Background

Coarctation patients before curative reconstruction are exposed to abnormal flow patterns which potentially could cause wall deterioration. This study evaluated the effect of age at correction on the pulse wave velocity (PWV) and peak wall shear stress (WSS) in adolescent patients with corrected coarctation. Effects of valve morphology and presence of reobstruction were also evaluated.

Methods

Twenty-one patients aged 13.7 ± 2.6 years (mean ± standard deviation) were included (bicuspid aortic valve, n = 14; reobstruction, n = 9). Mean age at correction was 1.0 ± 1.8 years. PWV was determined from two high-temporal through-plane phase-contrast magnetic resonance imaging (MRI) acquisitions, for two segments: ascending aorta plus aortic arch and descending aorta. WSS was determined from four-dimensional flow MRI. Peak WSS over five systolic phases was determined for ascending aorta, aortic arch, and descending aorta.

Results

Patients with tricuspid aortic valve showed a significant correlation between the age at correction and descending aorta PWV (r_s = 0.80, p = 0.010). Significant differences were found between patients without and with reobstruction for peak WSS in the aortic arch (3.9 ± 1.3 Pa versus 6.5 ± 2.2 Pa, respectively; p = 0.003) and descending aorta (5.0 ± 1.3 Pa versus 6.7 ± 1.1 Pa, respectively; p = 0.005).

Conclusions

A prolonged period of abnormal haemodynamic exposure may result in increased aortic wall stiffening. The increased peak WSS as results of a reobstruction possibly promotes different disease progression, which endorse longitudinal follow-up examination of corrected coarctation patients.

中文翻译：

---

年龄对青少年患者主动脉缩窄和反复梗阻的矫正作用：壁切应力和脉搏波速度的MRI评价。

背景

根治性治疗之前的缩窄患者会暴露于异常血流模式，这可能会导致壁变坏。这项研究评估了矫正年龄对矫正缩窄青少年患者脉搏波速度（PWV）和峰值壁切应力（WSS）的影响。还评估了瓣膜形态和再梗阻的影响。

方法

包括21名13.7±2.6岁（平均±标准差）的患者（二尖瓣主动脉瓣，n  = 14；再梗阻，n  = 9）。矫正的平均年龄为1.0±1.8岁。PWV是从两个高时间通面相衬磁共振成像（MRI）采集中确定的，分为两个部分：升主动脉加主动脉弓和降主动脉。WSS是从四维MRI确定的。确定升主动脉，主动脉弓和降主动脉五个收缩期的WSS峰值。

结果

三尖瓣主动脉瓣的患者显示矫正年龄与降主动脉PWV之间存在显着相关性（r _s  = 0.80，p  = 0.010）。在没有或有再梗阻的患者中，主动脉弓WSS峰值（分别为3.9±1.3 Pa和6.5±2.2 Pa；p  = 0.003）和降主动脉（分别为5.0±1.3 Pa和6.7±1.1 Pa ）之间存在显着差异。p  = 0.005）。

结论

长时间不正常的血液动力学暴露可能导致主动脉壁僵硬增加。由于再梗阻而导致的峰值WSS升高可能促进了不同的疾病进展，这支持了矫正缩窄患者的纵向随访检查。