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

  • Noritoshi Fukushima
  • Keiko FukushimaEmail author
  • Hiroki Sato
  • Chihiro Saito
  • Keiko Uchida
  • Jinko Yokota
  • Kyomi Ashihara
  • Nobuhisa Hagiwara
Original Article


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.


Ventricular septal defect Aortic root dilatation Left ventricular function Echocardiogram 



The authors thank Dr. Shinya Hatakeyama for assistance with data collection, Dr. Goki Matsumura for advice regarding the manuscript, and Edanz Group ( for editing a draft of this manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Noritoshi Fukushima
    • 1
    • 2
  • Keiko Fukushima
    • 2
    • 3
    Email author
  • Hiroki Sato
    • 1
    • 4
  • Chihiro Saito
    • 2
  • Keiko Uchida
    • 3
  • Jinko Yokota
    • 3
  • Kyomi Ashihara
    • 2
  • Nobuhisa Hagiwara
    • 2
  1. 1.Department of Preventive Medicine and Public HealthTokyo Medical UniversityTokyoJapan
  2. 2.Department of CardiologyTokyo Women’s Medical UniversityTokyoJapan
  3. 3.Health Care CenterTokyo Women’s Medical UniversityTokyoJapan
  4. 4.Oita Oka HospitalOitaJapan

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