{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T11:32:06Z","timestamp":1788607926335,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Aortic coarctation (CoA) comprises local narrowing of the aortic lumen, which is located at the level of the isthmus in 95% of patients and accounts for 5 to 8% of live births with congenital heart disease. It can be associated with other congenital defects, such as a bicuspid aortic valve (BAV), and in adulthood should be considered a secondary cause of hypertension in patients younger than 40 years, particularly in the presence of severe or resistant hypertension, in accordance with current hypertension guidelines. A correct diagnosis is necessary for the proper assessment and management of these patients. A multimodality imaging approach using ultrasound, computed tomography (CT), and MRI allows for accurate and effective diagnosis. The purpose of this review is to describe different non-invasive imaging techniques and highlight their advantages and disadvantages, aiming to provide a guide to clinicians and cardiovascular imaging specialists in choosing the best imaging tools to use in adults with native CoA.<\/jats:p>","DOI":"10.3390\/jcm15030949","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"949","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Multimodality Imaging Approach in Diagnosis and Follow-Up of Aortic Coarctation in Adulthood"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4648-0460","authenticated-orcid":false,"given":"Lucia","family":"La Mura","sequence":"first","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u201cFederico II\u201d University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-7507-5483","authenticated-orcid":false,"given":"Luigi","family":"Mannacio","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u201cFederico II\u201d University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Illuminato","sequence":"additional","affiliation":[{"name":"\u201cFerdinando Veneziale\u201d Hospital, Universit\u00e0 Degli Studi Del Molise, 86100 Campobasso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ferrone","sequence":"additional","affiliation":[{"name":"Catheterization Laboratory, Division of Cardiology, Montevergine Clinic, 83013 Mercogliano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Lembo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u201cFederico II\u201d University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saverio","family":"D\u2019Elia","sequence":"additional","affiliation":[{"name":"Cardiology Unit, AOU Luigi Vanvitelli, 80138 Naples, Italy"},{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia, 2, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8499-5428","authenticated-orcid":false,"given":"Carmine","family":"Izzo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, Via Salvador Allende, 84081 Baronissi, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Santoro","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende (CS), 87036 Arcavacata, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0308-2836","authenticated-orcid":false,"given":"Raffaele","family":"Izzo","sequence":"additional","affiliation":[{"name":"Department of Advanced Biomedical Sciences, \u201cFederico II\u201d University of Naples, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1097\/HCO.0000000000000430","article-title":"Imaging adult patients with coarctation of the aorta","volume":"32","author":"Thakkar","year":"2017","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1136\/heartjnl-2017-311173","article-title":"Diagnosis, imaging and clinical management of aortic coarctation","volume":"103","author":"Dijkema","year":"2017","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"W224","DOI":"10.2214\/AJR.14.12529","article-title":"CT and MRI of Aortic Coarctation: Pre- and Postsurgical Findings","volume":"204","author":"Karaosmanoglu","year":"2015","journal-title":"Am. J. Roentgenol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC Guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA Guideline for the Diagnosis and Management of Aortic Disease","volume":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1970","DOI":"10.1161\/HYPERTENSIONAHA.123.19454","article-title":"Coarctation of the Aorta: Modern Paradigms Across the Lifespan","volume":"80","author":"Salciccioli","year":"2023","journal-title":"Hypertension"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e023199","DOI":"10.1161\/JAHA.121.023199","article-title":"Cardiovascular Morbidity and Mortality in Adult Patients With Repaired Aortic Coarctation","volume":"10","author":"Meijs","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Leo, I., Sabatino, J., Avesani, M., Moscatelli, S., Bianco, F., Borrelli, N., De Sarro, R., Leonardi, B., Calcaterra, G., and Surkova, E. (2024). Non-Invasive Imaging Assessment in Patients with Aortic Coarctation. J. Clin. Med., 13.","DOI":"10.3390\/jcm13010028"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"167","DOI":"10.4330\/wjc.v12.i5.167","article-title":"Management of adults with coarctation of aorta","volume":"12","author":"Agasthi","year":"2020","journal-title":"World J. Cardiol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"La Mura, L., Lembo, M., Musella, F., D\u2019Amato, M., D\u2019Andrea, A., Izzo, R., and Esposito, G. (2024). Aortic Regurgitation in Bicuspid Aortic Valve: The Role of Multimodality Imaging. J. Clin. Med., 13.","DOI":"10.3390\/jcm13133924"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1161\/CIR.0000000000001265","article-title":"Cardiovascular Management of Aortopathy in Children: A Scientific Statement From the American Heart Association","volume":"150","author":"Morris","year":"2024","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0022-3476(83)80284-4","article-title":"Echocardiography reveals a high incidence of bicuspid aortic valve in Turner syndrome","volume":"102","author":"Miller","year":"1983","journal-title":"J. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.jtcvs.2016.10.088","article-title":"Cardiovascular operations for Loeys-Dietz syndrome: Intermediate-term results","volume":"153","author":"Patel","year":"2017","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1067\/mtc.2001.118043","article-title":"Anomalous origin of the left circumflex coronary artery associated with bicuspid aortic valve","volume":"122","author":"Doty","year":"2001","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1148\/radiology.158.2.3941875","article-title":"Coarctation of the aorta: MR imaging","volume":"158","author":"Higashino","year":"1986","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1148\/rg.2019180091","article-title":"Four-Dimensional Flow MRI: Principles and Cardiovascular Applications","volume":"39","author":"Azarine","year":"2019","journal-title":"RadioGraphics"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1863","DOI":"10.1016\/j.jcmg.2020.01.016","article-title":"Left Ventricular Remodeling After Transcatheter Versus Surgical Therapy in Adults With Coarctation of Aorta","volume":"13","author":"Egbe","year":"2020","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1093\/ehjci\/jeaa199","article-title":"Predictors of left ventricular reverse remodelling after coarctation of aorta intervention","volume":"22","author":"Egbe","year":"2021","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae646","article-title":"2024 ESC Guidelines for the management of elevated blood pressure and hypertension","volume":"45","author":"McCarthy","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3538","DOI":"10.1093\/eurheartj\/ehae179","article-title":"2024 ESC Guidelines for the management of peripheral arterial and aortic diseases: Developed by the task force on the management of peripheral arterial and aortic diseases of the European Society of Cardiology (ESC Endorsed by the European Association for Cardio-Thoracic Surgery (EACTS, the European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN, and the European Society of Vascular Medicine (ESVM)","volume":"45","author":"Mazzolai","year":"2024","journal-title":"Eur. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/j.1524-6175.2004.02868.x","article-title":"Coarctation of the aorta: A secondary cause of hypertension","volume":"6","author":"Prisant","year":"2004","journal-title":"J. Clin. Hypertens."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"298","DOI":"10.4070\/kcj.2018.0433","article-title":"Management of Coarctation of The Aorta in Adult Patients: State of The Art","volume":"49","author":"Alkashkari","year":"2019","journal-title":"Korean Circ. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1016\/j.recesp.2023.10.013","article-title":"Very long-term follow-up after aortic stenting for coarctation of the aorta","volume":"77","author":"Pan","year":"2024","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1111\/echo.14937","article-title":"Myocardial strain pattern progress in patients with Coarctation of the Aorta undergoing aortic stenting","volume":"38","author":"Borgo","year":"2021","journal-title":"Echocardiography"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Salahuddin, A., Chan, A., and Zaidi, A.N. (2018). The Adult with Coarctation of the Aorta. Congenital Heart Disease, IntechOpen.","DOI":"10.5772\/intechopen.79865"},{"key":"ref_26","first-page":"100530","article-title":"Increased prevalence of left ventricular diastolic dysfunction in adults with repaired coarctation of aorta","volume":"28","author":"Egbe","year":"2020","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1136\/hrt.2006.106377","article-title":"Effect of endovascular stenting of aortic coarctation on biventricular function in adults","volume":"93","author":"Lam","year":"2007","journal-title":"Heart"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1093\/ehjci\/jeu309","article-title":"Arterial-left ventricular-left atrial coupling late after repair of aortic coarctation and interruption","volume":"16","author":"Li","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jcct.2015.11.002","article-title":"Coarctation of the aorta in adolescents and adults: A review of clinical features and CT imaging","volume":"10","author":"Nance","year":"2016","journal-title":"J. Cardiovasc. Comput. Tomogr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1378\/chest.126.4.1169","article-title":"Follow-up of adults with coarctation of the aorta: Comparison of helical CT and MRI, and impact on assessing diameter changes","volume":"126","author":"Hager","year":"2004","journal-title":"Chest"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1136\/heartjnl-2021-319773","article-title":"Prognostic value of coronary computed tomography angiographic derived fractional flow reserve: A systematic review and meta-analysis","volume":"108","author":"Gaur","year":"2022","journal-title":"Heart"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1161\/01.CIR.0000154549.53684.64","article-title":"Magnetic resonance imaging predictors of coarctation severity","volume":"111","author":"Nielsen","year":"2005","journal-title":"Circulation"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"375","DOI":"10.21037\/cdt-24-497","article-title":"Non-invasive tissue characterization in children and young adults with aortic coarctation-an MRI-based prospective study","volume":"15","author":"Giertzsch","year":"2025","journal-title":"Cardiovasc. Diagn. Ther."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"9262","DOI":"10.1007\/s00330-021-08016-3","article-title":"Leaflet fusion length is associated with aortic dilation and flow alterations in non-dysfunctional bicuspid aortic valve","volume":"31","author":"Guala","year":"2021","journal-title":"Eur. Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e004077","DOI":"10.1161\/CIRCIMAGING.115.004077","article-title":"Cardiovascular Magnetic Resonance Myocardial Feature Tracking: Concepts and Clinical Applications","volume":"9","author":"Schuster","year":"2016","journal-title":"Circ. Cardiovasc. Imaging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/949\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T05:12:48Z","timestamp":1769836368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/949"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":35,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15030949"],"URL":"https:\/\/doi.org\/10.3390\/jcm15030949","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]}}}