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Early cardiac remodeling in aortic coarctation: insights from fetal and neonatal functional and structural assessment

Authors :
Fatima Crispi
Patricia Garcia-Canadilla
I. Soveral
Carin Walter
Hector Dejea
Bart Bijnens
J. M. Martínez
Andrew C. Cook
O. Gómez
Anne Bonnin
E. Gratacós
J Sánchez de Toledo
C Rovira-Zurriaga
L. Guirado
Source :
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, Fundació Sant Joan de Déu, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, instname
Publication Year :
2020
Publisher :
WILEY-BLACKWELL, 2020.

Abstract

OBJECTIVES: Coarctation of the aorta (CoA) is associated with left ventricular (LV) dysfunction in neonates and adults. Cardiac structure and function in fetal CoA and cardiac adaptation to early neonatal life have not been described. We aimed to investigate the presence of cardiovascular structural remodeling and dysfunction in fetuses with CoA and their early postnatal cardiac adaptation. METHODS: This was a prospective observational case-control study, conducted between 2011 and 2018 in a single tertiary referral center, of fetuses with CoA and gestational age-matched normal controls. All fetuses/neonates underwent comprehensive echocardiographic evaluation in the third trimester of pregnancy and after birth. Additionally, myocardial microstructure was assessed in one fetal and one neonatal CoA-affected heart specimen, using synchrotron radiation-based X-ray phase-contrast microcomputed tomography and histology, respectively. RESULTS: We included 30 fetuses with CoA and 60 gestational age-matched controls. Of these, 20 CoA neonates and 44 controls were also evaluated postnatally. Fetuses with CoA showed significant left-to-right volume redistribution, with right ventricular (RV) size and output dominance and significant geometry alterations with an abnormally elongated LV, compared with controls (LV midventricular sphericity index (median (interquartile range; IQR), 2.4 (2.0-2.7) vs 1.8 (1.7-2.0); P

Details

ISSN :
09607692 and 14690705
Database :
OpenAIRE
Journal :
ULTRASOUND IN OBSTETRICS & GYNECOLOGY, r-FSJD: Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, Fundació Sant Joan de Déu, Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology, r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu, instname
Accession number :
edsair.doi.dedup.....c0bbeba21f718c68937a4d9c619eb021