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(Hypertension. 2006;47:1197.)
© 2006 American Heart Association, Inc.

Original Articles

Transposition of Great Arteries Is Associated With Increased Carotid Artery Stiffness

Beatrix Mersich; Peter Studinger; Zsuzsanna Lenard; Krisztina Kadar; Mark Kollai

From the Institute of Human Physiology and Clinical Experimental Research (B.M., P.S., Z.L., M.K.), Semmelweis University, Budapest; and Gottsegen Institute of Cardiology (K.K.), Budapest, Hungary.

Correspondence to Mark Kollai, MD, PhD, Semmelweis University, Faculty of Medicine, Institute of Human Physiology and Clinical Experimental Research, PO Box 448, H–1446 Budapest, Hungary. E-mail kollai{at}elet2.sote.hu

Transposition of great arteries is the consequence of abnormal aorticopulmonary septation. Animal embryonic data indicate that septation and elastogenesis are related events, but human and clinical data are not available. We tested the hypothesis that large artery elastic function was impaired in patients with transposition of great arteries. We studied 34 patients aged 9 to 19 years, 12±3 years after atrial switch operation; 14 patients aged 7 to 9 years, 8±1 years after arterial switch operation; and 108 healthy control subjects matched for age. Carotid artery diastolic diameter and pulsatile distension were determined by echo wall-tracking; carotid blood pressure was measured by tonometry. Systolic pressure was higher and diastolic pressure was lower in patients than in controls. Patients with atrial and arterial switch repair were compared with their respective controls by 2-factor ANOVA. For patients with atrial switch repair versus control, stiffness index ß was 4.9±1.5 versus 3.1±1.0 (P<0.001); for patients witch arterial switch versus control, stiffness index ß was 3.8±1.1 versus 2.1±0.6 (P<0.001). Similar differences were observed for carotid compliance, distensibility, and incremental elastic modulus as well. The interaction term was not significant for any of the elastic variables, indicating that carotid stiffening was a characteristic of the condition and not the consequence of different hemodynamics. Carotid artery is markedly stiffer in patients, suggesting that impaired elastogenesis may constitute part of the congenital abnormality. Since carotid artery stiffness has been established as an independent cardiovascular risk factor, this condition may have consequences in the clinical management of these patients.

Key Words: carotid arteries • arteries • elasticity

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