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11.03.2019 | Original Article

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

verfasst von: Noritoshi Fukushima, Keiko Fukushima, Hiroki Sato, Chihiro Saito, Keiko Uchida, Jinko Yokota, Kyomi Ashihara, Nobuhisa Hagiwara

Erschienen in: Heart and Vessels | Ausgabe 9/2019

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Abstract

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.

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Titel: Association of aortic root dilatation with left ventricular function in patients with postoperative ventricular septal defect
verfasst von: Noritoshi Fukushima
Keiko Fukushima
Hiroki Sato
Chihiro Saito
Keiko Uchida
Jinko Yokota
Kyomi Ashihara
Nobuhisa Hagiwara
Publikationsdatum: 11.03.2019
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 9/2019
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-019-01372-7

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