Related Experiment Video
Updated: Aug 16, 2026
Murine Cervical Aortic Transplantation Model using a Modified Non-Suture Cuff Technique
Published on: November 2, 2019
Evidence of vascular dysfunction in young patients with successfully repaired coarctation of aorta
Stella Brili1, Dimitris Tousoulis, Charalambos Antoniades
1Cardiology Unit, Hippokration Hospital, Athens University Medical School, Vasilissis Sofias 114, 11528 Athens, Greece.
Insights
Adults who underwent successful coarctation repair (SCR) show impaired endothelial function and increased arterial stiffness. These cardiovascular changes may contribute to the higher risk of coronary artery disease after SCR.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Pediatric Cardiology
Background:
- Coarctation of the aorta (CoA) repair does not fully restore normal life expectancy.
- Cardiovascular events remain a primary concern for patients post-CoA repair.
- Long-term effects of successful coarctation repair (SCR) on vascular health are not fully understood.
Purpose of the Study:
- To investigate endothelial function, arterial mechanical properties, and inflammation in adults after SCR.
- To compare vascular parameters in SCR patients with age- and sex-matched healthy controls.
- To identify potential mechanisms linking SCR to long-term cardiovascular risks.
Main Methods:
- Forearm blood flow assessed using gauge-strain plethysmography to measure reactive hyperemia.
- High-resolution ultrasound used for intima-media thickness and distensibility of carotid and femoral arteries.
- Serum levels of adhesion molecules (sVCAM-1, sICAM-1, E-selectin) and interleukins (IL-1b, IL-6) measured via ELISA.
Main Results:
- Reduced reactive hyperemia in SCR patients indicates impaired endothelial function.
- Increased carotid intima-media thickness and decreased distensibility observed in SCR patients.
- Elevated serum levels of sICAM-1, sVCAM-1, E-selectin, and IL-1b in the SCR group compared to controls.
Conclusions:
- Adults post-SCR exhibit persistent endothelial dysfunction and arterial stiffening.
- Increased inflammatory markers and adhesion molecules suggest ongoing vascular inflammation.
- These vascular abnormalities may partially explain the elevated risk of coronary artery disease in repaired coarctation of the aorta patients.
Abstract:
It is well documented that in patients with coarctation of the aorta life expectancy is not normal even after successful coarctation repair (SCR), primarily due to cardiovascular events. We examined endothelial function in the forearm circulation, the mechanical properties and intima/media thickness in carotid and femoral arteries and the inflammatory process in normotensive patients, after coarctation repair. Fifteen patients, 29+/-2 years old, 12+/-2.9 years after SCR and 16 age- and sex-matched controls were enrolled in our study. Forearm blood flow was determined by gauge-strain plethysmography. Forearm vasodilatory response to reactive hyperemia was expressed as the %change from baseline to post-reactive hyperemia blood flow. High resolution ultrasound was used for determination of intima/media thickness and elastic properties of carotid and femoral arteries. Serum levels of soluble vascular adhesion molecule 1 (sVCAM-1), intercellular adhesion molecule 1 (sICAM-1), E-selectin, and interleukines 1b (IL-1b) and 6 (IL-6) were determined by ELISA. Reactive hyperemia was significantly decreased in patients compared to controls (p<0.01). Patients with SCR had higher intima/media thickness and decreased distensibility in the carotid arteries than controls (p<0.01 for both). Serum levels of sICAM-1, sSVCAM-1, E-selectin and IL-1b were higher in SCR group than in controls (p<0.05 for all). Adult patients after SCR have impaired endothelial function in the forearm circulation, increased intima/media thickness, decreased distensibility in the carotid arteries and increased levels of proinflammatory cytokines and adhesion molecules than healthy controls. These results may partly explain the high incidence of coronary artery disease in patients with repaired coarctation of the aorta.
