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Elevated Aortic Stiffness after Pediatric Heart Transplantation

John-Anthony Coppola1, Dipankar Gupta2, Dalia Lopez-Colon1

  • 1Congenital Heart Center, Department of Pediatrics, University of Florida College of Medicine, Gainesville, FL, USA.

Pediatric Cardiology
|August 3, 2023
PubMed

Insights

Pediatric heart transplant recipients show increased aortic stiffness and lower aortic distensibility compared to healthy children. These arterial changes may impact long-term transplant health and risk of coronary allograft vasculopathy.

Area of Science:

  • Cardiovascular Research
  • Pediatric Cardiology
  • Transplantation Medicine

Background:

  • Arterial stiffness is linked to end-organ damage in adults.
  • Increased arterial stiffness and endothelial dysfunction may contribute to microvascular dysfunction and coronary allograft vasculopathy (CAV).
  • Data on arterial stiffness in pediatric heart transplant recipients and its relation to CAV is limited.

Purpose of the Study:

  • To assess aortic stiffness and distensibility in pediatric patients post-heart transplantation.
  • To investigate potential alterations in aortic biomechanical properties following pediatric heart transplantation.

Main Methods:

  • Prospective, observational study in patients aged <21 years.
  • Transthoracic echocardiographic M-mode measurements of ascending (donor) and descending (recipient) aorta.
  • Calculation of Aortic Distensibility (AD) and Aortic Stiffness Index (ASI) using validated methods.

Main Results:

  • 39 heart transplant (HT) patients and 47 healthy controls were recruited.
  • Ascending aorta distensibility was significantly lower in HT patients (4.87) vs. controls (10.53, p<0.001).
  • Ascending aorta stiffness index was significantly higher in HT patients (4.63) vs. controls (2.21, p<0.001).

Conclusions:

  • Pediatric heart transplant recipients exhibit altered ascending aortic distensibility and stiffness.
  • These findings suggest potential biomechanical changes in the aorta post-transplantation.
  • Further research is needed to determine the impact on complications like coronary artery vasculopathy.

Keywords:
Arterial stiffnessCoronary allograft vasculopathyHeart transplantationPediatrics

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