Document Detail

Vascular dysfunction after coarctation repair is related to the age at surgery.
MedLine Citation:
PMID:  15749190     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite repair of aortic coarctation, hypertension is frequent in adults and premature coronary and cerebrovascular disease remain of concern. Persistent impairment of arterial dilation has been suspected to contribute to abnormal blood pressure regulation. We tested the hypothesis that arterial reactivity is more likely to be impaired in patients corrected at older age. METHODS: We studied changes in brachial artery diameter in response to reactive hyperemia (FMD) and to nitroglycerin (NMD) in 36 patients and 25 controls. Depending on their age at surgery, patients were divided in group A (surgery <9 years) and group B (surgery > or =9 years). RESULTS: Cholesterol levels and percentage of smokers were similar in patients and controls, but 16 patients had arterial hypertension compared to none of the controls. Endothelium-dependent vasodilation, FMD, and endothelium-independent vasodilation, NMD, were significantly impaired in patients vs. controls (8.2+/-6.2% vs. 13.0+/-5.1%, p<0.001 and 12.9+/-8.0% vs. 18.8+/-9.2%, p<0.01, respectively), both, in hypertensives (8.3+/-6.0%, p<0.01 and 11.8+/-6.0%, p<0.05) and in normotensives (8.1+/-6.5% p<0.01 and 13.8+/-9.3%, p<0.05). However, FMD and NMD in patients of group A did not significantly differ from that in controls (10.0+/-6.7% n.s. and 15.0+/-7.6% n.s.), whereas they were lowest in patients of group B (5.5+/-4.3%, p<0.0001 and 9.6+/-7.7% p<0.001). CONCLUSIONS: Persistent impairment of FMD and NMD after repair of coarctation is more likely to be present in patients corrected at older age. It may be an important contributor to abnormal blood pressure regulation and late morbidity and mortality.
Maria Heger; Andrea Willfort; Thomas Neunteufl; Raphael Rosenhek; Harald Gabriel; Gregor Wollenek; Maria Wimmer; Gerald Maurer; Helmut Baumgartner
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  International journal of cardiology     Volume:  99     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-03-07     Completed Date:  2005-06-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  295-9     Citation Subset:  IM    
Department of Cardiology, Vienna General Hospital--University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
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MeSH Terms
Age Factors
Aortic Coarctation / surgery*
Blood Vessel Prosthesis Implantation / adverse effects*
Brachial Artery / drug effects,  physiopathology*,  ultrasonography
Endothelium, Vascular / physiopathology
Follow-Up Studies
Middle Aged
Nitroglycerin / diagnostic use
Peripheral Vascular Diseases / etiology,  physiopathology*,  ultrasonography
Postoperative Complications*
Time Factors
Vasodilation / drug effects,  physiology*
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin
Comment In:
Int J Cardiol. 2005 Apr 20;100(2):335-6   [PMID:  15823645 ]

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