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Aortic GeometryNCT07131111

Impact of Aortic Geometry on Vascular Remodeling After Stent Implantation in Coarctation of the Aorta

An observational study of Aortic Geometry and Vascular Remodeling, run by Assiut University at 1 site in Egypt.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

This study aims to assess: 1. Aortic geometrical changes and their relationship to hypertension and cardiovascular events. 2. Aortic geometrical differences between healthy individuals and patients with repaired coarctation of the aorta. Read more about this study

Who is it for?
Ages 12 years and olderHealthy volunteers can take part
What is being tested?
CT aortography and CMR
Type of treatment
Surgery or procedure
How many people
50 participants
Where
1 siteEgypt
Study dates
1 Sep 2025to 31 Dec 2026
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 12 years and older
  • All sexes
  • Healthy volunteers accepted
  • Child, Adult, Older adult

Study population: The study population will consist of two groups: 1. Patients group: Individuals diagnosed with coarctation of the aorta (CoA) who have undergone successful stent implantation and will be evaluated six months post-stenting. 2. Control group: Age- and sex-matched healthy volunteers with no history of cardiovascular or systemic diseases. All participants will undergo imaging and functional evaluation including CT aortography, cardiac MRI, 24-hour ambulatory blood pressure monitoring (ABPM), and ECG as part of the study protocol. The study will be conducted at [Assiut University Hospital / Orman Cardiology Center - modify as needed], and participants will be recruited from the cardiology outpatient clinics and imaging units.

Who may be able to join

  • Age ≥ 12 years.
  • Diagnosed with native or recurrent coarctation of the aorta.
  • Transcatheter systolic pressure gradient ≥ 20 mmHg.
  • Body weight ≥ 20 kg.
  • Availability of pre- and post-stenting CT aortography data.

Who cannot join

  • Patients with obstructive lesion of LVOT or aortic valve dysfunction greater than moderate (requiring surgical intervention)..
  • Patients with other causes of secondary hypertension.
  • Associated complex congenital heart defects (aside from simple septal defects and patent ductus arteriosus)
  • Genetic syndromes
  • Connective tissue disorder
  • History of surgery involving the aortic root or ascending aorta.
  • Incomplete imaging or missing data relevant to the study.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Mena Wadee, Resident doctor contact

01282210873

menawade399@gmail.com

Egypt1 site
  • Institutional Review Board (IRB) of Faculty of Medicine

    Asyut

    Assiut University, +2088 22080150, irbasyut@aun.edu.eg

Other trials in Egypt

About this study

This study aims to assess:

  1. Aortic geometrical changes and their relationship to hypertension and cardiovascular events.
  2. Aortic geometrical differences between healthy individuals and patients with repaired coarctation of the aorta.
Read the detailed description

Coarctation of the aorta (CoA) is a congenital narrowing of the aortic lumen, accounting for 5-8% of congenital heart diseases, with an incidence of 1 in 3000-4000 live births . This narrowing leads to altered hemodynamics, including increased left ventricular afterload, systemic hypertension, and long-term vascular remodeling, which can persist even after anatomical correction .

Despite advances in interventions like stent implantation for native or recurrent CoA, many patients remain hypertensive post-procedure . This residual hypertension may not be purely mechanical but linked to persistent vascular dysfunction, abnormal aortic compliance, or inadequate aortic wall remodeling .

Aortic stiffness is now recognized as a key cardiovascular risk factor in CoA patients . Reduced elasticity contributes to high systolic blood pressure, increased cardiac workload, and late cardiovascular complications [7]. Moreover, abnormal aortic arch geometry-particularly the "gothic arch"-has been linked to impaired vascular function and unfavorable hemodynamics [13].

While cardiac magnetic resonance (CMR) is the standard for evaluating aortic stiffness and ventricular function , CT Aortography offers high-resolution images to assess aortic distensibility, luminal changes, and residual stenosis, especially post-stenting . When combined with blood pressure and ECG data, these insights can provide a fuller picture of outcomes .

This study investigates the relationship between post-stenting blood pressure and aortic geometry-including arch shape and residual stenosis-using CT Aortography in CoA patients. It also explores ECG changes as potential non-invasive markers of ventricular strain and hemodynamic stress ..

Being tested
CT aortography, CMR
Medical subject headings
Vascular Remodeling, Aortic Coarctation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CT aortographyRadiation

    Performed before and after stenting using a multidetector CT scanner (device model and parameters to be specified).

    Analysis will include:

    • Evaluation of aortic arch geometry (normal / gothic / crenel).
    • Measurement of residual stenosis at the site of coarctation.
    • Aortic diameter measurements at predefined anatomical levels:

    Ascending aorta (AA), Proximal descending thoracic aorta (PDA), At the level of the diaphragm (DA), Abdominal aorta (AbAo).

    • Aortic tortuosity. All CT data will be interpreted by two independent observers blinded to clinical outcomes
  • CMRRadiation

    CMR examinations will be performed using a commercially available 1.5 Tesla whole-body scanner (Ingenia, Philips Healthcare, release 4.1.3.0). In pediatric or uncooperative patients, free-breathing sequences were used when breath-holding was not feasible.

    Brachial blood pressure was measured in the right arm in the supine position immediately before image acquisition using automated oscillometric devices.

    Cine steady-state free precession (SSFP) sequences were obtained in multiple views including the short axis of the ascending aorta (AAO) and descending aorta (DAO), as well as the aortic root to evaluate aortic valve morphology (bicuspid vs tricuspid).

    Left ventricular (LV) and left atrial (LA) functional parameters were assessed by standard volumetric analysis. The following CMR-derived parameters were collected:

    Left ventricular ejection fraction (LVEF) Left ventricular strain Left ventricular mass index (LVMI) Left atrial volume Left atrial strain LV and LA strain were analyzed usi

Study groups in NCT07131111
Study groupRoleWhat they receive
COA patientsNot described
Receives: Radiation: CT aortography; Radiation: CMR
Healthy controlsNot described
Receives: Radiation: CT aortography

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Systolic Blood Pressure

    Difference in systolic blood pressure between baseline (pre-stenting) and 6 months post-stenting using standardized clinical sphygmomanometer.

    Unit of Measure: mmHg

    Measured: Baseline and 6 months post-stenting

  2. Change in Diastolic Blood Pressure

    Difference in diastolic blood pressure between baseline (pre-stenting) and 6 months post-stenting using standardized clinical sphygmomanometer.

    Unit of Measure: mmHg

    Measured: Baseline and 6 months post-stenting

Secondary outcomes (13)
  1. Aortic Arch Morphology Classification

    Classification of aortic arch morphology (normal, gothic, crenel) based on CT aortography.

    Unit of Measure: Categorical (normal/gothic/crenel)

    Measured: Baseline (within hospital stay, up to 2 days)

  2. Aortic Elasticity

    Aortic elasticity calculated from CT aortography using (ΔA/A)/ΔP, where A is cross-sectional area and P is pulse pressure.

    Unit of Measure: mm²/mmHg

    Measured: Baseline and 6 months post-stenting

  3. Aortic Distensibility

    Aortic distensibility measured from CT aortography. Unit of Measure: mmHg-¹

    Measured: Baseline and 6 months post-stenting

  4. Aortic Arch Angle

    Aortic arch angle measured from CT aortography. Unit of Measure: degrees

    Measured: Baseline and 6 months post-stenting

  5. Aortic Arch Curvature

    Curvature of the aortic arch measured from CT aortography. Unit of Measure: cm-¹

    Measured: Baseline and 6 months post-stenting

  6. Residual Stenosis

    Percentage of luminal narrowing remaining after stent implantation measured by CT angiography.

    Unit of Measure: %

    Measured: 6 months post-stenting

  7. Left Ventricular Ejection Fraction (LVEF)

    Description: LVEF measured by cardiac MRI. Unit of Measure: %

    Measured: Baseline and 6 months post-stenting

  8. LV Global Longitudinal Strain

    LV global longitudinal strain measured by cardiac MRI. Unit of Measure: %

    Measured: Baseline and 6 months post-stenting

  9. LV Mass Index (LVMI)

    LV mass indexed to body surface area measured by cardiac MRI. Unit of Measure: g/m²

    Measured: Baseline and 6 months post-stenting

  10. Left Atrial Volume Index (LAVI)

    Description: Left atrial volume indexed to body surface area measured by cardiac MRI.

    Unit of Measure: mL/m²

    Measured: Baseline and 6 months post-stenting

  11. QTc Dispersion

    QTc dispersion measured from 12-lead ECG using Bazett's formula. Unit of Measure: milliseconds

    Measured: Baseline and 6 months post-stenting

  12. Presence of Left Ventricular Hypertrophy on ECG

    Detection of LV hypertrophy based on standard ECG voltage criteria. Unit of Measure: Categorical (present/absent)

    Measured: Baseline and 6 months post-stenting

  13. Presence of Arrhythmia

    Detection of arrhythmias using standard 12-lead ECG or Holter monitoring. Unit of Measure: Categorical (present/absent)

    Measured: Baseline and 6 months post-stenting

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted20 Aug 2025
  2. Study start1 Sep 2025 (estimated)
  3. Primary completion1 Sep 2026 (estimated)
  4. Study completion31 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07131111
Sponsor's protocol ID
Vascular remodeling in COA
Status last verified
Aug 2025
First submitted
4 Aug 2025
Last updated
20 Aug 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Shepherd B, Abbas A, McParland P, Fitzsimmons S, Shambrook J, Peebles C, Brown I, Harden S. MRI in adult patients with aortic coarctation: diagnosis and follow-up. Clin Radiol. 2015 Apr;70(4):433-45. doi: 10.1016/j.crad.2014.12.005. Epub 2015 Jan 3.

    PubMed 25559379
  • Toro-Salazar OH, Steinberger J, Thomas W, Rocchini AP, Carpenter B, Moller JH. Long-term follow-up of patients after coarctation of the aorta repair. Am J Cardiol. 2002 Mar 1;89(5):541-7. doi: 10.1016/s0002-9149(01)02293-7.

    PubMed 11867038
  • Parati G, Stergiou GS, Asmar R, Bilo G, de Leeuw P, Imai Y, Kario K, Lurbe E, Manolis A, Mengden T, O'Brien E, Ohkubo T, Padfield P, Palatini P, Pickering T, Redon J, Revera M, Ruilope LM, Shennan A, Staessen JA, Tisler A, Waeber B, Zanchetti A, Mancia G; ESH Working Group on Blood Pressure Monitoring. European Society of Hypertension guidelines for blood pressure monitoring at home: a summary report of the Second International Consensus Conference on Home Blood Pressure Monitoring. J Hypertens. 2008 Aug;26(8):1505-26. doi: 10.1097/HJH.0b013e328308da66.

    PubMed 18622223
  • Iriart X, Laik J, Cremer A, Martin C, Pillois X, Jalal Z, Roubertie F, Thambo JB. Predictive factors for residual hypertension following aortic coarctation stenting. J Clin Hypertens (Greenwich). 2019 Feb;21(2):291-298. doi: 10.1111/jch.13452. Epub 2018 Dec 25.

    PubMed 30585428
  • Pushparajah K, Duong P, Mathur S, Babu-Narayan S. EDUCATIONAL SERIES IN CONGENITAL HEART DISEASE: Cardiovascular MRI and CT in congenital heart disease. Echo Res Pract. 2019 Oct 1;6(4):R121-38. doi: 10.1530/ERP-19-0048. Online ahead of print.

    PubMed 31730044
  • Faganello G, Cioffi G, Rossini M, Ognibeni F, Giollo A, Fisicaro M, Russo G, Di Nora C, Doimo S, Tarantini L, Mazzone C, Cherubini A, D'Agata Mottolesi B, Pandullo C, Di Lenarda A, Sinagra G, Viapiana O. Are aortic coarctation and rheumatoid arthritis different models of aortic stiffness? Data from an echocardiographic study. Cardiovasc Ultrasound. 2018 Jun 26;16(1):9. doi: 10.1186/s12947-018-0126-y.

    PubMed 29940971
  • Agasthi P, Pujari SH, Tseng A, Graziano JN, Marcotte F, Majdalany D, Mookadam F, Hagler DJ, Arsanjani R. Management of adults with coarctation of aorta. World J Cardiol. 2020 May 26;12(5):167-191. doi: 10.4330/wjc.v12.i5.167.

    PubMed 32547712
  • Ou P, Mousseaux E, Celermajer DS, Pedroni E, Vouhe P, Sidi D, Bonnet D. Aortic arch shape deformation after coarctation surgery: effect on blood pressure response. J Thorac Cardiovasc Surg. 2006 Nov;132(5):1105-11. doi: 10.1016/j.jtcvs.2006.05.061.

    PubMed 17059930
  • Ou P, Bonnet D, Auriacombe L, Pedroni E, Balleux F, Sidi D, Mousseaux E. Late systemic hypertension and aortic arch geometry after successful repair of coarctation of the aorta. Eur Heart J. 2004 Oct;25(20):1853-9. doi: 10.1016/j.ehj.2004.07.021.

    PubMed 15474701
  • Vonder Muhll IF, Sehgal T, Paterson DI. The Adult With Repaired Coarctation: Need for Lifelong Surveillance. Can J Cardiol. 2016 Aug;32(8):1038.e11-5. doi: 10.1016/j.cjca.2015.12.036. Epub 2016 Jan 21.

    PubMed 27084076

Questions about this trial

What is this clinical trial studying?

An observational study of Aortic Geometry and Vascular Remodeling, run by Assiut University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 20 Aug 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Mena Wadee, Resident doctor (01282210873, menawade399@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Systolic Blood Pressure (time frame: Baseline and 6 months post-stenting). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07131111, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Aug 2025.

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