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Atherosclerosis in Patients With Cyanotic Congenital Heart Disease

2010; Japanese Circulation Society; Volume: 74; Issue: 7 Linguagem: Inglês

10.1253/circj.cj-09-0858

1347-4820

Mari euml lle GJ Duffels, Karlijn M Mulder, Mieke D. Trip, Erik de Groot, Johan Gort, Arie P.J. van Dijk, Elke S. Hoendermis, Luciano Daliento, A. H. Zwinderman, Rolf M.F. Berger, Barbara J.M. Mulder,

Cardiovascular Function and Risk Factors

Background: Cyanotic patients with congenital heart disease (CHD) might be protected against atherosclerosis. Methods and Results: Atherosclerotic risk factors and carotid intima - media thickness (IMT) were investigated in adults with cyanotic CHD and in unaffected age- and sex-matched controls. Fifty-four cyanotic patients (30 men, mean age 38, range 19-60 years) and 54 controls were included. Mean transcutaneous saturation of the cyanotic patients was 81±6%. Mean carotid IMT adjusted for age was significantly decreased in cyanotic patients compared to controls (0.55±0.1 mm vs 0.58±0.08 mm: ΔIMT =0.04 mm [SE 0.015], P=0.01). In cyanotic patients lower total cholesterol levels were observed (4.4±1 mmol/L vs 4.9±1 mmol/L; P=0.02), as well as lower thrombocyte levels (173±81×109 /L vs 255±54×109 /L; P<0.01), higher bilirubin levels (18.6±11 μmol/L vs 12.7±6 μmol/L; P<0.01), and lower diastolic and systolic blood pressure (71±9 mmHg vs 76±9 mmHg, P<0.01; 113±14 mmHg vs 124±12 mmHg, P<0.01, respectively). Conclusions: In patients with cyanotic CHD carotid IMT, and hence atherosclerosis disease risk, was decreased. This might be due to a combination of reduced atherosclerotic risk factors such as lower blood pressure, lower total cholesterol levels, higher bilirubin levels and lower thrombocyte levels. (Circ J 2010; 74: 1436 - 1441)