Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls

Panzer, Joseph; Dequeker, Laure; Coomans, Ilse; Vandekerckhove, Kristof; Bové, Thierry; Wolf, Daniël De; Rietzschel, Ernst

doi:10.1136/openhrt-2019-001075

Cited by 2 publications

(1 citation statement)

References 37 publications

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“…The authors postulated that in children who had a successful CoA repair very early in life, persistently elevated aortic stiffness may lead to diastolic impairment. We also found decreased diastolic LV function in children with repaired CoA, despite early repair and absence of residual stenosis (35). It has long been proposed that (early) arterial reflection waves generated by scar tissue at the repair site or by a stent leads to a new pressure wave reflection, generating LVH, considered as an adaptive response to maintain wall stress.…”

Section: Discussionsupporting

confidence: 52%

Hypertension after coarctation repair—a systematic review

Panzer¹,

Bové²,

Vandekerckhove³

et al. 2022

Transl Pediatr

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Background: Coarctation of the Aorta (CoA) leads to increased morbidity and mortality later in life despite early surgical or percutaneous treatment. Many long-term complications are related to hypertension (HT) which is a common finding late after coarctation repair.Methods: A systematic Review was performed including articles published between February 2012 to December 2020. Systematic searches were conducted on PubMed and the Cochrane Controlled Trials Register to look for studies on HT after aortic CoA-repair. PRISMA guidelines were used.Results: In this systematic review on HT after CoA Repair the mean prevalence of HT was 47.3% (20-70%). A progressive character was of the HT was found, furthermore if only studies are included with 24 h blood pressure (BP) recording in addition to standard BP measurements, the incidence of HT rose to 57.8%. Discussion: Most clinical studies look at complications, mortality rate and residual pressure gradient rather than correlating hemodynamic indices with long-term outcome. Although HT is commonly based in measurement of peripheral BP, it has been shown that peripheral BP in CoA patients has a poor correlation with central aortic pressure. Central aortic hemodynamics are significantly altered in patients with repaired CoA, which can now adequately be investigated non-invasively. At the present time there are no studies linking long-term outcome with abnormal central hemodynamics.

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Section: Discussionsupporting

confidence: 52%

Hypertension after coarctation repair—a systematic review

Panzer¹,

Bové²,

Vandekerckhove³

et al. 2022

Transl Pediatr

Self Cite

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Rats are protected from the stress of chronic pressure overload compared with mice

Nishimura

Oydanich

Zhang

et al. 2020

American Journal of Physiology-Regulatory, Integrative and Comp

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Little is known about differences in responses to cardiac stress in different rodent species, i.e., rats vs mice. The goal of this investigation was to compare the effects of chronic, 1‐month, thoracic aortic constriction (TAC) in Sprague Dawley rats and C57BL/6 mice. Sham and TAC procedures were conducted in both rodent groups. TAC, in the thoracic aorta, just distal to the aortic valve, induced similar left ventricular (LV) aortic pressure gradients across the aortic constriction, but there was no pressure gradient in sham operated animals. LV ejection fraction was no different in sham rats and mice (73 ± 1%), and did not fall with TAC in the rats, but fell significantly, p<0.05, in mice with TAC to 59 ± 2%. LV end diastolic pressure was also not different in sham rats and mice (5 ± 1 mmHg) and did not increase with TAC in rats, but increased, p<0.05, in TAC mice to 15 ± 2 mmHg. The next goal was to examine potential mechanisms mediating these major differences in LV function. First, we examined LV systolic wall stress, which was also similar in sham rats and mice (73 ± 1 kdyn/cm2) and did not rise significantly in TAC rats, but rose, p<0.05, to 117 ± 7kdyn/cm2 in TAC mice. Since TAC induces LV hypertrophy, which in turn, impairs subendocardial coronary perfusion and coronary reserve, and consequently LV function, angiogenesis and arteriogenesis were examined next, as these mechanisms could alleviate the coronary subendocardial hypoperfusion. Immunofluorescent Ki67 staining of capillaries and arterioles revealed increased angiogenesis, i.e., greater increases, p<0.05, in capillaries in TAC rats (6.7 ± 0.3 Ki67+Isolectin positive cells/field) than in TAC mice (4.2 ± 1.1 Ki67+Isolectin positive cells/field). Arteriogenesis was also increased more in TAC rats than TAC mice, reflected by greater increases, p<0.05, in Ki67 stained arterioles in TAC rats (19.8 ± 0.3 Ki67+SMCα positive cells/field) vs TAC mice (7.9 ± 1.2 Ki67+SMCα positive cells/field). Thus, rats are more resistant to development of cardiac failure with chronic TAC compared with mice. The mechanism of this protection involved reduced LV systolic wall stress and increased angiogenesis and arteriogenesis in the rats with chronic pressure overload. Support or Funding Information Funding support: NIH R01 HL124282 This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls

Cited by 2 publications

References 37 publications

Hypertension after coarctation repair—a systematic review

Hypertension after coarctation repair—a systematic review

Rats are protected from the stress of chronic pressure overload compared with mice

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