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Impaired left atrial function in adults and adolescents with corrected aortic coarctation

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Abstract

This study examined the left atrial (LA) function using two-dimensional (2D) strain analysis after aortic coarctation (CoA) repair, as well as relationships between LA function and patient characteristics, especially aortic arch anatomy. 56 patients (34 males, age: 31 ± 16 years) with CoA repair (46 post ‘end-to-end anastomosis/subclavian flap’) and 56 controls were studied. 2D strain imaging was performed to assess left ventricular (LV) and LA functions including peak-positive LA strain, early and late diastolic LA strains, and global longitudinal (LV-GLS) and circumferential (LV-GCS) strains. LA dysfunction (LAD) was defined as a peak-positive LA strain value lower than the mean value of the control group minus 2 SDs. Peak-positive LA strain, early and late diastolic LA strains, and LV-GLS were significantly lower in the CoA group while LV-GCS did not differ. No significant correlation was found between LA strain and either current age, age at initial repair, or blood pressure; Ea and LV-GLS were moderately correlated to peak-positive LA strain (r = 0.49, p < 0.001 and r =  − 0.55, p < 0.001, respectively). 23 CoA patients (41%) presented LAD (abnormal peak-positive LA strain < 25%). Among patients who underwent end-to-end anastomosis/subclavian flap, those with a non-romanesque aortic arch anatomy exhibited a significantly lower peak-positive LA strain. Ischemic stroke and atrial arrhythmia were more frequent in CoA patients with LAD. Our findings suggest that LAD may be prevalent late after CoA repair. Postoperative aortic arch anatomy may impact peak-positive LA strain.

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Abbreviations

ACE:

Angiotensin-converting enzyme

CoA:

Aortic coarctation

ICCs:

Intraclass correlation coefficients

Ea:

Lateral mitral annular peak velocity during early diastole

LA:

Left atrial

LAD:

Left atrial dysfunction

LV:

Left ventricular

LV-GCS:

Global circumferential left ventricular strain

LV-GLS:

Global longitudinal left ventricular strain

MDCT:

Multidetector computed tomography

MRI:

Magnetic resonance imaging

TDI:

Tissue Doppler imaging

SDs:

Standard deviations

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Cardiology, CHU de Caen, Avenue cote de nacre, 14000, Caen, France

    Fabien Labombarda, Maud Bonopéra, Pascale Maragnes, Paul Milliez & Farzin Beygui

  2. Medical School, UNICAEN, CHU Caen, Université Caen Normandie, 4650, Caen, EA, France

    Fabien Labombarda, Paul Milliez, Alain Manrique & Farzin Beygui

  3. Signalisation, Electrophysiologie et Imagerie des Lésions d’ischémie-Reperfusion Myocardique, 14000, Caen, France

    Fabien Labombarda, Paul Milliez, Alain Manrique & Farzin Beygui

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  1. Fabien Labombarda
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Correspondence to Fabien Labombarda.

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Labombarda, F., Bonopéra, M., Maragnes, P. et al. Impaired left atrial function in adults and adolescents with corrected aortic coarctation. Pediatr Cardiol 42, 199–209 (2021). https://doi.org/10.1007/s00246-020-02471-3

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  • DOI: https://doi.org/10.1007/s00246-020-02471-3

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