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Purpose: Most patients with repaired coarctation of the aorta live normal lives and have good physical performance. However, even after surgical intervention, there are long-term cardiovascular risks including arterial hypertension and left ventricular hypertrophy.

Methods: Fifty-one cardiovascular magnetic resonance investigations inadult patients with repaired coarctation of the aorta were reviewed and left ventricular mass was calculated. Using binary logistic regression, factors associated with left ventricular mass index abovethe reference limit were analysed among clinical, anatomic and functional variables.

Results: In this population, 14 (27.5%) of the patients had leftventricular mass index above the upper reference limit. Higher systolic blood pressure (OR=1.042, p=0.028), > mild aortic valve disease/previous aortic valve intervention (OR=1.042, p=0.002), and diameter of the descending aorta (OR=1.475, p=0.003) wereindependently associated with left ventricular mass index above theupper reference limit. In a post hoc model where systolic blood pressure was categorised in four levels, only high systolic blood pressure (>160 mmHg) (OR=31.913, p=0.020), together with > mild aortic valve disease or previous aortic valve intervention (OR=25.493, p=0.002) remainedindependently associated with left ventricular mass index above theupper reference limit.

Conclusion: Increased left ventricular mass is a common finding late after repair in coarctation of the aorta and is associated with themodifiable factors blood pressure and aortic valve disease. As most patients are young, and increased mass will affect the left ventricle over decades, attention to blood pressure is important in this population.