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Updated: Jul 16, 2025
Non-invasive Assessment of Microvascular and Endothelial Function
Published on: January 29, 2013
Microvascular Endothelial Function Assessed Using Peripheral Arterial Tonometry in Adolescents with Repaired
Yutaka Odanaka1, Kanta Kishi2, Kiyohiro Takigiku3
1Department of Pediatrics, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan. yutaka.odanaka@ompu.ac.jp.
Insights
Adolescents with repaired congenital heart disease (CHD) show impaired endothelial function, a predictor of atherosclerosis. This microvascular dysfunction is present even in those with simple non-cyanotic CHD, highlighting the need for attention.
Area of Science:
- Cardiovascular Research
- Pediatric Cardiology
- Vascular Biology
Background:
- Atherosclerosis poses a risk for adults with congenital heart disease (CHD).
- Endothelial function predicts atherosclerosis but is understudied in repaired CHD patients.
- Assessing endothelial function in adolescents with repaired CHD is crucial.
Purpose of the Study:
- To evaluate endothelial function in adolescents with various types of repaired CHDs.
- To investigate the relationship between endothelial function and clinical factors in repaired CHD patients.
- To compare endothelial function between repaired CHD adolescents and healthy controls.
Main Methods:
- Peripheral arterial tonometry (PAT) was used to assess endothelial function.
- The reactive hyperemia index (RHI) was measured and compared between groups.
- Correlations between RHI and clinical/biochemical parameters were analyzed.
Main Results:
- Adolescents with repaired CHD exhibited significantly lower RHI compared to controls.
- No significant correlation was found between RHI and tested blood biochemical markers.
- Patients on ACE inhibitors/ARBs showed higher RHI than those not on these medications.
Conclusions:
- Endothelial function is impaired in adolescents with repaired CHD.
- Microvascular endothelial dysfunction is evident even in adolescents with simple non-cyanotic CHD.
- Medications like ACE inhibitors and ARBs may positively influence endothelial function in this population.
Abstract:
Atherosclerosis can develop in adult patients with congenital heart disease (CHD) and should be given attention. Endothelial function is well known as a predictor of the development of atherosclerosis but has not been well investigated in patients with repaired CHD. This study aimed to clarify the endothelial function and its relationship with clinical backgrounds and parameters in adolescents with various types of repaired CHDs. Endothelial function was evaluated using peripheral arterial tonometry (PAT). The reactive hyperemia index (RHI) was evaluated and compared between adolescents with repaired CHD and those in the control group. The relationship between the clinical background and parameters was also investigated in patients with repaired CHD. Forty-eight patients with repaired CHD (age 14.0 ± 3.3 years) and 114 healthy volunteers were included in this study. Patients with repaired CHD comprised 16 with repaired non-cyanotic CHD, 14 with repaired tetralogy of Fallot, and 18 who underwent the Fontan procedure. RHI in the repaired CHD group was significantly lower than in the control group. There was no significant correlation between the RHI and blood biochemical markers, such as uric acid, creatine, and brain natriuretic peptide levels. The RHI was significantly higher in patients taking angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) than in those not taking them. Endothelial function was impaired in adolescents with repaired CHD compared to that in the control group. Microvascular endothelial dysfunction developed even in adolescents with simple non-cyanotic CHD.
