomic/phosphoproteomic analysis also suggested changes in inositol signalling pathways and reduced expression of the antioxidant SOD3. This work demonstrates for the first time that coarcted aortic tissue in neonatal BAV patients has an altered proteome/phosphoproteome consistent with observed structural vascular changes when compared to TAV patients.

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What is Left Ventricular Strain in Healthy Neonates? A Systematic Review and Meta-analysis

et al. 2019

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Persistent reduced myocardial deformation in neonates after CoA repair

Cited by 11 publications

References 34 publications

Preserved Myocardial Deformation after Successful Coarctation Repair: A CMR Feature-Tracking Study

Preserved Myocardial Deformation after Successful Coarctation Repair: A CMR Feature-Tracking Study

Bicuspid Aortic Valve Alters Aortic Protein Expression Profile in Neonatal Coarctation Patients

What is Left Ventricular Strain in Healthy Neonates? A Systematic Review and Meta-analysis

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