PDF(Pubmed)
Abstract：
UNASSIGNED: Coarctation of the aorta is associated with long-term morbidity including decreased exercise capacity, despite successful repair. In the absence of discrete recoarctation, the haemodynamic mechanism remains unknown. This multicentre study evaluated the relationship between aorta shape, flow, and exercise capacity in patients after arch repair, specifically through the lens of aortic size mismatch and descending aortic (DAo) flow and their association with exercise.
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.
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.
摘要：
■主动脉缩窄与长期发病有关，包括运动能力下降，尽管修复成功。在没有离散的重熔的情况下，血液动力学机制尚不清楚。这项多中心研究评估了主动脉形状之间的关系，流量,足弓修复后患者的运动能力，特别是通过晶状体的主动脉大小不匹配和降主动脉（DAo）流量及其与运动的关联。
■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。
■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。
