Arterial Mechanics at Rest and During Exercise in Adolescents and Young Adults After Arterial Switch Operation for Complete Transposition of the Great Arteries

Resting and exercise arterial dysfunction in anthracycline-treated adult survivors of childhood cancers

“…High-intensity acute exercise has further been shown to increase carotid-femoral pulse wave velocity, a robust marker of central arterial stiffness, in patients with untreated recently diagnosed grade I essential hypertension but not in healthy subjects [25]. Our group has further reported on potential deleterious effect of augmented arterial stiffness during exercise on dilation of the neoaorta after arterial switch operation [13]. The findings in the present study of an augmented increase in carotid arterial stiffness with levels exceeding normal in about half of the survivors may hence have important haemodynamic and clinical implications as discussed later.…”

“…In patients with coronary artery disease, isometric handgrip exercise has helped to unmask the increase in arterial stiffness [12]. In patients after arterial switch operation for complete transposition of the great arteries, we have found associations between reduced aortic distensibility and strain at submaximal exercise and dilation of the neoaortic sinus [13]. In cancer survivors, dynamic changes of arterial stiffness during exercise have not been studied.…”

Left Ventricular Contractile Reserve in Young Adults Long-Term After Repair of Coarctation of the Aorta

“…Exaggerated blood pressure response during exertion in patients after CoA and IAA repair 3,4 has been hypothesized to be because of structural alteration 17 and stiffening of arteries proximal to the site of obstruction. 18 In patients after arterial switch operation who have stiffening of the ascending aorta at rest and during exercise, 19 Chen et al 16 have reported significantly flattening of the FFR. It is tempting to speculate, therefore, that adverse arterialventricular interaction in relation to chronically increased arterial load may explain worse LV contractile reserve in subjects with a greater blood pressure response during exercise.…”

Coronary artery compression three months after transcatheter pulmonary valve implantation

“…Our case sheds light into another potential mechanism of CAC in patients who may have a negative simulation test and dilated sinuses of Valsalva. As both enlarged aorta and altered aortic distensibility can be seen at rest and exercise in this patient population , a study of the interplay between the dynamic nature of the sinus of Valsalva and its proximity to the RVOT would be helpful. That CAC did not occur until exercise three months later suggests that the increased cardiac output leading to increase in aortic size must have contributed to compression of the RCA ostium.…”