title: Noninvasive Assessment of Vascular Function in Postoperative Cardiovascular Disease (Coarctation of the Aorta, Tetralogy of Fallot, and Transposition of the Great Arteries).
abstract: Using noninvasive techniques, we sought to assess arterial stiffness, impedance, hydraulic power, and efficiency in children with postoperative tetralogy of Fallot (TOF), coarctation of the aorta (COA), and transposition of the great arteries (TGAs). Results were compared with those of healthy peers. Fifty-five children with repaired congenital heart disease (24 TOFs, 20 COAs, and 11 TGAs) were compared with 55 age-matched control subjects (CTRL). Echocardiographic Doppler imaging and carotid artery applanation tonometry were preformed to measure aortic flow, dimensions, and calculate pulse wave velocity, vascular impedance and arterial stiffness indexes, hydraulic power (mean and total), and hydraulic efficiency (HE) which were calculated using standard fluid dynamics equations. All congenital heart disease subgroups had higher pulse wave velocity than CTRL. Only the COA group had higher characteristic impedance. Mean power was higher in TGA than in CTRL and TOF, and total power was higher in TGA than in CTRL and TOF. Hydraulic efficiency was higher in TOF than in COA and TGA. In conclusion, children with TOF, COA, and TGA have stiffer aortas than CTRL. These changes may be related to intrinsic aortic abnormalities, altered integrity of the aorta due to surgical repair, and/or acquired postsurgery. These patients may be at increased long-term cardiovascular risk, and long-term follow-up is important for monitoring and assessment of efforts to reduce risk.
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Mivelaz
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mande T
authors.initials: MT
authors.lastname: Leung
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mary Terri
authors.initials: MT
authors.lastname: Zadorsky
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Astrid M
authors.initials: AM
authors.lastname: De Souza
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: James E
authors.initials: JE
authors.lastname: Potts
authors.affiliation: Division of Cardiology, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: gsandor@cw.bc.ca.
authors.forename: George G S
authors.initials: GG
authors.lastname: Sandor
mesh_terms: D000293:Adolescent; D001017:Aortic Coarctation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006348:Cardiac Surgical Procedures; D002339:Carotid Arteries / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D015150:Echocardiography, Doppler; D017097:Electric Impedance; D005260:Female; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008365:Manometry; D063177:Pulse Wave Analysis; D013771:Tetralogy of Fallot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014188:Transposition of Great Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D059289:Vascular Stiffness