Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta

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Main Authors: Melody Farrashi, Shirin Habibi Khorasani, Ahmadreza Tanbakookar, Hamid Reza Pouraliakbar, Bahram Mohebbi, Jamal Moosavi, Mohammadreza Iranian, Seyed Mohammad Forouzannia, Mohammadreza Babaei, Arya Afrooghe, Ata Firouzi, Reza Kiani, Amineh Safavirad, Ehsan Khalilipur, Zahra Khajali, Sedigheh Saedi, Hooman Bakhshandeh, Parham Sadeghipour
Format: Artículo Open Access
Published: Wiley 2025
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author Melody Farrashi
Shirin Habibi Khorasani
Ahmadreza Tanbakookar
Hamid Reza Pouraliakbar
Bahram Mohebbi
Jamal Moosavi
Mohammadreza Iranian
Seyed Mohammad Forouzannia
Mohammadreza Babaei
Arya Afrooghe
Ata Firouzi
Reza Kiani
Amineh Safavirad
Ehsan Khalilipur
Zahra Khajali
Sedigheh Saedi
Hooman Bakhshandeh
Parham Sadeghipour
author_facet Melody Farrashi
Shirin Habibi Khorasani
Ahmadreza Tanbakookar
Hamid Reza Pouraliakbar
Bahram Mohebbi
Jamal Moosavi
Mohammadreza Iranian
Seyed Mohammad Forouzannia
Mohammadreza Babaei
Arya Afrooghe
Ata Firouzi
Reza Kiani
Amineh Safavirad
Ehsan Khalilipur
Zahra Khajali
Sedigheh Saedi
Hooman Bakhshandeh
Parham Sadeghipour
Melody Farrashi
Shirin Habibi Khorasani
Ahmadreza Tanbakookar
Hamid Reza Pouraliakbar
Bahram Mohebbi
Jamal Moosavi
Mohammadreza Iranian
Seyed Mohammad Forouzannia
Mohammadreza Babaei
Arya Afrooghe
Ata Firouzi
Reza Kiani
Amineh Safavirad
Ehsan Khalilipur
Zahra Khajali
Sedigheh Saedi
Hooman Bakhshandeh
Parham Sadeghipour
collection Wiley Open Access
contents Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta Melody Farrashi Shirin Habibi Khorasani Ahmadreza Tanbakookar Hamid Reza Pouraliakbar Bahram Mohebbi Jamal Moosavi Mohammadreza Iranian Seyed Mohammad Forouzannia Mohammadreza Babaei Arya Afrooghe Ata Firouzi Reza Kiani Amineh Safavirad Ehsan Khalilipur Zahra Khajali Sedigheh Saedi Hooman Bakhshandeh Parham Sadeghipour Echocardiography ABSTRACTBackgroundLimited research has explored the transformation of echocardiographic parameters during mid‐ to long‐term follow‐up in patients with native coarctation of the aorta (CoA) managed through stenting. This study assesses changes in echocardiographic parameters among patients undergoing stent coarctoplasty, by comparing baseline and 3‐year transthoracic echocardiographic (TTE) parameters.MethodsIn our earlier work, we detailed the 3‐year clinical safety and efficacy outcomes of balloon‐expandable versus self‐expandable stents for treating native CoA within a randomized clinical trial. The current substudy aims to assess the mid‐term effects of stenting by examining all participants with available baseline and 3‐year core laboratory‐confirmed TTE data.ResultsOf the 92 patients enrolled in the randomized trial, 32 individuals (median age: 32 years [IQR: 24.8–37.5]) were included in this substudy. At the 3‐year follow‐up, significant improvements were observed in myocardial diastolic function, characterized by increased septal E′ and lateral E′ velocities (p = 0.02 and p = 0.03, respectively) and decreased septal and lateral E/E′ ratios (10.84 ± 2.83 to 9.21 ± 3.17, p = 0.02 and 7.39 ± 2.24 to 6.29 ± 1.97, p = 0.02, respectively). At the 3‐year follow‐up, a significant reduction in left ventricular (LV) mass was observed, decreasing from 160 g (IQR: 130–203) to 142 g (IQR: 121–172) (p = 0.001). Among the 12 patients (37.5%) presenting with baseline LV hypertrophy, nine individuals (75%) experienced normalization, demonstrating a substantial improvement in LV mass. Additionally, the prevalence of diastolic dysfunction significantly decreased from 12 patients (41.3%) to four patients (13.7%) at the 3‐year evaluation.ConclusionsIn adult patients with de novo native CoA, stent coarctoplasty was found to result in significant and sustained improvements in LV diastolic function and reduced LV mass during the mid‐term follow‐up. Our findings imply that baseline structural parameters may serve as stronger predictors of long‐term therapeutic outcomes than demographic factors.Trail RegistrationIranian Registry of Clinical Trials: IRCT20181022041406N3. 10.1111/echo.70181 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/echo.70181
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publishDate 2025
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spellingShingle Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta
Melody Farrashi
Shirin Habibi Khorasani
Ahmadreza Tanbakookar
Hamid Reza Pouraliakbar
Bahram Mohebbi
Jamal Moosavi
Mohammadreza Iranian
Seyed Mohammad Forouzannia
Mohammadreza Babaei
Arya Afrooghe
Ata Firouzi
Reza Kiani
Amineh Safavirad
Ehsan Khalilipur
Zahra Khajali
Sedigheh Saedi
Hooman Bakhshandeh
Parham Sadeghipour
Echocardiography
Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta Melody Farrashi Shirin Habibi Khorasani Ahmadreza Tanbakookar Hamid Reza Pouraliakbar Bahram Mohebbi Jamal Moosavi Mohammadreza Iranian Seyed Mohammad Forouzannia Mohammadreza Babaei Arya Afrooghe Ata Firouzi Reza Kiani Amineh Safavirad Ehsan Khalilipur Zahra Khajali Sedigheh Saedi Hooman Bakhshandeh Parham Sadeghipour Echocardiography ABSTRACTBackgroundLimited research has explored the transformation of echocardiographic parameters during mid‐ to long‐term follow‐up in patients with native coarctation of the aorta (CoA) managed through stenting. This study assesses changes in echocardiographic parameters among patients undergoing stent coarctoplasty, by comparing baseline and 3‐year transthoracic echocardiographic (TTE) parameters.MethodsIn our earlier work, we detailed the 3‐year clinical safety and efficacy outcomes of balloon‐expandable versus self‐expandable stents for treating native CoA within a randomized clinical trial. The current substudy aims to assess the mid‐term effects of stenting by examining all participants with available baseline and 3‐year core laboratory‐confirmed TTE data.ResultsOf the 92 patients enrolled in the randomized trial, 32 individuals (median age: 32 years [IQR: 24.8–37.5]) were included in this substudy. At the 3‐year follow‐up, significant improvements were observed in myocardial diastolic function, characterized by increased septal E′ and lateral E′ velocities (p = 0.02 and p = 0.03, respectively) and decreased septal and lateral E/E′ ratios (10.84 ± 2.83 to 9.21 ± 3.17, p = 0.02 and 7.39 ± 2.24 to 6.29 ± 1.97, p = 0.02, respectively). At the 3‐year follow‐up, a significant reduction in left ventricular (LV) mass was observed, decreasing from 160 g (IQR: 130–203) to 142 g (IQR: 121–172) (p = 0.001). Among the 12 patients (37.5%) presenting with baseline LV hypertrophy, nine individuals (75%) experienced normalization, demonstrating a substantial improvement in LV mass. Additionally, the prevalence of diastolic dysfunction significantly decreased from 12 patients (41.3%) to four patients (13.7%) at the 3‐year evaluation.ConclusionsIn adult patients with de novo native CoA, stent coarctoplasty was found to result in significant and sustained improvements in LV diastolic function and reduced LV mass during the mid‐term follow‐up. Our findings imply that baseline structural parameters may serve as stronger predictors of long‐term therapeutic outcomes than demographic factors.Trail RegistrationIranian Registry of Clinical Trials: IRCT20181022041406N3. 10.1111/echo.70181 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Reverse Cardiac Remodeling Induced by Endovascular Treatment of Coarctation of the Aorta
topic Echocardiography
url https://onlinelibrary.wiley.com/doi/10.1111/echo.70181