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Common carotid artery characteristics in patients with repaired aortic coarctation compared to other cardiovascular risk factors

Lindow, Anna ; Kennbäck, Cecilia LU ; Åkesson, Anna ; Nilsson, Peter M. LU and Weismann, Constance G. LU orcid (2022) In International Journal of Cardiology Congenital Heart Disease 7.
Abstract

Aims: Increased common carotid artery (CCA) intima media thickness (cIMT) is a well-known risk factor for cardiovascular morbidity and mortality. cIMT thickening has been described in patients with repaired aortic coarctation (CoA), but data on mechanism and clinical relevance in this population are scarce. Our aim was to gain mechanistic insights into cIMT thickening of patients with repaired CoA by comparing their wall architecture to patients with coronary artery disease (CAD), other congenital heart diseases (oCHD), and healthy controls. Methods and results: A total of 310 subjects were included (CoA (n ​= ​58), oCHD (n ​= ​96), CAD (n ​= ​68) and healthy controls (n ​= ​88)). CIMT and lumen diameter (LD) were determined using... (More)

Aims: Increased common carotid artery (CCA) intima media thickness (cIMT) is a well-known risk factor for cardiovascular morbidity and mortality. cIMT thickening has been described in patients with repaired aortic coarctation (CoA), but data on mechanism and clinical relevance in this population are scarce. Our aim was to gain mechanistic insights into cIMT thickening of patients with repaired CoA by comparing their wall architecture to patients with coronary artery disease (CAD), other congenital heart diseases (oCHD), and healthy controls. Methods and results: A total of 310 subjects were included (CoA (n ​= ​58), oCHD (n ​= ​96), CAD (n ​= ​68) and healthy controls (n ​= ​88)). CIMT and lumen diameter (LD) were determined using semiautomated analysis software. Linear regression analyses were performed correcting for relevant covariates. While patients with repaired CoA and CAD both had significantly increased cIMT and cIMT/LD ratios, LD was increased only in CoA patients. Furthermore, patients with repaired CoA had decreased CCA stiffness. CCA characteristics in the oCHD group were not significantly different from controls. Conclusion: The mechanism of cIMT thickening in patients with repaired CoA may differ from CAD. While there is concentric remodeling in the latter, we see predominant eccentric remodeling in the CoA group, which could be due to increased flow as a result of compliance mismatch at the CoA repair site. We therefore suggest that the prognostic value of cIMT in post-CoA patients should be validated separately prior to using it to guide clinical management in this group.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Aortic coarctation, Arterial stiffness, Common carotid artery, Congenital heart disease, Dimension, Intima media thickness
in
International Journal of Cardiology Congenital Heart Disease
volume
7
article number
100319
publisher
Elsevier
external identifiers
  • scopus:85208515864
DOI
10.1016/j.ijcchd.2022.100319
language
English
LU publication?
yes
id
bdfc5268-80b8-4427-90b5-23cea34d6b56
date added to LUP
2025-02-21 14:02:05
date last changed
2025-04-04 14:55:20
@article{bdfc5268-80b8-4427-90b5-23cea34d6b56,
  abstract     = {{<p>Aims: Increased common carotid artery (CCA) intima media thickness (cIMT) is a well-known risk factor for cardiovascular morbidity and mortality. cIMT thickening has been described in patients with repaired aortic coarctation (CoA), but data on mechanism and clinical relevance in this population are scarce. Our aim was to gain mechanistic insights into cIMT thickening of patients with repaired CoA by comparing their wall architecture to patients with coronary artery disease (CAD), other congenital heart diseases (oCHD), and healthy controls. Methods and results: A total of 310 subjects were included (CoA (n ​= ​58), oCHD (n ​= ​96), CAD (n ​= ​68) and healthy controls (n ​= ​88)). CIMT and lumen diameter (LD) were determined using semiautomated analysis software. Linear regression analyses were performed correcting for relevant covariates. While patients with repaired CoA and CAD both had significantly increased cIMT and cIMT/LD ratios, LD was increased only in CoA patients. Furthermore, patients with repaired CoA had decreased CCA stiffness. CCA characteristics in the oCHD group were not significantly different from controls. Conclusion: The mechanism of cIMT thickening in patients with repaired CoA may differ from CAD. While there is concentric remodeling in the latter, we see predominant eccentric remodeling in the CoA group, which could be due to increased flow as a result of compliance mismatch at the CoA repair site. We therefore suggest that the prognostic value of cIMT in post-CoA patients should be validated separately prior to using it to guide clinical management in this group.</p>}},
  author       = {{Lindow, Anna and Kennbäck, Cecilia and Åkesson, Anna and Nilsson, Peter M. and Weismann, Constance G.}},
  keywords     = {{Aortic coarctation; Arterial stiffness; Common carotid artery; Congenital heart disease; Dimension; Intima media thickness}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology Congenital Heart Disease}},
  title        = {{Common carotid artery characteristics in patients with repaired aortic coarctation compared to other cardiovascular risk factors}},
  url          = {{http://dx.doi.org/10.1016/j.ijcchd.2022.100319}},
  doi          = {{10.1016/j.ijcchd.2022.100319}},
  volume       = {{7}},
  year         = {{2022}},
}