BACKGROUND Patients after aortic coarctation (CoA) repair show impaired aortic bioelasticity and altered left ventricular (LV) mechanics, predisposing diastolic dysfunction. Our purpose was to assess aortic bioelasticity and LV properties in CoA patients who underwent endovascular stenting or surgery using cardiovascular magnetic resonance (CMR) imaging. METHODS Fifty CoA patients (20.5 ± 9.5 years) were examined by 3-Tesla CMR. Eighteen patients had previous stent implantation and 32 had surgical repair. We performed volumetric analysis of both ventricles (LV, RV) and left atrium (LA) to measure biventricular volumes, ejection fractions, left atrial (LA) volumes, and functional parameters (LAEFPassive, LAEFContractile, LAEFReservoir). Aortic distensibility and pulse wave velocity (PWV) were assessed. Native T1 mapping was applied to examine LV tissue properties. In twelve patients post-contrast T1 mapping was performed. RESULTS LV, RV and LA parameters did not differ between the surgical and stent group. There was also no significant difference for aortic distensibility, PWV and T1 relaxation times. Aortic root distensibility correlated negatively with age, BMI, BSA and weight (p < 0.001). Native T1 values correlated negatively with age, weight, BSA and BMI (p < 0.001). Lower post-contrast T1 values were associated with lower aortic arch distensibility and higher aortic arch PWV (p < 0.001). CONCLUSIONS CoA patients after surgery or stent implantation did not show significant difference of aortic elasticity. Thus, presumably other factors like intrinsic aortic abnormalities might have a greater impact on aortic elasticity than the approach of repair. Interestingly, our data suggest that native T1 values are influenced by demographic characteristics.

中文翻译：

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主动脉缩窄缓解后的主动脉弹性：通过心血管磁共振成像比较外科手术和介入治疗。

背景技术主动脉缩窄（CoA）修复后的患者显示主动脉生物弹性受损，左心室（LV）力学改变，易患舒张功能障碍。我们的目的是评估接受血管内支架置入术或使用心血管磁共振（CMR）成像进行手术的CoA患者的主动脉生物弹性和LV特性。方法对50例CoA患者（20.5±9.5岁）进行3-Tesla CMR检查。18位患者以前曾进行过支架植入，32位患者进行过手术修复。我们对心室（LV，RV）和左心房（LA）进行了体积分析，以测量双心室的容积，射血分数，左心房（LA）的容积和功能参数（LAEFPassive，LAEFContractile，LAEFReservoir）。评估主动脉扩张性和脉搏波速度（PWV）。天然T1映射应用于检查左心室组织特性。在十二个患者中，进行了对比后的T1作图。结果手术组和支架组之间的LV，RV和LA参数没有差异。主动脉扩张性，PWV和T1松弛时间也没有显着差异。主动脉根的可扩张性与年龄，BMI，BSA和体重呈负相关（p <0.001）。原始T1值与年龄，体重，BSA和BMI呈负相关（p <0.001）。较低的造影剂后T1值与较低的主动脉弓扩张性和较高的主动脉弓PWV相关（p <0.001）。结论手术或支架植入术后的CoA患者主动脉弹性无明显差异。因此，大概其他因素，例如内在主动脉畸形，可能比修复方法对主动脉弹性的影响更大。有趣的是，我们的数据表明本地T1值受人口统计学特征的影响。