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Association of aortic root dilatation with left ventricular function in patients with postoperative ventricular septal defect

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Abstract

Proximal aortic enlargement is associated with an increased risk of heart failure and all-cause mortality. Recently, aortic root dilatation (ARD) was reported in postoperative patients with ventricular septal defects (VSDs). However, the impact of ARD on left ventricular (LV) function in postoperative VSD patients remains unclear. Thus, the aim of this study was to investigate the effect of ARD on LV function in patients with postoperative VSD. One hundred and thirty-five patients (> 15 years of age) with surgically repaired isolated ventricular defects and who underwent transthoracic echocardiography in our institution between 2009 and 2013 were identified. ARD was defined as an observed aortic root diameter/body surface area > 2.1 cm/m2. The propensity score estimating the probability of having ARD adjusted for anatomical and clinical characteristics was calculated. Forty-four patients (32.6%) had ARD. In unadjusted analyses, right ventricular systolic pressure, Tei index, and E/e’ were significantly (p < 0.05) higher in patients with ARD than in those without ARD (31.3 ± 7.5 vs. 35.4 ± 13.7 mmHg, 0.32 ± 0.10 vs. 0.44 ± 0.15, and 7.1 ± 1.7 vs. 9.5 ± 2.9, respectively). In the propensity score-adjusted analysis, significant differences in the Tei index and E/e’ were confirmed between the two groups (Tei index difference: 0.11, 95% confidence interval 0.05–0.17; E/e’ difference: 2.4, 95% confidence interval 1.3–3.5). However, there were no differences in the other echocardiographic measurements. The presence of ARD in patients with postoperative VSD was significantly associated with LV diastolic dysfunction. Thus, surgically repaired VSD patients require careful screening for aortic enlargement and LV function.

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Acknowledgements

The authors thank Dr. Shinya Hatakeyama for assistance with data collection, Dr. Goki Matsumura for advice regarding the manuscript, and Edanz Group (http://www.edanzediting.com/ac) for editing a draft of this manuscript.

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  1. Noritoshi Fukushima and Keiko Fukushima contributed equally to this work.

Authors and Affiliations

  1. Department of Preventive Medicine and Public Health, Tokyo Medical University, Tokyo, Japan

    Noritoshi Fukushima & Hiroki Sato

  2. Department of Cardiology, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Noritoshi Fukushima, Keiko Fukushima, Chihiro Saito, Kyomi Ashihara & Nobuhisa Hagiwara

  3. Health Care Center, Tokyo Women’s Medical University, Tokyo, Japan

    Keiko Fukushima, Keiko Uchida & Jinko Yokota

  4. Oita Oka Hospital, 3-7-11 Nishitsurusaki, Oita, 870-0192, Japan

    Hiroki Sato

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  1. Noritoshi Fukushima
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Fukushima, N., Fukushima, K., Sato, H. et al. Association of aortic root dilatation with left ventricular function in patients with postoperative ventricular septal defect. Heart Vessels 34, 1491–1498 (2019). https://doi.org/10.1007/s00380-019-01372-7

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