Background: Left ventricular hypertrophy (LVH) is common among patients with coarctation of the aorta (CoA). Cardiovascular magnetic resonance imaging (CMR) can be used to accurately measure left ventricular mass (LVM), but also the myocardial extracellular volume fraction (ECV), which reflects the degree of diffuse myocardial fibrosis.
Aims: This study aimed to investigate the prevalence of increased left ventricular myocardial ECV in adults with CoA, and to assess the relationship between increased ECV and LVH.
Material and methods: Adult patients with CoA (n = 21, age 28.5 (19.1-65.1) years, 33% female, 86% with prior CoA repair) referred clinically for CMR were investigated with T1 and ECV mapping. Clinical and echocardiographic data were retrieved from medical records.
Results: Median ECV was 29.0 (22.0-35.0) %; 29.0 (22.0-33.0) % for men versus 32.0 (27.0-35.0) % for women, p = 0.026). Median LVM indexed to body surface area (BSA) was 71.5 (44.0-99.6) g/m2, and LVM/BSA did not correlate with ECV (r = -0.184, p = 0.450). An increased myocardial ECV exceeding the upper normal limit (30.6 %) was found in 6/21 (29 %) of the patients. Of the patients with increased ECV, 5/6 (83 %) were female (p = 0.002). Patients with increased ECV did not differ from the rest of the study population in terms of age, age at intervention, blood pressure, or functional parameters such as left ventricular volumes or ejection fraction (p > 0.05 for all).
Conclusion: In a clinical population of adults with CoA, increased myocardial ECV was common, and associated with female sex, but not with LVM.