Elevated Aortic Stiffness after Pediatric Heart Transplantation
In adults, arterial stiffness has been linked to the development of target end-organ damage, thought to be related to abnormal transmission of pulse pressure. Increased arterial stiffness and endothelial dysfunction have been hypothesized to contribute to the development of microvascular dysfunction...
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| Veröffentlicht in: | Pediatric cardiology 2024-12, Vol.45 (8), p.1652-1658 |
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| container_title | Pediatric cardiology |
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| creator | Coppola, John-Anthony Gupta, Dipankar Lopez-Colon, Dalia DeGroff, Curt Vyas, Himesh V. |
| description | In adults, arterial stiffness has been linked to the development of target end-organ damage, thought to be related to abnormal transmission of pulse pressure. Increased arterial stiffness and endothelial dysfunction have been hypothesized to contribute to the development of microvascular dysfunction and coronary allograft vasculopathy (CAV), an important comorbidity after heart transplantation. However, little data exists regarding arterial stiffness in pediatric heart transplantation and its influence on development of coronary allograft vasculopathy is not well understood. We sought to assess aortic stiffness and distensibility in pediatric post-heart transplant patients. A prospective, observational study analyzing the ascending (donor tissue) and descending aorta (recipient tissue) using transthoracic echocardiographic M-mode measurements in patients aged |
| doi_str_mv | 10.1007/s00246-023-03245-3 |
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p
= 0.01). Ascending aortic distensibility in post-transplant patients was significantly lower than in the control group (4.87 vs. 10.53,
p
< 0.001). Ascending aortic stiffness index was higher in the transplant patients compared to the controls (4.63 vs. 2.21,
p
< 0.001). There is evidence of altered ascending aortic distensibility and stiffness parameters in post-heart transplant patients. Further studies are required to assess its influence on complications like development of coronary artery vasculopathy.</description><identifier>ISSN: 0172-0643</identifier><identifier>ISSN: 1432-1971</identifier><identifier>EISSN: 1432-1971</identifier><identifier>DOI: 10.1007/s00246-023-03245-3</identifier><identifier>PMID: 37535078</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adolescent ; Aorta - diagnostic imaging ; Aorta - physiopathology ; Aorta, Thoracic - diagnostic imaging ; Aorta, Thoracic - physiopathology ; Cardiac Surgery ; Cardiology ; Case-Control Studies ; Child ; Child, Preschool ; Echocardiography ; Female ; Heart Transplantation - adverse effects ; Humans ; Male ; Medicine ; Medicine & Public Health ; Postoperative Complications - etiology ; Prospective Studies ; Vascular Stiffness ; Vascular Surgery</subject><ispartof>Pediatric cardiology, 2024-12, Vol.45 (8), p.1652-1658</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c342t-2613896797391c0f900cede4f08398eddc89562c1213840116a2282183c1abd23</cites><orcidid>0000-0003-0143-7143 ; 0000-0002-1264-3244</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00246-023-03245-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00246-023-03245-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37535078$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coppola, John-Anthony</creatorcontrib><creatorcontrib>Gupta, Dipankar</creatorcontrib><creatorcontrib>Lopez-Colon, Dalia</creatorcontrib><creatorcontrib>DeGroff, Curt</creatorcontrib><creatorcontrib>Vyas, Himesh V.</creatorcontrib><title>Elevated Aortic Stiffness after Pediatric Heart Transplantation</title><title>Pediatric cardiology</title><addtitle>Pediatr Cardiol</addtitle><addtitle>Pediatr Cardiol</addtitle><description>In adults, arterial stiffness has been linked to the development of target end-organ damage, thought to be related to abnormal transmission of pulse pressure. Increased arterial stiffness and endothelial dysfunction have been hypothesized to contribute to the development of microvascular dysfunction and coronary allograft vasculopathy (CAV), an important comorbidity after heart transplantation. However, little data exists regarding arterial stiffness in pediatric heart transplantation and its influence on development of coronary allograft vasculopathy is not well understood. We sought to assess aortic stiffness and distensibility in pediatric post-heart transplant patients. A prospective, observational study analyzing the ascending (donor tissue) and descending aorta (recipient tissue) using transthoracic echocardiographic M-mode measurements in patients aged < 21 years was conducted. Descending and ascending aorta M-modes were obtained from the subcostal long axis view, and the parasternal long axis view 3–5mm above the sinotubular junction, respectively. Two independent reviewers averaged measurements over 2–3 cardiac cycles, and Aortic Distensibility (AD) and Aortic Stiffness Index (ASI) were calculated using previously validated methods. We recruited 39 heart transplant (HT) patients and 47 healthy controls. Median end diastolic dimension of the ascending aorta (donor tissue) was significantly larger in the transplant group than the control group (1.92 cm vs. 1.74 cm,
p
= 0.01). Ascending aortic distensibility in post-transplant patients was significantly lower than in the control group (4.87 vs. 10.53,
p
< 0.001). Ascending aortic stiffness index was higher in the transplant patients compared to the controls (4.63 vs. 2.21,
p
< 0.001). There is evidence of altered ascending aortic distensibility and stiffness parameters in post-heart transplant patients. Further studies are required to assess its influence on complications like development of coronary artery vasculopathy.</description><subject>Adolescent</subject><subject>Aorta - diagnostic imaging</subject><subject>Aorta - physiopathology</subject><subject>Aorta, Thoracic - diagnostic imaging</subject><subject>Aorta, Thoracic - physiopathology</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Echocardiography</subject><subject>Female</subject><subject>Heart Transplantation - adverse effects</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>Vascular Stiffness</subject><subject>Vascular Surgery</subject><issn>0172-0643</issn><issn>1432-1971</issn><issn>1432-1971</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kD1PwzAQhi0EoqXwBxhQRhbD-SOJM6GqKhSpEkiU2XKdC0qVJsV2kPj3dUlhZLrhnvfV3UPINYM7BpDfewAuMwpcUBBcplSckDGTglNW5OyUjIHlnEImxYhceL8BAAUqPScjkacihVyNycO8wS8TsEymnQu1Td5CXVUtep-YKqBLXrGsTXBxs0DjQrJypvW7xrTBhLprL8lZZRqPV8c5Ie-P89VsQZcvT8-z6ZJaIXmgPGNCFVle5KJgFqoCwGKJsgIlCoVlaVWRZtwyHjkJjGWGc8WZEpaZdcnFhNwOvTvXffbog97W3mITD8Gu95ormWapVOqA8gG1rvPeYaV3rt4a960Z6IM4PYjTUZz-EadFDN0c-_v1Fsu_yK-pCIgB8HHVfqDTm653bfz5v9o9HbZ23g</recordid><startdate>20241201</startdate><enddate>20241201</enddate><creator>Coppola, John-Anthony</creator><creator>Gupta, Dipankar</creator><creator>Lopez-Colon, Dalia</creator><creator>DeGroff, Curt</creator><creator>Vyas, Himesh V.</creator><general>Springer US</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-0143-7143</orcidid><orcidid>https://orcid.org/0000-0002-1264-3244</orcidid></search><sort><creationdate>20241201</creationdate><title>Elevated Aortic Stiffness after Pediatric Heart Transplantation</title><author>Coppola, John-Anthony ; Gupta, Dipankar ; Lopez-Colon, Dalia ; DeGroff, Curt ; Vyas, Himesh V.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c342t-2613896797391c0f900cede4f08398eddc89562c1213840116a2282183c1abd23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Aorta - diagnostic imaging</topic><topic>Aorta - physiopathology</topic><topic>Aorta, Thoracic - diagnostic imaging</topic><topic>Aorta, Thoracic - physiopathology</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Echocardiography</topic><topic>Female</topic><topic>Heart Transplantation - adverse effects</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Postoperative Complications - etiology</topic><topic>Prospective Studies</topic><topic>Vascular Stiffness</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coppola, John-Anthony</creatorcontrib><creatorcontrib>Gupta, Dipankar</creatorcontrib><creatorcontrib>Lopez-Colon, Dalia</creatorcontrib><creatorcontrib>DeGroff, Curt</creatorcontrib><creatorcontrib>Vyas, Himesh V.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coppola, John-Anthony</au><au>Gupta, Dipankar</au><au>Lopez-Colon, Dalia</au><au>DeGroff, Curt</au><au>Vyas, Himesh V.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elevated Aortic Stiffness after Pediatric Heart Transplantation</atitle><jtitle>Pediatric cardiology</jtitle><stitle>Pediatr Cardiol</stitle><addtitle>Pediatr Cardiol</addtitle><date>2024-12-01</date><risdate>2024</risdate><volume>45</volume><issue>8</issue><spage>1652</spage><epage>1658</epage><pages>1652-1658</pages><issn>0172-0643</issn><issn>1432-1971</issn><eissn>1432-1971</eissn><abstract>In adults, arterial stiffness has been linked to the development of target end-organ damage, thought to be related to abnormal transmission of pulse pressure. Increased arterial stiffness and endothelial dysfunction have been hypothesized to contribute to the development of microvascular dysfunction and coronary allograft vasculopathy (CAV), an important comorbidity after heart transplantation. However, little data exists regarding arterial stiffness in pediatric heart transplantation and its influence on development of coronary allograft vasculopathy is not well understood. We sought to assess aortic stiffness and distensibility in pediatric post-heart transplant patients. A prospective, observational study analyzing the ascending (donor tissue) and descending aorta (recipient tissue) using transthoracic echocardiographic M-mode measurements in patients aged < 21 years was conducted. Descending and ascending aorta M-modes were obtained from the subcostal long axis view, and the parasternal long axis view 3–5mm above the sinotubular junction, respectively. Two independent reviewers averaged measurements over 2–3 cardiac cycles, and Aortic Distensibility (AD) and Aortic Stiffness Index (ASI) were calculated using previously validated methods. We recruited 39 heart transplant (HT) patients and 47 healthy controls. Median end diastolic dimension of the ascending aorta (donor tissue) was significantly larger in the transplant group than the control group (1.92 cm vs. 1.74 cm,
p
= 0.01). Ascending aortic distensibility in post-transplant patients was significantly lower than in the control group (4.87 vs. 10.53,
p
< 0.001). Ascending aortic stiffness index was higher in the transplant patients compared to the controls (4.63 vs. 2.21,
p
< 0.001). There is evidence of altered ascending aortic distensibility and stiffness parameters in post-heart transplant patients. Further studies are required to assess its influence on complications like development of coronary artery vasculopathy.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>37535078</pmid><doi>10.1007/s00246-023-03245-3</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-0143-7143</orcidid><orcidid>https://orcid.org/0000-0002-1264-3244</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Aorta - diagnostic imaging Aorta - physiopathology Aorta, Thoracic - diagnostic imaging Aorta, Thoracic - physiopathology Cardiac Surgery Cardiology Case-Control Studies Child Child, Preschool Echocardiography Female Heart Transplantation - adverse effects Humans Male Medicine Medicine & Public Health Postoperative Complications - etiology Prospective Studies Vascular Stiffness Vascular Surgery |
| title | Elevated Aortic Stiffness after Pediatric Heart Transplantation |
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