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Hypertensive changes within the aortic arch of infants and children with isolated coarctation

Michael F Swartz1, David Morrow, Nader Atallah-Yunes

  • 1Pediatric Cardiac Consortium of Upstate New York, Rochester, New York, USA. michael_swartz@urmc.rochester.edu

The Annals of Thoracic Surgery
|June 5, 2013
PubMed

Insights

Preoperative aortic arch tissue in children with coarctation of the aorta (CoA) shows variable collagen and smooth muscle cell marker expression. Absence of a patent ductus arteriosus (PDA) is linked to increased collagen-I and TGF-β expression.

Area of Science:

  • Pediatric Cardiology
  • Vascular Biology
  • Molecular Genetics

Background:

  • Coarctation of the aorta (CoA) repair often results in late hypertension.
  • Increased aortic wall collagen and smooth muscle cell markers are associated with hypertension.
  • A patent ductus arteriosus (PDA) can limit proximal hypertension before CoA repair.

Purpose of the Study:

  • To investigate the variability of aortic arch collagen and vascular smooth muscle cell marker expression in children with CoA.
  • To determine if the presence or absence of a PDA influences this preoperative gene expression.

Main Methods:

  • Quantitative polymerase chain reaction (qPCR) was used to analyze gene expression in 25 children with CoA.
  • Aortic arch tissue proximal to the coarctation was compared to distal descending aortic tissue.
  • Expression of Collagen-I, transforming growth factor-β (TGF-β), elastin, and calponin was measured.

Main Results:

  • Infants without a PDA exhibited significantly higher Collagen-I expression (7.0-fold) compared to those with a PDA (0.8-fold).
  • Expression of TGF-β (4.3-fold vs 2.6-fold) and calponin (3.7-fold vs 0.6-fold) was also elevated in infants without a PDA.
  • No significant differences in age or weight were observed between infants with or without a PDA.

Conclusions:

  • Preoperative aortic arch tissue in children with CoA shows distinct molecular changes.
  • The absence of a PDA is associated with increased expression of collagen and smooth muscle markers in the aortic arch prior to repair.
Abstract

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