Author + information
- Received February 1, 2005
- Revision received May 17, 2005
- Accepted May 31, 2005
- Published online September 20, 2005.
- Ju-Le Tan, MBBS, MRCP⁎,‡,
- Sonya V. Babu-Narayan, MBBS, MRCP⁎,
- Michael Y. Henein, MD, PhD†,
- Michael Mullen, MD, MRCP⁎ and
- Wei Li, MD, PhD⁎,†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Wei Li, Department of Echocardiography, Royal Brompton Hospital, Sydney Street, London SW3 6NP, United Kingdom
Objectives We sought to assess the effect of successful stenting on the Doppler profile of aortic coarctation and to identify echocardiographic indexes that could be used for follow-up of such patients.
Background Doppler echocardiography demonstrates characteristic flow patterns in significant aortic coarctation.
Methods We undertook retrospective echocardiographic analyses before and at six to nine months after coarctation stenting in consecutive patients from 2002 to 2003. Peak systolic pressure gradient (SPG), diastolic velocity (DV), end-diastolic tail velocity (EDTV), systolic velocity half-time index (SVHTi) and diastolic velocity half-time index (DVHTi), and systolic pressure half-time index (SPHTi) and diastolic pressure half-time index (DPHTi) were measured. The severity of aortic coarctation was compared with cardiovascular magnetic resonance (CMR) imaging using the coarctation index (CoAi).
Results The patient cohort was divided into two groups: group 1 (13 patients; age 30 ± 8 years), which consisted of patients with significant aortic coarctation treated with stenting, and group 2 (11 patients; age 39 ± 16 years), which consisted of patients with previous surgical repair of aortic coarctation without evidence of re-coarctation. After stenting, there was significant reduction in SPG (p = 0.001), DV (p = 0.001), EDTV (p = 0.005), DVHTi (p = 0.001), and DPHTi (p = 0.001) values. In the patient group as a whole, there was a significant correlation between SPG and DV (r = 0.86; p < 0.001), EDTV (r = 0.80; p < 0.001), DVHTi (r = 0.56; p < 0.001), and DPHTi (r = 0.50; p = 0.002). In addition, DV >193 cm/s (100% sensitivity, 100% specificity) and diastolic/systolic velocity ratio >0.53 (100% sensitivity, 96% specificity) had high predictive values for severe aortic coarctation (CoAi <0.25).
Conclusions After stenting, peak SPG, DV, and pressure half-time indexes (i.e., DVHTi and DPHTi) decreased significantly. These findings can confidently be used in the follow-up of coarctation patients after stenting, particularly in those with limited two-dimensional images.
Dr. Tan is supported by grants from the Health Manpower Development Plan (Singhealth, Ministry of Health, Singapore) and the National Heart Center, Singapore. Dr. Babu-Narayan is supported by the British Heart Foundation
- Received February 1, 2005.
- Revision received May 17, 2005.
- Accepted May 31, 2005.
- American College of Cardiology Foundation