TY - JOUR

T1 - Vascular function in adults with cyanotic congenital heart disease

AU - Tarp, Julie Bjerre

AU - Clausen, Peter

AU - Celermajer, David

AU - Christoffersen, Christina

AU - Jensen, Annette Schophuus

AU - Sorensen, Keld

AU - Sillesen, Henrik

AU - Estensen, Mette-Elise

AU - Nagy, Edit

AU - Holstein-Rathlou, Niels-Henrik

AU - Engstrom, Thomas

AU - Feldt-Rasmussen, Bo

AU - Sondergaard, Lars

PY - 2020

Y1 - 2020

N2 - Background: Patients with cyanotic congenital heart disease (CCHD) may have a low burden of atherosclerosis. Endothelial dysfunction is an early stage of atherosclerosis and endothelial function is previously studied in smaller CCHD groups with different techniques and variable results. We aimed to examine endothelial function and carotid atherosclerosis in a larger group of CCHD patients.Methods: This multicentre study assessed endothelial function in adults with CCHD and controls by measuring the dilatory response of the brachial artery to post-ischemic hyperaemia (endothelium-dependent flow-mediated-vasodilatation (FMD)), and to nitroglycerin (endothelium-independent nitroglycerin-induced dilatation (NID)). Flow was measured at baseline and after ischaemia (reactive hyperaemia). Carotid-intima-media-thickness (CIMT), prevalence of carotid plaque and plaque thickness (cPT-max) were evaluated ultrasonographically. Lipoproteins, inflammatory and vascular markers, including sphingosine-1-phosphate (S1P) were measured.Results: Forty-five patients with CCHD (median age 50 years) and 45 matched controls (median age 52 years) were included. The patients presented with lower reactive hyperaemia (409 +/- 114% vs. 611 +/- 248%, p <0.0001), however preserved FMD response compared to controls (106.5 +/- 8.3% vs. 106. 4 +/- 6.1%, p = 0.95). In contrast, NID was lower in the patients (110.5 +/- 6.1% vs. 115.1 +/- 7.4%, p = 0.053). There was no difference in CIMT, carotid plaque or cPT-max. The patients presented with lower high-density-lipoprotein cholesterol, and higher level of inflammatory markers and S1P.Conclusion: Adults with CCHD had preserved FMD in the brachial artery, but impaired NID response and lower reactive hyperaemia than controls. The preserved FMD and the comparable prevalence of carotid atherosclerosis indicate that CCHD patients have the same risk of atherosclerosis as controls. (C) 2020 The Authors. Published by Elsevier B.V.

AB - Background: Patients with cyanotic congenital heart disease (CCHD) may have a low burden of atherosclerosis. Endothelial dysfunction is an early stage of atherosclerosis and endothelial function is previously studied in smaller CCHD groups with different techniques and variable results. We aimed to examine endothelial function and carotid atherosclerosis in a larger group of CCHD patients.Methods: This multicentre study assessed endothelial function in adults with CCHD and controls by measuring the dilatory response of the brachial artery to post-ischemic hyperaemia (endothelium-dependent flow-mediated-vasodilatation (FMD)), and to nitroglycerin (endothelium-independent nitroglycerin-induced dilatation (NID)). Flow was measured at baseline and after ischaemia (reactive hyperaemia). Carotid-intima-media-thickness (CIMT), prevalence of carotid plaque and plaque thickness (cPT-max) were evaluated ultrasonographically. Lipoproteins, inflammatory and vascular markers, including sphingosine-1-phosphate (S1P) were measured.Results: Forty-five patients with CCHD (median age 50 years) and 45 matched controls (median age 52 years) were included. The patients presented with lower reactive hyperaemia (409 +/- 114% vs. 611 +/- 248%, p <0.0001), however preserved FMD response compared to controls (106.5 +/- 8.3% vs. 106. 4 +/- 6.1%, p = 0.95). In contrast, NID was lower in the patients (110.5 +/- 6.1% vs. 115.1 +/- 7.4%, p = 0.053). There was no difference in CIMT, carotid plaque or cPT-max. The patients presented with lower high-density-lipoprotein cholesterol, and higher level of inflammatory markers and S1P.Conclusion: Adults with CCHD had preserved FMD in the brachial artery, but impaired NID response and lower reactive hyperaemia than controls. The preserved FMD and the comparable prevalence of carotid atherosclerosis indicate that CCHD patients have the same risk of atherosclerosis as controls. (C) 2020 The Authors. Published by Elsevier B.V.

KW - Cyanotic congenital heart disease

KW - Atherosclerosis

KW - Endothelial function

KW - Lipoproteins

KW - ENDOTHELIAL DYSFUNCTION

KW - APOLIPOPROTEIN M

KW - BRACHIAL-ARTERY

KW - RISK

KW - ATHEROSCLEROSIS

KW - DILATION

KW - CHILDREN

KW - S1P

U2 - 10.1016/j.ijcha.2020.100632

DO - 10.1016/j.ijcha.2020.100632

M3 - Journal article

C2 - 32995473

VL - 30

JO - IJC Heart and Vasculature

JF - IJC Heart and Vasculature

SN - 2352-9067

M1 - 100632

ER -