Evaluation of Subclinical Right Ventricular Dysfunction in Adults with Repaired Aortic Coarctation.

Abstract

Background: Right ventricular (RV) function and strain are becoming significant predictors of clinical outcomes in adults with repaired aortic coarctation (CoA).

Objective: In this work, we aimed to evaluate RV function in adults after CoA repair or intervention, and its relation to patient characteristics, CoA morphology, and left side parameters.

Patients and methods: This cross-sectional study included adult patients who underwent CoA surgical repair or catheter intervention and attended the congenital heart disease clinic in the cardiology department of Tanta University for follow-up between August 2023 and May 2025.

Results: We enrolled 33 patients and 33 healthy control volunteers. The mean age of initial repair was 13.14 ± 10.14 years. Both groups were evaluated by echocardiography regarding RV function, RV strain, and the relation between RV dysfunction and different demographic, morphological, and other echocardiographic parameters. RV global longitudinal strain (RV GLS) was impaired in eight patients of the patients' group (24.2%). TAPSE and FAC were not significantly different between both groups, meanwhile, peak RV systolic velocity (S' wave), and RV GLS were significantly lower in the CoA group. RV systolic pressure, and tricuspid E/E' were significantly higher than the control group. RV GLS was significantly affected by BMI, mitral septal and lateral S wave velocity, mitral septal E' velocity, LV filling pressure, LV GLS and LA volume using simple linear regression model. Mitral septal S wave velocity and LV GLS significantly affect RV GLS using multiple linear regression analysis.

Conclusions: Subclinical RV dysfunction exists in adult patients with repaired CoA and can be practically evaluated using 2D RV strain using speckle tracking imaging.