BP in coarctation:genomic,autonomic and ventricular-vascular influence
Research type
Research Study
Full title
Evaluation of genomic, autonomic, and ventricular-vascular influences on blood pressure control post coarctation repair
IRAS ID
122670
Contact name
Massimo Caputo
Contact email
Research summary
Coarctation of the aorta is the fifth most common congenital heart defect. It is classically manifest by a narrowing of the aorta distal to the origin of the left subclavian artery, but can affect the aortic arch in a highly variable manner. Hypertension remains a major long term consequence despite successful surgical repair at an early age. it is unclear as to why some patients go on to develop hypertension whilst others do not despite similar surgical outcome. We hypothesize that patients with increased expression of specific genes implicated in vascular remodelling have higher risk of developing hypertension and other cardiovascular morbidity despite coarctation repair. They are also likely to have autonomic dysfunction (leading to hypertension) which although not exhibited during rest may be expressed during stress in addition to abnormal ventricular-vascular interaction. We propose a study to analyse mRNA transcripts from coarctectomy tissue for specific genes associated with inflammation and vascular remodelling which is known to contribute to hypertensive changes. The tissue specimens are collected from discarded aortic tissue which are held for diagnostic purposes during coarctation repair. At the same time, we will evaluate the clinical outcome of these children by assessing for abnormalities in ambulatory blood pressure, autonomic function and ventricular-vascular interaction. The primary aim is to analyse the expression patterns of genes in aortic tissue associated with development of hypertension and correlate genetic findings with clinical outcomes. the secondary aim of this study is to evaluate blood pressure profile and ventricular-vascular interaction in patients post coarctation repair compared with normal population. Identification of clinically useful tools to predict development of hypertension would help to guide early preventive therapy and to inform prognosis.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
14/SW/0118
Date of REC Opinion
7 Aug 2014
REC opinion
Further Information Favourable Opinion