{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T17:29:22Z","timestamp":1769016562873,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011889","name":"Diamond Light Source","doi-asserted-by":"publisher","award":["proposal MT11716"],"award-info":[{"award-number":["proposal MT11716"]}],"id":[{"id":"10.13039\/100011889","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI14\/00226"],"award-info":[{"award-number":["PI14\/00226"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/00263"],"award-info":[{"award-number":["PI15\/00263"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["PI15\/00130"],"award-info":[{"award-number":["PI15\/00130"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["INT16\/00168"],"award-info":[{"award-number":["INT16\/00168"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp;amp; Gyne"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Coarctation of the aorta (CoA) is associated with left ventricular (LV) dysfunction in neonates and adults. Cardiac structure and function in fetal CoA and cardiac adaptation to early neonatal life have not been described. We aimed to investigate the presence of cardiovascular structural remodeling and dysfunction in fetuses with CoA and their early postnatal cardiac adaptation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective observational case\u2013control study, conducted between 2011 and 2018 in a single tertiary referral center, of fetuses with CoA and gestational age\u2010matched normal controls. All fetuses\/neonates underwent comprehensive echocardiographic evaluation in the third trimester of pregnancy and after birth. Additionally, myocardial microstructure was assessed in one fetal and one neonatal CoA\u2010affected heart specimen, using synchrotron radiation\u2010based X\u2010ray phase\u2010contrast  microcomputed tomography and histology, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 30 fetuses with CoA and 60 gestational age\u2010matched controls. Of these, 20 CoA neonates and 44 controls were also evaluated postnatally. Fetuses with CoA showed significant left\u2010to\u2010right volume redistribution, with right ventricular (RV) size and output dominance and significant geometry alterations with an abnormally elongated LV, compared with controls (LV midventricular sphericity index (median (interquartile range; IQR), 2.4 (2.0\u20132.7) <jats:italic>vs<\/jats:italic> 1.8 (1.7\u20132.0); <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Biventricular function was preserved and no ventricular hypertrophy was observed. Synchrotron tomography and histological assessment revealed normal myocyte organization in the fetal and neonatal specimens, respectively. Postnatally, the LV in CoA cases showed prompt remodeling, becoming more globular (LV midventricular sphericity index (mean\u2009\u00b1\u2009SD), 1.5\u2009\u00b1\u20090.3 in CoA <jats:italic>vs<\/jats:italic> 1.8\u2009\u00b1\u20090.2 in controls; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) with preserved systolic and normalized output, but altered diastolic, parameters compared with controls (LV  inflow peak velocity in early diastole (mean\u2009\u00b1\u2009SD), 97.8\u2009\u00b1\u200914.5 <jats:italic>vs<\/jats:italic> 56.5\u2009\u00b1\u200912.9\u2009cm\/s; LV  inflow peak velocity in atrial contraction (median (IQR), 70.5 (60.1\u201384.9) <jats:italic>vs<\/jats:italic> 47.0 (43.0\u201355.0) cm\/s; LV peak myocardial velocity in atrial contraction (mean\u2009\u00b1\u2009SD), 5.1\u2009\u00b1\u20092.6 <jats:italic>vs<\/jats:italic> 6.3\u2009\u00b1\u20092.2\u2009cm\/s; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The neonatal RV showed increased longitudinal function in the presence of a patent arterial duct.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest unique fetal cardiac remodeling in CoA, in which the LV stays smaller from the decreased growth stimulus of reduced volume load. Postnatally, the LV is acutely volume\u2010loaded, resulting in an overall geometry change with higher filling velocities and preserved systolic function. These findings improve our understanding of the evolution of CoA from fetal to neonatal life. Copyright \u00a9 2020 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.21970","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T11:17:16Z","timestamp":1578395836000},"page":"837-849","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Early cardiac remodeling in aortic coarctation: insights from fetal and neonatal functional and structural assessment"],"prefix":"10.1002","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3571-1780","authenticated-orcid":false,"given":"I.","family":"Soveral","sequence":"first","affiliation":[{"name":"BCNatal\u2010Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Crispi","sequence":"additional","affiliation":[{"name":"BCNatal\u2010Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer Universitat de Barcelona  Barcelona Spain"},{"name":"Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Walter","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Guirado","sequence":"additional","affiliation":[{"name":"BCNatal\u2010Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Garc\u00eda\u2010Ca\u00f1adilla","sequence":"additional","affiliation":[{"name":"PhySense, DTIC Universitat Pompeu Fabra  Barcelona Spain"},{"name":"Institute of Cardiovascular Science University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Cook","sequence":"additional","affiliation":[{"name":"Institute of Cardiovascular Science University College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Bonnin","sequence":"additional","affiliation":[{"name":"Swiss Light Source Paul Scherrer Institut  Villigen Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Dejea","sequence":"additional","affiliation":[{"name":"Swiss Light Source Paul Scherrer Institut  Villigen Switzerland"},{"name":"Institute for Biomedical Engineering, ETH Z\u00fcrich  Z\u00fcrich Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Rovira\u2010Zurriaga","sequence":"additional","affiliation":[{"name":"Department of Pathology Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"S\u00e1nchez de Toledo","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Hospital Sant Joan de D\u00e9u  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Gratac\u00f3s","sequence":"additional","affiliation":[{"name":"BCNatal\u2010Barcelona Center for Maternal\u2013Fetal and Neonatal Medicine (Hospital Cl\u00ednic and Hospital Sant Joan de D\u00e9u)  Barcelona Spain"},{"name":"Institut d'Investigacions Biom\u00e8diques August Pi i Sunyer Universitat de Barcelona  Barcelona Spain"},{"name":"Centre for Biomedical Research on Rare Diseases (CIBER\u2010ER)  Barcelona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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