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Lasso-Mendez J, Spence C, Hornberger LK, Sivak A, Davenport MH. Vascular Health in Congenital Heart Disease: A Systematic Review and Meta-Analysis. Can J Cardiol 2025; 41:71-86. [PMID: 39490408 DOI: 10.1016/j.cjca.2024.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 10/02/2024] [Accepted: 10/06/2024] [Indexed: 11/05/2024] Open
Abstract
BACKGROUND Congenital heart disease (CHD) affects 1% of live births and is a risk factor for cardiovascular disease and reduced life expectancy. Previous studies have suggested CHD is associated with impaired vascular health, but this has not been established. Therefore, the objective of this study was to examine the effect of CHD on vascular health. METHODS Eight electronic databases were searched through April 12, 2024. Studies of all designs (except case studies and reviews) that reported on the population (individuals with CHD of any age), comparator (individuals without CHD), and outcomes of interest: endothelial dependent (flow-mediated vasodilation, reactive hyperemia index) and independent (nitroglycerin-mediated dilation) vascular function, arterial stiffness (pulse wave velocity, stiffness index, augmentation index, distensibility, and compliance), and carotid intima-media thickness were included. Results are presented as standardized mean difference (SMD) with 95% confidence interval (CI) and as effect size. RESULTS We included 138 studies (N = 16,115) in the meta-analysis. Individuals with CHD exhibited decreased vascular function compared with those without including decreased low-mediated vasodilation (SMD, -0.96 [95% CI, -1.22 to -0.70]; I2 = 85%; large effect size), reactive hyperemia index using ultrasound (SMD, -2.88 [95% CI, -4.85 to -0.90]; I2 = 96%; large effect size), and nitroglycerin-mediated dilation (SMD, -0.98 [95% CI, -1.35 to -0.61]; I2 = 87%; large effect size). Various CHD subtypes including coarctation of the aorta, transposition of the great arteries, and tetralogy of Fallot, after the Fontan procedure showed significant vascular dysfunction. Shunt lesions did not show significant vascular dysfunction. CONCLUSIONS CHD is associated with vascular dysfunction, increased arterial stiffness, and greater carotid intima-media thickness in pediatric and adult patients.
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Affiliation(s)
- Juliana Lasso-Mendez
- Division of Cardiology, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Christopher Spence
- Division of Cardiology, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Lisa K Hornberger
- Division of Cardiology, Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada; Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada; Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Allison Sivak
- Geoffrey & Robyn Sperber Health Sciences Library, University of Alberta, Edmonton, Alberta, Canada
| | - Margie H Davenport
- Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada; Program for Pregnancy and Postpartum Health, Faculty of Kinesiology, Sport and Recreation, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada.
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Făgărășan A, Săsăran MO, Gozar L, Toma D, Șuteu C, Ghiragosian-Rusu S, Al-Akel FC, Szabo B, Huțanu A. Circulating Matrix Metalloproteinases for Prediction of Aortic Dilatation in Children with Bicuspid Aortic Valve: A Single-Center, Observational Study. Int J Mol Sci 2024; 25:10538. [PMID: 39408865 PMCID: PMC11476682 DOI: 10.3390/ijms251910538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2024] [Revised: 09/19/2024] [Accepted: 09/25/2024] [Indexed: 10/20/2024] Open
Abstract
Circulating biomarkers have been proposed for early identification of aortic dilatation progression associated with bicuspid aortic valve (BAV), but matrix metalloproteinases (MMPs) are distinguished as signatures of increased extracellular matrix degradation, a landmark of aneurysm formation. The current study aims to identify the role of MMP-1, MMP-2, MMP-9, and the MMP inhibitor, TIMP-1, in identifying aortic dilation in children with BAV. We conducted a study on 73 children divided into two study groups, depending on the presence of aortic dilatation (group 1-43 BAV controls and group 2-30 children with BAV and aortic dilatation). Each patient underwent a cardiac ultrasound and, in each case, serum MMP-1, MMP-2, MMP-9, and TIMP-1 were quantified using xMAP technology. Comparison of the MMPs between the two study groups revealed significantly higher values only in the case of TIMP-1, among BAV controls. Moreover, the same TIMP-1 inversely correlated with aortic annulus absolute size and z score, as well as with ascending aorta z score. No particular correlation between the aortic phenotype and the presence of aortic dilatation was found. Future longitudinal research starting at pediatric ages could show the significance of MMPs screening in BAV individuals as predictors of aortic aneurysm formation.
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Affiliation(s)
- Amalia Făgărășan
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (A.F.); (L.G.); (D.T.); (C.Ș.); (S.G.-R.)
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Maria Oana Săsăran
- Department of Pediatrics III, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540142 Târgu Mureș, Romania
| | - Liliana Gozar
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (A.F.); (L.G.); (D.T.); (C.Ș.); (S.G.-R.)
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Daniela Toma
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (A.F.); (L.G.); (D.T.); (C.Ș.); (S.G.-R.)
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Carmen Șuteu
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (A.F.); (L.G.); (D.T.); (C.Ș.); (S.G.-R.)
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Simina Ghiragosian-Rusu
- Department of Pediatrics III, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (A.F.); (L.G.); (D.T.); (C.Ș.); (S.G.-R.)
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Flavia Cristina Al-Akel
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
- Pathophysiology Department, Faculty of Medicine in English, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania
| | - Boglarka Szabo
- Department of Pediatric Cardiology, Emergency Institute for Cardiovascular Diseases and Transplantation of Târgu Mureș, Gheorghe Marinescu Street No 50, 540136 Târgu Mureș, Romania; (F.C.A.-A.); (B.S.)
| | - Adina Huțanu
- Department of Laboratory Medicine, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
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Gårdinger Y, Dieden A, Hlebowicz J, Björgell O, Dencker M. Effect of food intake on myocardial performance index. Cardiovasc Ultrasound 2017; 15:10. [PMID: 28381254 PMCID: PMC5382399 DOI: 10.1186/s12947-017-0101-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 03/29/2017] [Indexed: 02/06/2023] Open
Abstract
Background Myocardial performance index (MPI) has been investigated in a variety of populations, but the effect of food intake has not been evaluated. We assessed whether myocardial performance index is affected by food intake in healthy subjects. Methods Twenty-three healthy subjects aged 25.6 ± 4.5 years were investigated. MPI was measured before, 30 min after, and 110 min after a standardized meal. Results MPI decreased significantly (P < 0.05) from fasting values 30 min after the meal, and had almost returned to baseline after 110 min. MPI decreased from 0.28 ± 0.06 (fasting) to 0.20 ± 0.07 30 min after eating. At 110 min after eating the index value was almost back to the baseline value 0.26 ± 0.06. (P = 0.15). Conclusions This study shows that myocardial performance index is affected by food intake in healthy subjects.
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Affiliation(s)
- Ylva Gårdinger
- Department of Translational medicine, Unit of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Malmö, Sweden. .,Department of Translational medicine, Unit of Radiology, Skåne University Hospital, Lund University, Malmö, Sweden.
| | - Anna Dieden
- Department of Translational medicine, Unit of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Joanna Hlebowicz
- Department of Clinical Sciences, Division of Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Ola Björgell
- Department of Translational medicine, Unit of Radiology, Skåne University Hospital, Lund University, Malmö, Sweden
| | - Magnus Dencker
- Department of Translational medicine, Unit of Clinical Physiology and Nuclear Medicine, Skåne University Hospital, Lund University, Malmö, Sweden
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