Hostname: page-component-5cf477f64f-h6p2m Total loading time: 0 Render date: 2025-03-31T05:52:45.939Z Has data issue: false hasContentIssue false
  • English
  • Français

Aortic stiffness assessed by blood pressure and echocardiography in young and normotensive patients with isolated aortic coarctation versus those with aortic coarctation and ventricular septal defect

Published online by Cambridge University Press:  26 March 2025

Sophie Duignan ,
Michaela Pentony Open the ORCID record for Michaela Pentony [Opens in a new window] ,
Kevin Patrick Walsh ,
Colin Joseph McMahon Open the ORCID record for Colin Joseph McMahon [Opens in a new window]  and
Pier Paolo Bassareo Open the ORCID record for Pier Paolo Bassareo [Opens in a new window]
Sophie Duignan
Affiliation:
Children’s Health Ireland at Crumlin, Dublin, Ireland
Michaela Pentony
Affiliation:
Children’s Health Ireland at Crumlin, Dublin, Ireland
Kevin Patrick Walsh
Affiliation:
Children’s Health Ireland at Crumlin, Dublin, Ireland National Adult Congenital Heart Disease Service, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine, University College of Dublin, Dublin, Ireland
Colin Joseph McMahon
Affiliation:
Children’s Health Ireland at Crumlin, Dublin, Ireland School of Medicine, University College of Dublin, Dublin, Ireland
Pier Paolo Bassareo*
Affiliation:
Children’s Health Ireland at Crumlin, Dublin, Ireland National Adult Congenital Heart Disease Service, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine, University College of Dublin, Dublin, Ireland
*
Corresponding author: Pier Paolo Bassareo; Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Aortic coarctation can occur isolated or associated with ventricular septal defect. This study evaluated aortic stiffness in normotensive patients surgically treated for aortic coarctation and ventricular septal defect and in those who underwent simple aortic coarctation repair. Both groups were compared with healthy controls. Again, the two pathological groups were compared with each other regarding aortic stiffness and left ventricular diastolic function. A possible relationship between aortic stiffness and left ventricular diastolic function was investigated.

Methods:

Twenty-two isolated aortic coarctation patients and 17 aortic coarctation and ventricular septal defect patients were enrolled. Aortic root distensibility and aortic stiffness index were calculated from echocardiography and blood pressure. E wave to A wave (E/A) ratio was measured from mitral valve inflow profile.

Results:

Aortic root distensibility and aortic stiffness index in simple aortic coarctation vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index in aortic coarctation/ventricular septal defect vs healthy controls: both p < 0.0001. Aortic root distensibility and aortic stiffness index were similar in the two pathological groups (both p = ns). No statistically significant difference was detected in relation to left ventricular diastolic function (p = ns). No correlation was detected between aortic stiffness and diastolic function in simple aortic coarctation and aortic coarctation/ventricular septal defect groups (both p = ns).

Conclusions:

In both normotensive isolated aortic coarctation and aortic coarctation/ventricular septal defects subgroups, aortic stiffness is increased in a similar way in comparison with controls. Diastolic function was normal and similar in both groups. Aortic stiffness was not related to left ventricular diastolic function in this specific setting.

Keywords

aortic coarctationventricular septal defectblood pressureechocardiographyaortic elasticityaortic stiffness
Type
Original Article
Information
Cardiology in the Young , First View , pp. 1 - 5
Check for updates
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Van Praagh, R, Bernhard, WF, Rosenthal, A, Parisi, LF, Fyler, DC. Interrupted aortic arch: surgical treatment. Am J Cardiol 1971; 27: 200–211.CrossRefGoogle ScholarPubMed
Leanage, R, Taylor, JF, de Leval, MR, Stark, J, Macartney, FJ. Surgical management of coarctation of aorta with ventricular septal defect. Multivariate analysis. Br Heart J 1981; 46: 269–277.CrossRefGoogle ScholarPubMed
Smallhorn, JF, Anderson, RH, Macartney, FJ. Morphological characterisation of ventricular septal defects associated with coarctation of aorta by cross-sectional echocardiography. Br Heart J 1983; 49: 485–494.CrossRefGoogle ScholarPubMed
Anderson, RH, Lenox, CC, Zuberbuhler, JR. Morphology of ventricular septal defect associated with coarctation of aorta. Br Heart J 1983; 50: 176–181.CrossRefGoogle ScholarPubMed
Sennari, E. Morphological study of ventricular septal defect associated with obstruction of the aortic arch among Japanese. Jpn Circ J 1985; 49: 61–67.CrossRefGoogle ScholarPubMed
Ferencz, C, Correa-Villasenor, A, Loffredo, C, Wilson, PD. Genetic and environmental risk factors of major cardiovascular malformations: the Baltimore-Washington Infant Study 1981–1989. Futura, Armonk, NY, 1997.Google Scholar
Róg, B, Okólska, M, Dziedzic-Oleksy, H, et al. Arterial stiffness in adult patients after coarctation of aorta repair and with bicuspid aortic valve. Acta Cardiol 2019; 74: 517–524.CrossRefGoogle ScholarPubMed
Kocabay, G, Karabay, CY, Kalkan, S, et al. Relationship between left ventricular diastolic function and arterial stiffness in patients with bicuspid aortic valve. J Heart Valve Dis 2014; 23: 279–288.Google ScholarPubMed
Bassareo, PP, Saba, L, Marras, AR, Mercuro, G. Altered aortic upper wall TDI velocity is inversely related with left ventricular diastolic function in operated tetralogy of fallot. Congenit Heart Dis 2016; 11: 598–605.CrossRefGoogle ScholarPubMed
Egbe, AC, Qureshi, MY, Connolly, HM. Determinants of left ventricular diastolic function and exertional symptoms in adults with coarctation of aorta. Circ Heart Fail 2020; 13: e006651.CrossRefGoogle ScholarPubMed
Lombardi, KC, Northrup, V, McNamara, RL, Sugeng, L, Weismann, CG. Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation. Am J Cardiol 2013; 112: 1828–1833.CrossRefGoogle ScholarPubMed
Graham, TP Jr. Ventricular performance in congenital heart disease. Circulation 1991; 84: 2259–2274.CrossRefGoogle ScholarPubMed
Fusco, F, Borrelli, N, Palma, M, Sarubbi, B, Scognamiglio, G. Imaging of ventricular septal defect: native and post-repair. Int J Cardiol Congenit Heart Dis 2022; 7: 100335. doi: 10.1016/j.ijcchd.2022.100335.CrossRefGoogle ScholarPubMed
Seidlerová, J, Filipovský, J, Mayer, O, Wohlfahrt, P, Cífková, R. Positive effects of antihypertensive treatment on aortic stiffness in the general population. Hypertens Res 2014; 37: 64–68.CrossRefGoogle ScholarPubMed
Flynn, JT, Kaelber, DC, Baker-Smith, CM, et al. SUBCOMMITTEE ON SCREENING AND MANAGEMENT OF HIGH BLOOD PRESSURE IN CHILDREN. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140: e20173035.CrossRefGoogle ScholarPubMed
Leo, I, Sabatino, J, Avesani, M, et al. Non-Invasive Imaging Assessment in Patients with Aortic Coarctation: A Contemporary Review. J Clin Med 2023; 13: 28.CrossRefGoogle ScholarPubMed
Bassareo, PP, Calcaterra, G, Sabatino, J, et al. Primary and secondary paediatric hypertension. J Cardiovasc Med (Hagerstown) 2023; 24 ( Suppl 1 ): e77–e85.CrossRefGoogle ScholarPubMed
Bassareo, PP, Marras, AR, Manai, ME, Mercuro, G. The influence of different surgical approaches on arterial rigidity in children after aortic coarctation repair. Pediatr Cardiol 2009; 30: 414–418.CrossRefGoogle ScholarPubMed
Stefanadis, C, Stratos, C, Boudoulas, H, Kourouklis, C, Toutouzas, P. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease. Eur Heart J 1990; 11: 990–996.CrossRefGoogle ScholarPubMed
Bassareo, PP, Saba, L, Puddu, M, Fanos, V, Mercuro, G. Impaired central arterial elasticity in young adults born with intrauterine growth restriction. Int Angiol 2017; 36: 362–367.CrossRefGoogle Scholar
Bons, LR, Van Den Hoven, AT, Malik, M, et al. Abnormal aortic wall properties in women with turner syndrome. Aorta (Stamford) 2020; 8: 121–131.Google ScholarPubMed
Elzenga, NJ, Gittenberger-de Groot, AC, Oppenheimer-Dekker, A. Coarctation and other obstructive aortic arch anomalies: their relationship to the ductus arteriosus. Int J Cardiol 1986; 13: 289–308.CrossRefGoogle Scholar
Isner, JM, Donaldson, RF, Fulton, D, Bhan, I, Payne, DD, Cleveland, RJ. Cystic medial necrosis in coarctation of the aorta: a potential factor contributing to adverse consequences observed after percutaneous balloon angioplasty of coarctation sites. Circulation 1987; 75: 689–695.CrossRefGoogle ScholarPubMed
Russell, GA, Berry, PJ, Watterson, K, Dhasmana, JP, Wisheart, JD. Patterns of ductal tissue in coarctation of the aorta in the first three months of life. J Thorac Cardiovasc Surg 1991; 102: 596–601.CrossRefGoogle ScholarPubMed
Wollins, DS, Ferencz, C, Boughman, JA, Loffredo, CA. A population-based study of coarctation of the aorta: comparisons of infants with and without associated ventricular septal defect. Teratology 2001; 64: 229–236.CrossRefGoogle ScholarPubMed
Bassareo, PP, Calcaterra, G, Deidda, M, Marras, AR, Mercuro, G. Does oxygen content play a role in spontaneous closure of perimembranous ventricular septal defects? Children (Basel) 2021; 8: 881.Google ScholarPubMed
Bassareo, PP, Marras, AR, Mercuro, G. Ventricular septal defect in a child with alport syndrome: a case report. BMC Cardiovasc Disord 2010; 10: 48.CrossRefGoogle Scholar
Niwa, K. Aortopathy in congenital heart disease in adults: aortic dilatation with decreased aortic elasticity that impacts negatively on left ventricular function. Korean Circ J 2013; 43: 215–220.CrossRefGoogle ScholarPubMed
Nishimura, RA, Borlaug, BA. Diastology for the clinician. J Cardiol 2019; 73: 445–452.CrossRefGoogle ScholarPubMed
Egbe, AC, Miranda, WR, Connolly, HM. Increased prevalence of left ventricular diastolic dysfunction in adults with repaired coarctation of aorta. Int J Cardiol Heart Vasc 2020; 28: 100530.Google ScholarPubMed
Isaaz, K. Tissue doppler imaging for the assessment of left ventricular systolic and diastolic functions. Curr Opin Cardiol 2002; 17: 431–442.CrossRefGoogle ScholarPubMed
Kasner, M, Westermann, D, Steendijk, P, et al. Utility of Doppler echocardiography and tissue Doppler imaging in the estimation of diastolic function in heart failure with normal ejection fraction: a comparative Doppler-conductance catheterization study. Circulation 2007; 116: 637–647.CrossRefGoogle ScholarPubMed