UNASSIGNED: Cardiac magnetic resonance, cardiopulmonary exercise test, and echocardiogram data within 1 year were analysed from 58 patients (age 28 ± 10 years, 48% male) across four centres with history of isolated arch repair. Aortic arch measurements were correlated with % predicted VO2max with subgroup analyses of those with residual arch obstruction, bicuspid aortic valve, and hypertension. Ascending aorta (AAo) to DAo diameter ratio (DAAo/DDAo) was negatively correlated with % predicted VO2max. %DAo flow positively correlated with VO2max. Sub-analyses demonstrated that the negative correlation of DAAo/DDAo with VO2max was maintained only in patients without arch obstruction and with a bicuspid aortic valve. Smaller aortic arch measurements were associated with both hypertension and exercise-induced hypertension.
UNASSIGNED: Aorta size mismatch, due to AAo dilation or small DAo, and associated decreased %DAo flow, correlated significantly with decreased exercise capacity after aortic arch repair. These correlations were stronger in patients without arch obstruction and with a bicuspid aortic valve. Aorta size mismatch and %DAo flow capture multiple mechanisms of altered haemodynamics beyond blood pressure gradient or discrete obstruction and can inform the definition of a successful repair.
■心脏磁共振,心肺运动试验,分析了58例患者(年龄28±10岁,48%男性)在四个有孤立弓修复史的中心。主动脉弓测量值与预测的VO2max%相关,并对残余弓梗阻患者进行亚组分析,二叶主动脉瓣,和高血压。升主动脉(AAo)与DAo直径之比(DAAo/DDAo)与预测的VO2max%呈负相关。%DAo流量与VO2max呈正相关。子分析表明,DAAo/DDAo与VO2max的负相关仅在无弓阻塞和二叶主动脉瓣的患者中保持。较小的主动脉弓测量值与高血压和运动性高血压有关。
■主动脉大小不匹配,由于AAo扩张或小DAo,和相关的%DAo流量减少,主动脉弓修复后运动能力下降显著相关。在没有弓部阻塞和二叶主动脉瓣的患者中,这些相关性更强。主动脉大小不匹配和%DAo流量捕获了超出血压梯度或离散阻塞的血液动力学改变的多种机制,并且可以告知成功修复的定义。