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Microvascular Endothelial Function Assessed Using Peripheral Arterial Tonometry in Adolescents with Repaired Congenital Heart Disease

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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.

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No funding was received to assist with the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Pediatrics, Osaka Medical and Pharmaceutical University, 2-7 Daigakumachi, Takatsuki, Osaka, 569-8686, Japan

    Yutaka Odanaka, Kanta Kishi, Atsuko Ashida, Noriyasu Ozaki & Akira Ashida

  2. Department of Pediatric Cardiology, Nagano Children’s Hospital, Nagano, Japan

    Kiyohiro Takigiku

Authors
  1. Yutaka Odanaka
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  2. Kanta Kishi
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  3. Kiyohiro Takigiku
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  4. Atsuko Ashida
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  5. Noriyasu Ozaki
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  6. Akira Ashida
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by YO, KK, AA, and KT. The first draft of the manuscript was written by YO and all authors commented on the previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Yutaka Odanaka.

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There are no potential competing interests to disclose.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the ethics committee of the Osaka Medical and Pharmaceutical University (Code No. 134).

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Odanaka, Y., Kishi, K., Takigiku, K. et al. Microvascular Endothelial Function Assessed Using Peripheral Arterial Tonometry in Adolescents with Repaired Congenital Heart Disease. Pediatr Cardiol (2023). https://doi.org/10.1007/s00246-023-03283-x

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