Abstract 11362: Applanation Tonometry Reveals Increased Arterial Stiffness Associated With Aortic Dilatation in Adults With Repaired Tetralogy of Fallot
Purpose: Aortic root dilatation has been observed in adults with repaired tetralogy of Fallot (TOF) but remains insufficiently understood. Histological abnormalities of the aortic wall including elastic fragmentation and fibrosis have been reported. We hypothesized that aortic root diameters may be related to increased arterial stiffness in these patients.[[Unable to Display Character:]]
Methods: We recruited 35 consecutive patients with repaired TOF (mean age 39±15 years, 18 males) and 25 healthy controls (mean age 36±14 years, 11 males). All subjects underwent prospective assessment of augmentation index, pulse wave velocity and central pulse pressure using applanation tonometry (SphygmoCor, AtCor Medical Ltd, Australia). Aortic root dimensions were measured by 2D echocardiography and z-scores were calculated to adjust for body surface area and age.
Results: Aortic root dimensions were significantly larger in patients as compared to controls (z-score, 2.74 ± 2.29 vs. -0.77 ± 1.11). Augmentation index (AIx, 17.55 ± 14.23 % vs. -1.74 ± 15.79 %), pulse wave velocity (PWV, 6.46 ± 1.49 m/s vs. 5.70 ± 0.95 m/s) and central aortic pulse pressure (CPP, 39.29 ± 11.81 mmHg vs. 31.09 ± 9.32 mmHg) were significantly higher in patients as compared to controls (Figure 1). PWV and CPP were related to aortic root z-score (Spearman's r= 0.35, p=0.039 and r=0.39, p=0.019).
Conclusions: Arterial stiffness is significantly increased in adults with repaired TOF. These hemodynamic changes are associated with an increase in aortic root diameter, emphasizing the presence of clinically relevant aortopathy in TOF. Further studies are needed to evaluate the prognostic value of applanation tonometry in these patients.
- © 2012 by American Heart Association, Inc.