Increased aortic wall stiffness is predictive of aortic dilation in adult patients following coarctation of the aorta repair

Abstract Background: Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients. Methods and results: From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]). Conclusions: Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

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Management of Coarctation of The Aorta in Adult Patients: State of The Art

Korean Circulation Journal ◽

10.4070/kcj.2018.0433 ◽

2019 ◽

Vol 49 (4) ◽

pp. 298 ◽

Cited By ~ 7

Author(s):

Wail Alkashkari ◽

Saad Albugami ◽

Ziyad M. Hijazi

Keyword(s):

State Of The Art ◽

Coarctation Of The Aorta ◽

Adult Patients

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The Development of the Ascending Aortic Wall in Tricuspid and Bicuspid Aortic Valve: A Process from Maturation to Degeneration

Journal of Clinical Medicine ◽

10.3390/jcm9040908 ◽

2020 ◽

Vol 9 (4) ◽

pp. 908

Author(s):

Nimrat Grewal ◽

Adriana C. Gittenberger-de Groot ◽

Jan von der Thusen ◽

Lambertus J. Wisse ◽

Margot M. Bartelings ◽

...

Keyword(s):

Aortic Valve ◽

Young Child ◽

Bicuspid Aortic Valve ◽

Aortic Wall ◽

Age Groups ◽

Intimal Thickening ◽

Aortic Dilation ◽

Future Studies ◽

Increased Risk ◽

Two Phases

Background: Patients with a bicuspid aortic valve (BAV) have an increased risk for aortic dilation and dissection. In this study, we provide a histological stratification of the developing aorta in the tricuspid aortic valve (TAV) and the BAV populations as a reference for future studies on aortopathy and related syndromes. Methods: Non-dilated TAV and BAV ascending aortic wall samples were collected, including 60 TAV (embryonic–70 years) and 32 BAV specimens (fetal–72 years, categorized in eight age groups. Results: In TAV, intimal development starts in the neonatal phase. After birth, the thickness of the medial layer increases significantly by increase of elastic lamellae up to and including the “young child” phase stabilizing afterwards. The BAV shows already prenatal intimal thickening becoming significantly thinner after birth subsequently stabilizing. In BAV, increase in elastic lamellae is seen between the young child and the adolescent phases, stabilizing afterwards. Conclusions: Vascular development in TAV is described in three phases: maturation, stabilization, and degeneration. For BAV, the development can be described in two phases: maturation (already prenatally) and degeneration. After birth, the development of the aorta is characterized by degeneration, leading to weakening of the ascending aortic wall and increasing the risk of aortopathy.

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P735Utility of 18F-FDG PET/CT imaging in detecting aortic wall inflammation of adult patients after successful coarctation repair

European Heart Journal ◽

10.1093/eurheartj/ehx501.p735 ◽

2017 ◽

Vol 38 (suppl_1) ◽

Author(s):

A.S. Antonopoulos ◽

S. Brili ◽

E. Oikonomou ◽

I. Cutajar ◽

N. Pianou ◽

...

Keyword(s):

Fdg Pet ◽

Aortic Wall ◽

Ct Imaging ◽

Adult Patients ◽

Coarctation Repair ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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In vivo angiotensin II receptor blockade and converting enzyme inhibition on canine aortic viscoelasticity

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1997.272.2.h859 ◽

1997 ◽

Vol 272 (2) ◽

pp. H859-H868 ◽

Cited By ~ 5

Author(s):

J. G. Barra ◽

J. Levenson ◽

R. L. Armentano ◽

E. I. Cabrera Fischer ◽

R. H. Pichel ◽

...

Keyword(s):

Angiotensin Ii ◽

Enzyme Inhibition ◽

Aortic Wall ◽

Early Stage ◽

Viscosity Index ◽

Pressure Curve ◽

Converting Enzyme ◽

Angiotensin Ii Receptor ◽

Wall Stiffness ◽

Converting Enzyme Inhibition

The influence of the renin-angiotensin system (RAS) on the aortic wall mechanical properties under angiotensin I converting enzyme inhibition (enalaprilat, 0.3 mg/kg iv) or angiotensin II receptor (AT1) blockade (E-3174, 1 mg/kg iv) was examined in eight normotensive and eight renovascular hypertensive conscious dogs. Aortic diameter (D; sonomicrometry)-pressure (P; microtransducer) hysteresis loops during steady state and during rapid distal aortic occlusion allowed (after hysteresis elimination) calculation of the aortic wall viscosity index, the purely elastic P-D relationship, and derivation into compliance-pressure curves. At the early stage ofrenovascular hypertension when activation of RAS is more pronounced, aortic wall stiffness and wall viscosity were increased as compared with normotensive states. Blood pressure remained unchanged in normotensive animals and was reduced during hypertension after antihypertensive treatments. In hypertensive animals, enalaprilat and E-3174 decreased viscosity index and shifted the compliance-pressure curve upward with respect to pretreatment conditions. In normotensive dogs, whereas E-3174 did not change the compliance-pressure curve and viscosity index, enalaprilat increased compliance and reduced viscosity index. We concluded that in normotensive dogs converting enzyme inhibition modifies arterial viscoelastic parameters by angiotensin-independent mechanisms that contribute to the modulation of the buffering function of large arteries.

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