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Wave Reflection and Ventriculo-Arterial Coupling in Bicuspid Aortic Valve Patients With Repaired Aortic Coarctation

Title: Wave Reflection and Ventriculo-Arterial Coupling in Bicuspid Aortic Valve Patients With Repaired Aortic Coarctation
Authors: Milano, Elena Giulia; Neumann, Sandra; Sophocleous, Froso; Pontecorboli, Giulia; Curtis, Stephanie L.; Bedair, Radwa; Caputo, Massimo; Luciani, Giovanni Battista; Bucciarelli-Ducci, Chiara; Biglino, Giovanni
Source: Frontiers in Pediatrics ; volume 9 ; ISSN 2296-2360
Publisher Information: Frontiers Media SA
Publication Year: 2022
Collection: Frontiers (Publisher - via CrossRef)
Description: Background Ventriculo-arterial (VA) coupling in bicuspid aortic valve (BAV) patients can be affected by the global aortopathy characterizing BAV disease and the presence of concomitant congenital lesions such as aortic coarctation (COA). This study aimed to isolate the COA variable and use cardiovascular magnetic resonance (CMR) imaging to perform wave intensity analysis non-invasively to shed light on VA coupling changes in BAV. The primary hypothesis was that BAV patients with COA exhibit unfavorable VA coupling, and the secondary hypothesis was that BAV patients with COA exhibit increased wave speed as a marker of reduced aortic distensibility despite successful surgical correction. Methods Patients were retrospectively identified from a CMR database and divided into two groups: isolated BAV and BAV associated with repaired COA. Aortic and ventricular dimensions, global longitudinal strain (GLS), and ascending aortic flow data and area were collected and used to derive wave intensity from CMR data. The main variables for the analysis included all wave magnitudes (forward compression/expansion waves, FCW and FEW, respectively, and reflected backward compression wave, BCW) and wave speed. Results In the comparison of patients with isolated BAV and those with BAV associated with repaired COA ( n = 25 in each group), no differences were observed in left ventricular ejection fraction, GLS, or ventricular volumes, whilst significant increases in FCW and FEW magnitude were noted in the BAV and repaired COA group. The FCW inversely correlated with age and aortic size. Whilst the BCW was not significantly different compared with that in patients with/without COA, its magnitude tends to increase with a lower COA index. Patients with repaired COA exhibited higher wave speed velocity. Aortic wave speed (inversely related to distensibility) was not significantly different between the two groups. Conclusion In the absence of a significant restenosis, VA coupling in patients with BAV and COA is not negatively affected ...
Document Type: article in journal/newspaper
Language: unknown
DOI: 10.3389/fped.2021.770754
DOI: 10.3389/fped.2021.770754/full
Availability: https://doi.org/10.3389/fped.2021.770754; https://www.frontiersin.org/articles/10.3389/fped.2021.770754/full
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.A1142017
Database: BASE