The Dilated Aorta in Patients With Congenital Cardiac Defects

Yetman, Anji T.; Graham, T.P.

doi:10.1016/j.jacc.2008.10.035

Cited by 83 publications

(57 citation statements)

References 63 publications

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“…There are common pathological features found in different structural defects, including abnormalities of transforming growth factor-β signaling. 78 Isolated aortic dilation often presents a dilemma for the physician with regard to recommendations for physical activity. Extreme dilation (diameter >99th percentile) is likely pathological 79 and can result in aortic aneurysm and dissection.…”

Section: Ventricular Dysfunctionmentioning

confidence: 99%

Promotion of Physical Activity for Children and Adults With Congenital Heart Disease

Longmuir¹,

Ferranti²,

Hayman³

et al. 2013

Circulation

255

171

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The American Heart Association recognizes the importance of physically active lifestyles to the health and well-being of children and adults with congenital heart defects. Counseling of patients with congenital heart defects should emphasize the importance of daily physical activity and decreasing sedentary behavior as appropriate for the patient’s clinical status. The suggested practices are based on relevant research regarding the benefits of physical activity for healthy children and adults, because research on physical activity among patients with congenital heart defects is lacking. There is no evidence regarding whether or not there is a need to restrict recreational physical activity among patients with congenital heart defects, apart from those with rhythm disorders. It is important to recognize that most patients with congenital heart defects are relatively sedentary and that the physical and psychosocial health benefits of physical activity are important for this population, which is at risk for exercise intolerance, obesity, and psychosocial morbidities. Therefore, counseling to encourage daily participation in appropriate physical activity should be a core component of every patient encounter.

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Section: Ventricular Dysfunctionmentioning

confidence: 99%

Promotion of Physical Activity for Children and Adults With Congenital Heart Disease

Longmuir¹,

Ferranti²,

Hayman³

et al. 2013

Circulation

255

171

View full text Add to dashboard Cite

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“…Although the former has proved to be associated with pulmonary circulation, 24) the clinical significance of the latter remains unknown. Anatomical and functional properties of dilated aAO have been studied in patients with tetralogy of Fallot; [25][26][27] however, little data on these aortic properties and their clinical significance are available in Fontan patients. 28,29) Accordingly, we evaluated aortae in Fontan patients to clarify the aortic size and stiffness and hypothesized the following: 1) aortic size and stiffness of Fontan patients are different from those of control patients; 2) these abnormalities are associated with Fontan hemodynamics and traditional biomarkers for cardiovascular disease; and 3) aortic stiffness has a significant impact on exercise physiology.…”

mentioning

confidence: 99%

Determinants of Aortic Size and Stiffness and the Impact on Exercise Physiology in Patients After the Fontan Operation

et al. 2017

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SummaryThe pathophysiology of congenital heart disease includes aortic dilation and increased stiffness. However, the clinical determinants and significance remain unclear in patients after the Fontan operation.Size and stiffness index (SI) of the ascending and descending aorta (aAO and dAO, respectively) were assessed using angiography in 130 consecutive Fontan patients and 30 age-matched controls. Compared with controls, Fontan patients showed a dilated aAO and smaller dAO (P < 0.0001) with greater SI (3.2 ± 0.7 versus 2.2 ± 0.3 for aAO and 2.7 ± 0.6 versus 2.2 ± 0.3 for dAO, P < 0.0001 for both). aAO was stiffer than dAO (P < 0.0001) and the greater aAO size was independently determined by the presence of pulmonary atresia, older age at Fontan operation, and low arterial oxygen saturation (P < 0.05-0.01). High plasma levels of brain natriuretic peptide (BNP) and glucose were independently associated with aAO SI (P < 0.05-0.01) and the SI ratio of aAO to dAO SI, whereas body mass index, plasma levels of highsensitivity C-reactive protein, and dAO size were independently associated with dAO SI (P < 0.05-0.01). A greater aAO and aAO/dAO ratio predicted an impaired exercise blood pressure response (P < 0.0001). Furthermore, in addition to age at Fontan operation and BNP level, the aAO SI independently predicted a lower peak oxygen uptake (P < 0.05).Fontan patients have a stiffer dilated aAO with rapidly tapering smaller dAO that predicts exercise pathophysiology. In addition to intrinsic aortic structural abnormalities, heart failure severities as well as traditional cardiovascular risk factors are also involved in the aortic structural and functional abnormalities. (Int Heart J 2017; 58: 73-80)

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“…Расширение восходящего отдела аорты выявляется в 45-50% случаев БАК, из них около 8% осложняется диссекцией [7]. Также при БАК доста-точно часто формируется аортальный стеноз.…”

Section: Discussionunclassified

Polymorphisms of Matrix Metalloproteases 2 and 9 Genes in Ascending Aorta Aneurism Patients

Гаврилюк¹,

Иртюга²,

Дружкова³

et al. 2015

Ross. kardiol. ž.

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Цель. Изучить роль однонуклеотидных полиморфизмов генов матриксных металлопротеиназ MMP2 и MMP9 в развитии аневризмы восходящего отдела аорты (АВОА). Материал и методы. В исследование включено 287 пациентов с АВОА и 227 человек контрольной группы. Всем пациентам выполнено эхокардиографиче-ское исследование и определение однонуклеотидных полиморфизмов генов MMP2 (rs2285053) и MMP9 (rs11697325, rs2274755, rs17577) с помощью ПЦР в реальном времени. Результаты. Подтверждена ассоциация полиморфизма MMP9 (rs11697325) с формированием АВОА. Генотип АА достоверно чаще встречался среди паци-ентов с АВА (c 2 =7,2; p=0,01). Носители генотипа АА имели больший диаметр восходящей аорты по сравнению с лицами с другими вариантами (p=0,02). Установлена связь между полиморфизмом ММР2 (rs2285053) и развитием АВОА. Лица с генотипом СС преобладали в группе больных с патологией аорты (c 2 =7,0; р=0,03). Заключение. Генетические варианты генов ММР9 и ММР2 могут быть допол-нительными факторами риска развития аневризмы восходящего отдела аорты. Поэтому исследование полиморфных вариантов генов матриксных металлопротеиназ можно использовать для стратификации риска пациентов с расширением восходящего отдела аорты.

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The Dilated Aorta in Patients With Congenital Cardiac Defects

Cited by 83 publications

References 63 publications

Promotion of Physical Activity for Children and Adults With Congenital Heart Disease

Promotion of Physical Activity for Children and Adults With Congenital Heart Disease

Determinants of Aortic Size and Stiffness and the Impact on Exercise Physiology in Patients After the Fontan Operation

Polymorphisms of Matrix Metalloproteases 2 and 9 Genes in Ascending Aorta Aneurism Patients

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