Assessment of proximal and distal aortic properties with magnetic resonance after successful coarctation management in adults

Background: Aortic coarctation poses a lifelong high cardiovascular risk, despite successful surgical or percutaneous management. Objective: To investigate whether an abnormal aortic function is involved in the higher cardiovascular risk in patients after correction of aortic coarctation. Methods: We recorded aortic pressure waveforms and elastic properties by MRI in 13 patients with normal blood pressure following successful intervention for coarctation in adolescence, with or without the use of medication. Findings were compared to 13 ageand blood pressure-matched controls. Age, blood pressure and body mass index were comparable between a group of 13 patients and 13 control subjects, who underwent cardiac MR imaging for conditions other than aortic pathology. Patients with aneurysm formation and recoarctation were excluded. Results: Aortic distensibility appeared to be significantly lower for patients (14.5 10 ± 7.82 10 kPa) as compared to controls (30.9 10 ± 1.99 10 kPa, p = 0.01) in the ascending aorta, whereas it was not significantly different at the site of coarctation and at the level of the diaphragm. Pulse wave velocity (PWV) in the ascending aorta was calculated to be significantly higher for patients (4.71 ± 1.17 m/s) compared to controls (3.65 ± 0.965 m/s; p = 0.0187). No significant differences were found for PWV of distal aortic segments. Indexed left ventricular mass was found to be 75.6 ± 39.7 g/m in patients and 42.6 ± 10.4 g/m in controls (p=0.0141). Conclusion: These data show abnormal proximal aortic properties in subjects with normal blood pressure following successful coarctation management in adolescence with or without antihypertensive medication. This finding may contribute to the high cardiovascular burden upon these patients. Aortic flow measurements in adults after coarctation repair