Abstract 18373: Arterial Stiffness (Pulse Wave Velocity) is Higher in Single Ventricle Patients With Reconstructed Aortas as Compared to Those Without: A Cardiac Magnetic Resonance Phase Contrast Study
Background: Pulse wave velocity (PWV) is a measure of arterial stiffness and has been associated in adults with cardiovascular risk for morbidity and mortality including the association with atherosclerosis. Single ventricle patients who undergo an aortic to pulmonary anastomosis via the Norwood procedure have non-compliant patch material inserted into the vessel, possibly affecting PWV. The purpose of this study is to determine if PWV in these patients differs from single ventricle patients who did not undergo aortic reconstruction.
Methods: We retrospectively reviewed 40 single ventricle pts from 2012 to the present, matched for age, who underwent cardiac magnetic resonance anatomic imaging and phase contrast evaluations at the neoartic valve (AoV) and the descending aorta at the level of the diaphragm (DAo). 20 had undergone Norwood reconstruction (recon) of the aorta while 20 had not (Nl). PWV was calculated as the distance from the AoV to the DAo, traced on the candycane view of the aorta, divided by the difference in time to reach 50% peak flow on the flow-time diagrams between AoV and DAo. See images below. Significance was a P < 0.05.
Results: PWV in Recon were significantly higher than in Nl (3.9 +/- 1.7 m/s vs 3.0 +/- 1 m/s, P=0.01). There was no statistically significant difference in ages (4.1 +/- 4.2 vs 5.1 +/- 5.7 years), body surface area (0.61 +/- 0.3 vs 0.7 +/- 0.4 meter2) or cardiac index (4.9 +/- 1.5 vs 5.2 +/- 1.7 liters/minute/meter2) between Recon and Nl respectively.
Conclusion: PWV in single ventricle patients undergoing the Norwood procedure with resulting recon is higher than single ventricle patients who do not. This implies a higher arterial stiffness and may pose an additional cardiovascular risk as the patient grows; future studies should monitor PWV in these patients for clinical outcome. Other biomaterials may potentially be used in the future to moderate PWV if clinical outcome is adversely affected.
- © 2013 by American Heart Association, Inc.