The classical teachings suggest that endothelial dysfunction is very common in older children and adults with repaired coarctation of the aorta. Such abnormal endothelial function, in association with increased aortic wall stiffness, has been considered a potential cause of hypertension in those patients without evidence of re-coarctation.
Recent new research however suggests that endothelial dysnfunction in adults with repaired coarctation could be much less common than what previsously thought.
The most recent study investigating the prevalence of endothelial dysfunction in this setting is a paper from Munster, Germany. Using a comprehensive and sophisticad array of investigations, the authors demonstrated normal endothelial function in a group of adults with repaired aortic coarctation. When compared to healthy individuals who were matched for age and gender, the investigators found no evidence of endothelial dysfunction on molecular, cellular and vascular level in aortic coarctation patients.
The authors raised the fascinating possiblity that optimal blood pressure control in their patients might justify the difference with previous studies which have shown a more common occurrence of endothelial dysfunction. This hypothesis, even if unproven deserves consideration. Indeed, 2 prospective trials which used statins and ACE-inhibitors have shown that endothelial dysfunction may, in fact, be reversible.
The full text is available at:http://www.ncbi.nlm.nih.gov/pubmed/25095828
Recent new research however suggests that endothelial dysnfunction in adults with repaired coarctation could be much less common than what previsously thought.
The most recent study investigating the prevalence of endothelial dysfunction in this setting is a paper from Munster, Germany. Using a comprehensive and sophisticad array of investigations, the authors demonstrated normal endothelial function in a group of adults with repaired aortic coarctation. When compared to healthy individuals who were matched for age and gender, the investigators found no evidence of endothelial dysfunction on molecular, cellular and vascular level in aortic coarctation patients.
The authors raised the fascinating possiblity that optimal blood pressure control in their patients might justify the difference with previous studies which have shown a more common occurrence of endothelial dysfunction. This hypothesis, even if unproven deserves consideration. Indeed, 2 prospective trials which used statins and ACE-inhibitors have shown that endothelial dysfunction may, in fact, be reversible.
The full text is available at:http://www.ncbi.nlm.nih.gov/pubmed/25095828
Dr. Alessandro Giardini
Paediatric Cardiologist in London
www.childheartspecialist.com
No comments:
Post a Comment