Faganello Giorgio, Cioffi Giovanni, Rossini Maurizio, Ognibeni Federica, Giollo Alessandro, Fisicaro Maurizio, Russo Giulia, Di Nora Concetta, Doimo Sara, Tarantini Luigi, Mazzone Carmine, Cherubini Antonella, D'Agata Mottolesi Biancamaria, Pandullo Claudio, Di Lenarda Andrea, Sinagra Gianfranco, Viapiana Ombretta
Cardiovascular Centre, Department of Cardiology, Azienda Sanitaria Universitaria Integrata di Trieste, via Slataper n°9, 34134, Trieste, Italy.
Department of Cardiology, Villa Bianca Hospital, Trento, Italy.
Cardiovasc Ultrasound. 2018 Jun 26;16(1):9. doi: 10.1186/s12947-018-0126-y.
Patients who underwent a successful repair of the aortic coarctation (CoA) show high risk for cardiovascular (CV) events. Mechanical and structural abnormalities in the ascending aorta (Ao) might have a role in the prognosis of CoA patients. We analyzed the elastic properties of Ao measured as aortic stiffness index (AoSI) in CoA patients in the long-term period and we compared AoSI with a cohort of 38 patients with rheumatoid arthritis (RA) and 38 non-RA matched controls.
Data from 19 CoA patients were analyzed 28 ± 13 years after surgery. Abnormally high AoSI was diagnosed if AoSI > 6.07% (95th percentile of the AoSI detected in our reference healthy population). AoSI was assessed at the level of the aortic root by two-dimensional guided M-mode evaluation.
CoA patients showed more than two-fold higher AoSI compared to RA and controls (9.8 ± 12.6 vs 4.8 ± 2.5% and 3.1 ± 2.0%, respectively; all p < 0.05 and in 5 of 19 patients with CoA (26%) AoSI was exceptionally high. The 5 patients with abnormally high AoSI were older with higher BP, LV mass and prevalence of LV diastolic dysfunction. Multiple linear regression analysis revealed that AoSI was independently related to the presence of LV hypertrophy and higher LV relative wall thickness.
CoA patients have higher AoSI levels than RA patients and non-RA matched controls. AoSI levels are abnormally high in a small sub-group of CoA patients who show a very high-risk clinical profile for adverse CV events.
成功修复主动脉缩窄（CoA）的患者发生心血管（CV）事件的风险较高。升主动脉（Ao）的机械和结构异常可能在CoA患者的预后中起作用。我们分析了长期随访的CoA患者升主动脉的弹性特性，以主动脉僵硬度指数（AoSI）衡量，并将AoSI与38例类风湿关节炎（RA）患者和38例非RA匹配对照进行比较。
对19例CoA患者术后28±13年的数据进行分析。如果AoSI>6.07%（在我们的健康参考人群中检测到的AoSI第95百分位数），则诊断为AoSI异常升高。通过二维引导M型评估在主动脉根部水平评估AoSI。
与RA患者和对照组相比，CoA患者的AoSI高出两倍多（分别为9.8±12.6%、4.8±2.5%和3.1±2.0%；所有p<0.05），19例CoA患者中有5例（26%）的AoSI异常高。5例AoSI异常高的患者年龄较大，血压、左心室质量和左心室舒张功能障碍患病率较高。多元线性回归分析显示，AoSI与左心室肥厚和较高的左心室相对壁厚度独立相关。
CoA患者的AoSI水平高于RA患者和非RA匹配对照。一小部分CoA患者的AoSI水平异常高，这些患者显示出发生不良CV事件的极高风险临床特征。
