Left Ventricular Remodeling After Transcatheter Versus Surgical Therapy in Adults With Coarctation of Aorta

• Published in: JACC. Cardiovascular imaging 2020-09, Vol.13 (9), p.1863-1872
• Main Authors: Egbe, Alexander C., Anderson, Jason H., Ammash, Naser M., Taggart, Nathaniel W.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Angiotensin Receptor Antagonists; Angiotensin-Converting Enzyme Inhibitors; Aortic Coarctation; coarctation of aorta; Diastole; Female; Humans; left ventricular hypertrophy; left ventricular remodeling; Male; Middle Aged; Predictive Value of Tests; Retrospective Studies; transcatheter stent therapy; Ventricular Dysfunction, Left; Ventricular Function, Left; Ventricular Remodeling; Young Adult
• ISSN: 1936-878X; 1876-7591
• DOI: 10.1016/j.jcmg.2020.01.016

The purpose of this retrospective cohort study was to compare remodeling of left ventricular (LV) structure and function after transcatheter stent therapy with remodeling of LV structure and function after surgical therapy for COA. Transcatheter stent therapy is as effective as surgery in producing acute hemodynamic improvement in patients with coarctation of aorta (COA). However, LV remodeling after transcatheter COA intervention has not been systematically investigated. LV remodeling was assessed at 1, 3, and 5 years post-intervention by using LV mass index (LVMI), LV end-diastolic dimension, LV ejection fraction, LV global longitudinal strain (LVGLS), LV mitral annular tissue Doppler early velocity (LVe′), and ratio of mitral inflow pulsed wave Doppler early velocity and e′ (E/e′) ratio. There were 44 patients in the transcatheter group and 128 patients in the surgical group. Compared to the surgical group, the transcatheter group had less regression of LVMI (−4.6; 95% confidence interval [CI]: −5.5 to −3.7 vs. −7.3; 95% CI: −8.4 to −6.6 g/m2; p