Quantitative echocardiographic characterization of abdominal aortic pulsatility in children with coarctation

Obstructed blood flow due to aortic coarctation leads to a pressure drop an d loss of the pulse wave distal to the stenosis. This can be observed by ec hocardiography as typically decreased pulsatility of the abdominal aorta af ter cardiac systole. Our study intended to quantitatively describe abnormal abdominal aortic pulsatility in children with coarctation. A standardized M-mode echocardiographic study of the abdominal aorta was prospectively per formed with measurements of minimum and maximum abdominal aortic diameters and the corresponding time intervals during the cardiac cycle. Of these mea surements the percent increase in aortic diameter was calculated and this i ncrease was indexed to a unit of time. A total of 50 children were studied: 27 had angiographically proven severe coarctation (19 unoperated and 8 ope rated children with recurrent coarctation) with a mean minimum aortic lumen of 32 +/- 6% of the prestenotic aortic lumen. A total of 23 healthy childr en were studied as a control group. Children with significant coarctation d iffered from normals in all parameters evaluated. Two calculated values, th e percent increase in aortic diameter (5-25% in patients and 27-50% in norm als) and the percent increase per unit of time (18-108%/s in patients and 1 54-288%/s in normals) allowed for a clear discrimination between patients a nd normals with no overlap of individual values. Quantitative characterizat ion of abnormal pulsatility of the abdominal aorta due to the loss of pulse wave pressure clearly: discriminated children with angiographically proven significant coarctation from normal controls.