Abstract 19021: Abnormalities of Ventricular Morphology and Compaction Are Prevalent in Adults With Coarctation of the Aorta - A Two-centre Cardiac Magnetic Resonance Imaging (CMR) Study
Introduction: Coarctation of the aorta (CoA) is associated with valvular and aortic disease but abnormalities of ventricular morphology are less well understood. Echocardiographic case series suggest a high prevalence of left ventricular non-compaction (LVNC) however; this has not been clarified by cardiac magnetic resonance imaging (CMR).
Methods: CMR images of CoA adults were collated from two statewide tertiary referral centres in Australia. LVNC was defined as ratio of non-compacted to compacted myocardium of greater than 2.3 and abnormal compaction (LVAC) was defined by a ratio of 1.5-2.3 in end-diastole. Clinical information, volumetric data and mass calculations were obtained.
Results: CMR scans of 293 CoA patients were analysed (Mean age 30+/-13 years; 50% male). 140 patients (48%) had bicuspid aortic valves (BAV) and 14 had unrepaired CoA. LVAC was evident in 78 % of patients and LVNC in 15 %. The most prevalent abnormality was mid-ventricular septal trabeculation in 40 patients. Patients with LVNC had significantly higher indexed end-diastolic (97+/-24 mL/m2 vs. 119+/-29 mL/m2; p=0.006) and end-systolic volumes (58+/-19 mL/m2 vs. 47+/-16 mL/m2; p = 0.03) compared to normally compacted ventricles, irrespective of the severity of aortic valvular disease. Ejection fraction did not significantly differ between the LVAC and normally compacted patients. (EF 60+/-6% vs. abnormally compacted EF 52+/-1; p = 0.30). Age, gender or presence of BAV did not correlate with presence of NC. In a subset of 148 cases, detailed short axis LV cine stacks were performed, revealing abnormalities of the mitral valve leaflets in 10, papillary muscles in 17 and myocardial clefts in 28 patients.
Conclusions: Abnormal ventricular morphology is prevalent in CoA and should be considered in addition to the known valvular and vascular complications. LVNC correlates with increased end-diastolic volumes and may impact on ventricular function over time.
Author Disclosures: P. Choudhary: Other Research Support; Modest; NHMRC and NHF Co-funded Post-graduate Research Scholarship. C. Hamilton-Craig: None. W. Strugnell: None. R. Puranik: None. D.S. Celermajer: None.
- © 2014 by American Heart Association, Inc.