Determinants and prognostic implications of left atrial reverse remodelling after coarctation of aorta repair in adults
Authors' conclusion
COA repair resulted in improved LA function and decreased risk for atrial fibrillation, especially in patients without residual hypertension or significant residual COA gradient.
Study context
- Population
- Adults undergoing coarctation of aorta (COA) repair, 2003–20
- Participants
- 261 adults
- Outcome
- LA reverse remodelling (change in LA reservoir strain by speckle tracking echocardiography) and its relationship with incident AF
- Follow-up
- 12-24 months post intervention
Main finding
As reported in the abstract
LA reservoir strain
Left atrial (LA) reservoir strain pre intervention
32 ± 8%
LA reservoir strain post intervention
39 ± 7%
Relative increase in LA reservoir strain
21 ± 5%
LA reverse remodelling and AF risk, HR per 1% increase from pre-intervention LA function
0.97
95% CI 0.96–0.98P = 0.006
Observational data: associations, not effects.
Further findings
Determinants of less LA reverse remodelling (post intervention)
- Older age, β ± SE per 5 years (P = 0.02)
- −0.16 ± 0.09
- Higher SBP, β ± SE per 5 mmHg (P = 0.005)
- −0.12 ± 0.04
- Higher residual COA mean gradient, β ± SE per 5 mmHg (P = 0.002)
- −0.17 ± 0.06
- Adjusted for sex, hypertension diagnosis and LV indices
Original publication
Determinants and prognostic implications of left atrial reverse remodelling after coarctation of aorta repair in adults. Eur Heart J Cardiovasc Imaging. Published 16 August 2023. doi:10.
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