BACKGROUND Aortic shape has been proposed as an important determinant of adverse haemodynamics following coarctation repair. However, previous studies have not demonstrated a consistent relationship between shape and vascular load. In this study, 3D aortic shape was evaluated using principal component analysis (PCA), allowing investigation of the relationship between 3D shape and haemodynamics. METHODS Sixty subjects (38 male, 25.0 ± 7.8 years) with repaired coarctation were recruited. Central aortic haemodynamics including wave intensity analysis were measured noninvasively using a combination of blood pressure and phase contrast cardiovascular magnetic resonance (CMR). 3D curvature and radius data were derived from CMR angiograms. PCA was separately performed on 3D radius and curvature data to assess the role of arch geometry on haemodynamics. Clinical findings were corroborated using 1D vascular models. RESULTS There were no independent associations between 3D curvature and any hemodynamic parameters. However, the magnitude of the backwards compression wave was related to the 1st (r = - 0.36, p = 0.005), 3rd (r = 0.27, p = 0.036) and 4th (r = - 0.31, p = 0.017) principle components of radius. The 4th principle componentof radius also correlated with central aortic systolic pressure. These aortas had larger aortic roots, more transverse arch hypoplasia and narrower aortic isthmuses. CONCLUSIONS There are major modes of variation in 3D aortic shape after coarctation repair witha modest association between variation in aortic radius and pathological wave reflections, but not with 3D curvature. Taken together, these data suggest that shape is not the major determinant of vascular load following coarctation repair, and calibre is more important than curvature.

中文翻译：

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缩窄修复后的主动脉 - 口径和曲率对动脉血流动力学的影响。


背景技术主动脉形状已被认为是缩窄修复后不良血流动力学的重要决定因素。然而，先前的研究尚未证明形状和血管负荷之间存在一致的关系。在本研究中，使用主成分分析 (PCA) 评估 3D 主动脉形状，从而可以研究 3D 形状与血液动力学之间的关系。方法 招募了 60 名缩窄修复受试者（38 名男性，25.0 ± 7.8 岁）。结合血压和相差心血管磁共振（CMR），以无创方式测量包括波强度分析在内的中央主动脉血流动力学。 3D 曲率和半径数据源自 CMR 血管造影。分别对 3D 半径和曲率数据进行 PCA，以评估牙弓几何形状对血液动力学的作用。使用一维血管模型证实了临床结果。结果 3D 曲率与任何血流动力学参数之间不存在独立关联。然而，向后压缩波的幅度与第 1 个（r = - 0.36，p = 0.005）、第 3 个（r = 0.27，p = 0.036）和第 4 个（r = - 0.31，p = 0.017）主成分有关。半径。半径的第四主成分也与中心主动脉收缩压相关。这些主动脉具有较大的主动脉根部、较多的横弓发育不全和较窄的主动脉峡部。结论 缩窄修复术后 3D 主动脉形状存在主要变化模式，主动脉半径变化与病理波反射之间存在适度关联，但与 3D 曲率无关。综上所述，这些数据表明形状并不是缩窄修复后血管负荷的主要决定因素，口径比曲率更重要。