Does Left Ventricular Function On Echocardiography At Rest And Exercise Predict Recoarctation In Children With Postoperative Coarctation Of Aorta

Abstract

Objective: The aim of this study was to evaluate ventricular performance before and after exercise in children who had surgically repaired coarctation of aorta (CoA) by using two dimensional, M- mode and Doppler echocardiography and to determine whether this method can be used for identifying recoarctation in comparison to Magnetic Resonance Imaging (MRI). Design: We studied on 24 patients who were operated for CoA previously and compared with 24 healthy controls. Blood pressure monitoring, echocardiographies at rest and after exercise and MRI of aortic arc were performed. Patients having had ? 30 % of isthmic stenosis on MRI was diagnosed as recoarctation. The patient group were divided as Group A (patient without recoarctation) and Group B (patients with recoarctation) and were compared. Results: We found that 8 of 24 patients had recoarctation on MRI. Physical examination and echocardiographic evaluation revealed that hypertension on the right arm at rest, systolic and diastolic hypotension on the left leg after exercise, increased values of ejection fraction, fractioned shortening and aortic gradient on exercise may predict more than 30 % narrowing of the aortic isthmus. Conclusion: These findings can be useful as predictors for recoarctation.

Keywords

• Coarctation of aorta, exercise, Doppler echocardiography, Magnetic Resonance Imaging, MRI, recoarctation.

Postoperatif Aort Koarktasyonlu Çocuklarda, İstirahat ve Egzersizdeki Ekokardiyografik Sol Ventrikül Fonksiyonları Rekoarktasyonu Tahmin Ettirir mi?

Abstract

Amaç: Bu çalışmanın amacı cerrahi olarak düzeltilmiş aort koarktasyonlu çocuklarda egzersiz öncesi ve sonrası yapılan 2 boyutlu, M-mod ve Doppler ekokardiyografiyle değerlendirilen sol ventrikül fonksiyonlarının, rekoarktasyonu gösterip göstermediğinin Magnetik Rezonans Görüntüleme ile kıyaslanarak belirlenmesidir. Gereç ve Yöntemler: Aort koarktasyonu operasyonu geçiren 24 çocuk, 24 sağlıklı kontrolle karşılaştırıldı. Kan basıncı monitorizasyonu, istirahat ve egzersizde ekokardiyografik değerlendirme ve MRG yapıldı. MRG'de %30 ve daha çok isthmus daralması görülen çocuklar rekoarktasyon olarak değerlendirildi. Rekoarktasyon grubu Grup A, kontrol grubu Grup B olarak belirlendi. Bulgular: MRG'de 24 hasta çocuktan 8'inde rekoarktasyon saptandı. Fizik muayene ve ekokardiyografiye göre istirahatte sağ kolda hipertansiyonu olma, egzersizle bacakta sistoNaci lik ve diyastolik hipotansiyon olma, ekokardiyografide yüksek ejeksiyon fraksiyonu, fraksiyone kısalma ve aortik gradyent olması rekoarktasyon göstergesi olarak kabul edildi. Sonuçlar: Bu bulgular rekoarktasyonu göstermesi açısından önemlidir

Keywords

• Aort koarktasyonu; Egzersiz; ekokardiyografi,dopler; Manyetik rezonans görüntüleme.

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