Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study

Jose D. Martins, Justin Zachariah, Elif Seda Selamet Tierney, Uyen Truong, Shaine A. Morris, Shelby Kutty, Sarah D. De Ferranti, Jonathan Rhodes, Marta Antonio, Maria Guarino, Boban Thomas, Diana Oliveira, Kimberlee Gauvreau, Nuno Jalles, Tal Geva, Miguel Carmo, Ashwin Prakash

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Background: Coarctation of the aorta (CoA) can be treated using surgery, balloon angioplasty, or stent implantation. Although short-term results are excellent with all three treatment modalities, long-term cardiovascular (CV) morbidity and mortality remain high, likely due to persistently abnormal vascular function. The effects of treatment modality on long-term vascular function remain uncharacterized. The goal of this study is to assess vascular function in this patient population for comparison among the treatment modalities. Methods: We will prospectively assess vascular Afunction in large and small arteries fusing multiple noninvasive modalities and compare the results among the three groups of CoA patients previously treated using surgery, balloon angioplasty, or stent implantation after frequency matching for confounding variables. A comprehensive vascular function assessment protocol has been created to be used in 7 centers. Our primary outcome is arterial stiffness measured by arterial tonometry. Inclusion and exclusion criteria have been carefully established after consideration of several potential confounders. Sample size has been calculated for the primary outcome variable. Conclusion: Treatment modalities for CoA may have distinct impact on large and small arterial vascular function. The results of this study will help identify the treatment modality that is associated with the most optimal level of vascular function, which, in the long term, may reduce CV risk.

Original languageEnglish (US)
Pages (from-to)282-296
Number of pages15
JournalAnnals of Pediatric Cardiology
Volume11
Issue number3
DOIs
StatePublished - Sep 1 2018

Fingerprint

Aortic Coarctation
Blood Vessels
Balloon Angioplasty
Therapeutics
Stents
Vascular Stiffness
Confounding Factors (Epidemiology)
Manometry
Sample Size
Arteries
Morbidity
Mortality
Population

Keywords

  • Arterial stiffness
  • cardiac magnetic resonance imaging
  • coarctation of the aorta
  • long-term outcomes
  • pulse wave velocity
  • vascular function

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Cardiology and Cardiovascular Medicine

Cite this

Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study. / Martins, Jose D.; Zachariah, Justin; Tierney, Elif Seda Selamet; Truong, Uyen; Morris, Shaine A.; Kutty, Shelby; De Ferranti, Sarah D.; Rhodes, Jonathan; Antonio, Marta; Guarino, Maria; Thomas, Boban; Oliveira, Diana; Gauvreau, Kimberlee; Jalles, Nuno; Geva, Tal; Carmo, Miguel; Prakash, Ashwin.

In: Annals of Pediatric Cardiology, Vol. 11, No. 3, 01.09.2018, p. 282-296.

Research output: Contribution to journalReview article

Martins, JD, Zachariah, J, Tierney, ESS, Truong, U, Morris, SA, Kutty, S, De Ferranti, SD, Rhodes, J, Antonio, M, Guarino, M, Thomas, B, Oliveira, D, Gauvreau, K, Jalles, N, Geva, T, Carmo, M & Prakash, A 2018, 'Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study', Annals of Pediatric Cardiology, vol. 11, no. 3, pp. 282-296. https://doi.org/10.4103/apc.APC_64_18
Martins, Jose D. ; Zachariah, Justin ; Tierney, Elif Seda Selamet ; Truong, Uyen ; Morris, Shaine A. ; Kutty, Shelby ; De Ferranti, Sarah D. ; Rhodes, Jonathan ; Antonio, Marta ; Guarino, Maria ; Thomas, Boban ; Oliveira, Diana ; Gauvreau, Kimberlee ; Jalles, Nuno ; Geva, Tal ; Carmo, Miguel ; Prakash, Ashwin. / Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study. In: Annals of Pediatric Cardiology. 2018 ; Vol. 11, No. 3. pp. 282-296.
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T1 - Rationale and design of long-term outcomes and vascular evaluation after successful coarctation of the aorta treatment study

AU - Martins, Jose D.

AU - Zachariah, Justin

AU - Tierney, Elif Seda Selamet

AU - Truong, Uyen

AU - Morris, Shaine A.

AU - Kutty, Shelby

AU - De Ferranti, Sarah D.

AU - Rhodes, Jonathan

AU - Antonio, Marta

AU - Guarino, Maria

AU - Thomas, Boban

AU - Oliveira, Diana

AU - Gauvreau, Kimberlee

AU - Jalles, Nuno

AU - Geva, Tal

AU - Carmo, Miguel

AU - Prakash, Ashwin

PY - 2018/9/1

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N2 - Background: Coarctation of the aorta (CoA) can be treated using surgery, balloon angioplasty, or stent implantation. Although short-term results are excellent with all three treatment modalities, long-term cardiovascular (CV) morbidity and mortality remain high, likely due to persistently abnormal vascular function. The effects of treatment modality on long-term vascular function remain uncharacterized. The goal of this study is to assess vascular function in this patient population for comparison among the treatment modalities. Methods: We will prospectively assess vascular Afunction in large and small arteries fusing multiple noninvasive modalities and compare the results among the three groups of CoA patients previously treated using surgery, balloon angioplasty, or stent implantation after frequency matching for confounding variables. A comprehensive vascular function assessment protocol has been created to be used in 7 centers. Our primary outcome is arterial stiffness measured by arterial tonometry. Inclusion and exclusion criteria have been carefully established after consideration of several potential confounders. Sample size has been calculated for the primary outcome variable. Conclusion: Treatment modalities for CoA may have distinct impact on large and small arterial vascular function. The results of this study will help identify the treatment modality that is associated with the most optimal level of vascular function, which, in the long term, may reduce CV risk.

AB - Background: Coarctation of the aorta (CoA) can be treated using surgery, balloon angioplasty, or stent implantation. Although short-term results are excellent with all three treatment modalities, long-term cardiovascular (CV) morbidity and mortality remain high, likely due to persistently abnormal vascular function. The effects of treatment modality on long-term vascular function remain uncharacterized. The goal of this study is to assess vascular function in this patient population for comparison among the treatment modalities. Methods: We will prospectively assess vascular Afunction in large and small arteries fusing multiple noninvasive modalities and compare the results among the three groups of CoA patients previously treated using surgery, balloon angioplasty, or stent implantation after frequency matching for confounding variables. A comprehensive vascular function assessment protocol has been created to be used in 7 centers. Our primary outcome is arterial stiffness measured by arterial tonometry. Inclusion and exclusion criteria have been carefully established after consideration of several potential confounders. Sample size has been calculated for the primary outcome variable. Conclusion: Treatment modalities for CoA may have distinct impact on large and small arterial vascular function. The results of this study will help identify the treatment modality that is associated with the most optimal level of vascular function, which, in the long term, may reduce CV risk.

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