Asymmetric dimethylarginine and vascular indices of atherosclerosis in patients after coarctation of aorta repair

Mizia-Stec, Katarzyna; Trojnarska, Olga; Szczepaniak‐Chicheł, Ludwina; Gabriel, Marcin; Bartczak, Agnieszka; Ciepłucha, Aleksandra; Chudek, Jerzy; Grajek, Stefan; Tykarski, Andrzej; Gąsior, Zbigniew

doi:10.1016/j.ijcard.2011.01.037

Cited by 15 publications

(6 citation statements)

References 40 publications

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“…In this way, GDF-15 did not adequately reflect overall cardiovascular burden of CoAo survivors. These findings should be interpreted with respect to one of our institution's previous reports, which demonstrated a markedly elevated concentration of asymmetric dimethylarginine (ADMA) in this group of patients, highly suggestive of underlying diffuse atherosclerosis [46].…”

Section: Discussionsupporting

confidence: 65%

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

Mizia‐Stec

Wybraniec

Trojnarska

et al. 2013

Journal of Rare Cardiovascular Diseases

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Background: Coarctation of aorta (CoAo) is a congenital heart anomaly associated with high cardiovascular morbidity and mortality attributable to vascular remodeling in adult survivors following surgical management of aortic stenosis. This study sought to adjudicate the significance of novel stress-responsive biomarker, growth differentiation factor 15 (GDF-15), as an indicator of vascular remodeling and its correlation with numerous laboratory and vascular parameters in patients after successful CoAo repair. Methods and results:This research is a case-control study comprising 33 consecutive patients (19 men, 57.58%; mean age 33.9 ±9.3 years; mean age at surgery: 9.1 ±7 years; mean follow-up duration 24.8 ±6.8 years) admitted to outpatient clinic for routine follow-up after repair of CoAo (mainly Dacron patch technique) and matched with 20 healthy controls (10 men, 50%; mean age 34.8 ±9.9 years). Laboratory (GDF-15, high-sensitivity C-reactive protein) and vascular parameters (intima-media thickness, flow-and nitrate-mediated dilation, pulse-wave velocity, central arterial pressure) were assessed. Significant aortic residual gradient was present in 24 (72.7%). The circulating GDF-15 level was lower in CoAo survivors than in control group (539.56 vs. 744.98 pg/ml respectively; p < 0.001). GDF-15 concentration <550 pg/ml successfully differentiated patients after CoA repair (odds ratio [OR] = 9.2; 95%CI: 2.45-34.56, p = 0.0005). There was no difference in GDF-15 level depending on the presence of significant residual gradient (p = 0.19). No significant correlation between GDF-15 and other variables was observed. Conclusions: Low concentration of GDF-15 is characteristic of asymptomatic patients following CoAo repair, however, its clinical significance and relationship with vascular remodeling substantiates further investigation. JRCD 2013; 1 (2): 41-48

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Section: Discussionsupporting

confidence: 65%

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

Mizia‐Stec

Wybraniec

Trojnarska

et al. 2013

Journal of Rare Cardiovascular Diseases

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“…The mechanisms mediating plaque deposition in response to altered indices of WSS are still being elucidated in the human thoracic aorta, but coarctations induced in experimental animal models caused altered WSS and vascular biomechanics responsible for elevated NADPH oxidase and antioxidant enzyme expression, which increased reactive oxygen species (ROS). 25 ROS and endothelial dysfunction commonly observed in CoA patients despite treatment 26 are known to be involved in the pathogenesis of atherosclerosis and are associated with concomitant alterations in WSS indices in other vascular beds. 27 The current CFD results are consistent with velocity streamlines presented in recent imaging papers using 4D sequences with control subjects and a sampling of treated CoA patients.…”

Section: Discussionmentioning

confidence: 99%

Computational Simulations Demonstrate Altered Wall Shear Stress in Aortic Coarctation Patients Treated by Resection with End-to-end Anastomosis

LaDisa

Dholakia

Figueroa³

et al. 2011

Congenital Heart Disease

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Background Atherosclerotic plaque in the descending thoracic aorta (dAo) is related to altered wall shear stress (WSS) for normal patients. Resection with end-to-end anastomosis (RWEA) is the gold standard for coarctation of the aorta (CoA) repair, but may lead to altered WSS indices that contribute to morbidity. Methods Computational fluid dynamics (CFD) models were created from imaging and blood pressure data for control subjects and age- and gender-matched CoA patients treated by RWEA (4 male, 2 female, 15±8 years). CFD analysis incorporated downstream vascular resistance and compliance to generate blood flow velocity, time-averaged WSS (TAWSS) and oscillatory shear index (OSI) results. These indices were quantified longitudinally and circumferentially in the dAo, and several visualization methods were used to highlight regions of potential hemodynamic susceptibility. Results The total dAo area exposed to subnormal TAWSS and OSI was similar between groups, but several statistically significant local differences were revealed. Control subjects experienced left-handed rotating patterns of TAWSS and OSI down the dAo. TAWSS was elevated in CoA patients near the site of residual narrowings and OSI was elevated distally, particularly along the left dAo wall. Differences in WSS indices between groups were negligible more than 5 dAo diameters distal to the aortic arch. Conclusions Localized differences in WSS indices within the dAo of CoA patients treated by RWEA suggest that plaque may form in unique locations influenced by the surgical repair. These regions can be visualized in familiar and intuitive ways allowing clinicians to track their contribution to morbidity in longitudinal studies.

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“…The prevalence of late hypertension after successful repair of coarctation of the aorta is between 35 and 50% in adults with a follow-up duration of 20-30 years. [25][26][27][28][29] In paediatric studies, the prevalence of office hypertension has been reported as 15-30%. 7,30 Depending on the definition, the prevalence of Comparison of left ventricular mass index between controls and patients with CoA, which were grouped according to ambulatory measurements by using the 2014-American Heart Association guideline.…”

Section: Discussionmentioning

confidence: 99%

Is the burden of late hypertension and cardiovascular target organ damage in children and adolescents with coarctation of the aorta after early successful repair different to healthy controls?

et al. 2020

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Objective: Cardiovascular morbidity is high in patients with coarctation of aorta even after successful repair. This study aimed to assess the frequency of late hypertension and the relationship between ambulatory hypertension and cardiovascular target organ damage in children and adolescents after early and successful repair of coarctation of the aorta. Methods: Twenty-five children and adolescents (mean age 13.5 ± 3.43 years) with repaired coarctation of the aorta (median age at repair 4 months, arm–leg gradient <20 mmHg) and 16 healthy controls were included. Office and ambulatory blood pressure, pulse wave velocity, and left ventricular mass index were assessed. Results: Both day- and night-time systolic blood pressure standard deviation score and left ventricular mass index were significantly higher in patients compared to controls (p ≤ 0.001 for all), whereas pulse wave velocity did not differ. The prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy were 40, 28, and 24%, respectively. Left ventricular mass index was higher in patients with sustained hypertension, masked hypertension, and normotension compared to controls (p < 0.05). In multivariate analysis, higher night-time systolic blood pressure standard deviation score was the only independent predictor of left ventricular mass index. Conclusion: The present study reveals a high prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy in children and adolescents with coarctation of the aorta even after early and successful repair. Ambulatory blood pressure monitoring should be considered to diagnose hypertension. All coarctation of aorta patients should be followed up lifelong and encouraged to establish a healthy lifestyle starting from childhood.

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Asymmetric dimethylarginine and vascular indices of atherosclerosis in patients after coarctation of aorta repair

Cited by 15 publications

References 40 publications

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

Growth differentiation factor 15 and arterial remodeling in adult patients after succesful repair of aortic coarctation (RCD code: IV-5.A.1)

Computational Simulations Demonstrate Altered Wall Shear Stress in Aortic Coarctation Patients Treated by Resection with End-to-end Anastomosis

Is the burden of late hypertension and cardiovascular target organ damage in children and adolescents with coarctation of the aorta after early successful repair different to healthy controls?

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