Key result
Repaired aortic coarctation linked to increased cIMT and lumen diameter with eccentric remodeling unlike CAD.
Why the study?
Common carotid artery intima media thickness thickening occurs in patients with repaired aortic coarctation, but data on the mechanism and clinical relevance in this population are scarce.
How do common carotid artery characteristics differ in patients with repaired aortic coarctation compared to those with CAD, other congenital heart diseases, and healthy controls?
Cross-Sectional (n=310)
How do common carotid artery characteristics differ in patients with repaired aortic coarctation compared to those with CAD, other congenital heart diseases, and healthy controls?
The mechanism of cIMT thickening in repaired aortic coarctation involves predominant eccentric remodeling, differing from the concentric remodeling seen in CAD, suggesting its prognostic value needs separate validation.
Eccentric carotid remodeling in repaired coarctation needs separate prognostic validation; leaves open differential outcome prediction versus CAD.
Aims: Increased common carotid artery (CCA) intima media thickness (cIMT) is a well-known risk factor for cardiovascular morbidity and mortality. cIMT thickening has been described in patients with repaired aortic coarctation (CoA), but data on mechanism and clinical relevance in this population are scarce. Our aim was to gain mechanistic insights into cIMT thickening of patients with repaired CoA by comparing their wall architecture to patients with coronary artery disease (CAD), other congenital heart diseases (oCHD), and healthy controls. Methods and results: A total of 310 subjects were included (CoA (n = 58), oCHD (n = 96), CAD (n = 68) and healthy controls (n = 88)). CIMT and lumen diameter (LD) were determined using semiautomated analysis software. Linear regression analyses were performed correcting for relevant covariates. While patients with repaired CoA and CAD both had significantly increased cIMT and cIMT/LD ratios, LD was increased only in CoA patients. Furthermore, patients with repaired CoA had decreased CCA stiffness. CCA characteristics in the oCHD group were not significantly different from controls. Conclusion: The mechanism of cIMT thickening in patients with repaired CoA may differ from CAD. While there is concentric remodeling in the latter, we see predominant eccentric remodeling in the CoA group, which could be due to increased flow as a result of compliance mismatch at the CoA repair site. We therefore suggest that the prognostic value of cIMT in post-CoA patients should be validated separately prior to using it to guide clinical management in this group.
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Lindow et al. (2022) conducted a cross-sectional in Repaired aortic coarctation (n=310). Repaired aortic coarctation vs. Coronary artery disease, other congenital heart diseases, and healthy controls was evaluated on Common carotid artery intima media thickness (cIMT) and lumen diameter (LD). Patients with repaired aortic coarctation had significantly increased cIMT and lumen diameter with eccentric remodeling, differing from the concentric remodeling seen in coronary artery disease.
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