{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:38:09Z","timestamp":1789537089696,"version":"build-2803163510"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,27]]},"abstract":"\n Background<\/jats:title>\n \n Patients with hypoplastic left heart syndrome after a Norwood operation show dilatation and reduced distensibility of the reconstructed proximal aorta. Cardiac magnetic resonance imaging (\n CMR<\/jats:styled-content>\n ) and angiographic examinations indicate that the native descending aorta (\n DA<\/jats:styled-content>\n o) is also dilated, but this has not been studied in detail.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Seventy\u2010nine children with hypoplastic left heart syndrome in Fontan circulation (aged 6.3\u00b13.2\u00a0years) and 18 control participants (aged 6.8\u00b12.4\u00a0years) underwent 3.0\u2010tesla\n CMR<\/jats:styled-content>\n . Gradient\u2010echo cine and phase\u2010contrast imaging was applied to measure cross\u2010sectional areas (\n CSA<\/jats:styled-content>\n s), distensibility, pulse wave velocity, and the incremental elastic modulus of the thoracic aorta.\n CSA<\/jats:styled-content>\n of the\n DA<\/jats:styled-content>\n o in patients was also compared with published percentiles for aortic\n CSA<\/jats:styled-content>\n . Patients had significantly larger\n CSA<\/jats:styled-content>\n of the\n DA<\/jats:styled-content>\n o at the level of pulmonary artery bifurcation (229.1\u00b197.2 versus 175.7\u00b124.3\u00a0mm\/m\n 2<\/jats:sup>\n ,\n P<\/jats:italic>\n =0.04) and the diaphragm (196.2\u00b166.0 versus 142.6\u00b116.7\u00a0mm\/m\n 2<\/jats:sup>\n ,\n P<\/jats:italic>\n <0.01). In 41 patients (52%),\n CSA<\/jats:styled-content>\n of the\n DA<\/jats:styled-content>\n o was >95th percentile level for control participants, and the incremental elastic modulus of the aortic arch and the\n DA<\/jats:styled-content>\n o was higher than in patients with normal\n CSA<\/jats:styled-content>\n s (arch: 90.1\u00b164.3 versus 45.6\u00b138.9\u00a0m\/s;\n DA<\/jats:styled-content>\n o: 86.3\u00b153.7 versus 47.1\u00b147.6\u00a0m\/s;\n P<\/jats:italic>\n <0.01). Incremental elastic modulus of the aortic arch and the\n DA<\/jats:styled-content>\n o correlated with the\n CSA<\/jats:styled-content>\n of the\n DA<\/jats:styled-content>\n o (arch:\n r<\/jats:italic>\n =0.5;\n DA<\/jats:styled-content>\n o:\n r<\/jats:italic>\n =0.49;\n P<\/jats:italic>\n <0.01).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Children with hypoplastic left heart syndrome frequently show dilatation of their\n DA<\/jats:styled-content>\n o associated with increased stiffness of the aortic arch. Higher aortic impedance increases the afterload of the systemic circulation and likely contributes to the burden of the systemic right ventricle.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002107","type":"journal-article","created":{"date-parts":[[2015,10,6]],"date-time":"2015-10-06T02:48:34Z","timestamp":1444099714000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Frequent Dilatation of the Descending Aorta in Children With Hypoplastic Left Heart Syndrome Relates to Decreased Aortic Arch Elasticity"],"prefix":"10.1161","volume":"4","author":[{"given":"Inga","family":"Voges","sequence":"first","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Jerosch\u2010Herold","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham & Women's Hospital & Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Wegner","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominik","family":"Gabbert","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah","family":"Al Bulushi","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunther","family":"Fischer","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina","family":"Andrade","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoang Minh","family":"Pham","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines","family":"Kristo","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans\u2010Heiner","family":"Kramer","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carsten","family":"Rickers","sequence":"additional","affiliation":[{"name":"Department of Congenital Heart Disease and Pediatric Cardiology, University Hospital of Schleswig\u2010Holstein, Kiel, 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