Key result
Patients with prior aortic coarctation repair had significantly increased carotid bulb intima-media thickness compared to controls (1.05 vs. 0.67 mm in men; p=0.003).
Why the study?
Patients still suffer from cardiovascular complications after aortic coarctation (CoA) repair.
Do patients with a history of aortic coarctation repair have increased carotid atherosclerosis and altered tissue remodeling biomarkers compared to controls?
Observational
Do patients with a history of aortic coarctation repair have increased carotid atherosclerosis and altered tissue remodeling biomarkers compared to controls?
Patients with repaired aortic coarctation exhibit increased carotid intima-media thickness and altered biomarkers of tissue remodeling compared to controls, indicating a higher burden of subclinical atherosclerosis.
May support enhanced vascular surveillance after coarctation repair; extends observational data on subclinical atherosclerosis but remains hypothesis-generating.
BACKGROUND AND AIMS: After aortic coarctation (CoA) repair, patients still suffer from cardiovascular complications. The aim of this study was to measure cardiovascular markers, intima-media thickness (IMT) and plaques in controls and patients with CoA. METHODS: Sixty-four patients with CoA (66% male, mean age 48 ± 15 years) and controls (54% men, mean age 47 ± 16 years) underwent ultrasound of their arteries. A multiplex platform to analyze circulating blood levels biomarkers reflecting inflammation, tissue remodeling and repair was used. RESULTS: In men following CoA repair, a significantly increased carotid bulb IMT was observed in comparison to the control group (1.05 [0.72-1.24] vs. 0.67 [0.59-0.95] mm; p = 0.003). Median common carotid artery (CCA) IMT was increased in men compared to controls (0.82 [0.61-0.97] mm vs. 0.58 [0.53-0.76] mm, p < 0.003) and in women compared to controls (0.83 [0.70-0.92] vs. 0.60 [0.55-0.69], p < 0.004). CoA demonstrated an independent association with IMT in both men and women. Men with CoA were also more likely to have a plaque in their carotid arteries (p = 0.010). In women with CoA, we observed significantly lower levels of stem cell factor (SCF, p = 0.004) while in men with CoA we observed significantly lower levels of matrix metalloproteinase-3 (MMP-3, p = 0.048), tumor necrosis factor receptor 1 (TNF-R1, p = 0.032), tumor necrosis factor receptor superfamily member 10B (TRAIL-R2, p = 0.019) and monocyte chemotactic protein 1 (MCP-1, p = 0.015). CONCLUSIONS: This is the first study to show that despite successful CoA repair, patients have more carotid atherosclerosis than can be explained by changes in tissue remodeling and repair.
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Hlebowicz et al. (2021) conducted an observational in Aortic coarctation. History of aortic coarctation repair vs. Controls was evaluated on Carotid bulb intima-media thickness (IMT) in men (p=0.003). Patients with prior aortic coarctation repair had significantly increased carotid bulb intima-media thickness compared to controls (1.05 vs. 0.67 mm in men; p=0.003).
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