Abstract 3220: Increased Central Aortic Stiffness and Left Ventricular Mass in Normotensive Young Subjects after Successful Coarctation Repair
Background Hypertension occurs in 20 – 40% of survivors of anatomically successful repair of aortic coarctation (CoA) and is associated with premature cardiovascular morbidity and mortality. The pathophysiology of this late hypertension is unclear and few studies have examined the role of central aortic function, in this setting.
Methods Forty normotensive asymptomatic subjects with successful CoA repair (age 12 ±9 years, blood pressure 110 ±10 / 62 ±7 mmHg, no residual stenosis on clinical, echo and MRI measurements) and 20 healthy control subjects underwent detailed Magnetic Resonance Imaging investigation of the thoracic aorta and left ventricle. Aortic distensibility, compliance and stiffness β index were calculated in the central (pre-coarctation) and descending (post-coarctation) aorta and aortic pulse wave velocity (PWV) was measured. Left ventricular (LV) mass was measured by disc-summation.
Results Compared to controls, CoA subjects had markedly abnormal central aortic stiffness indices (Table⇓) and increased LV mass index. LV mass index correlated with aortic stiffness measures (P<0.001). By contrast, descending aortic parameters were similar between groups.
Conclusion Central aortic stiffness is markedly increased and associated with increased left ventricular mass index in normotensive young subjects after successful coarctation repair.