Haemodynamics after coarctation repair during isometric exercise
Research type
Research Study
Full title
MR assessment of haemodynamics in patients after coarctation repair during submaximal isometric exercise compared with healthy volunteers.
IRAS ID
181439
Contact name
Vivek Muthurangu
Contact email
Sponsor organisation
Great Ormond Street Hospital for Children NHS foundation Trust & The UCL Institute of Child Health
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Coarctation of Aorta (CoA) is a narrowing of the large blood vessel (aorta), which branches off the heart and delivers oxygen-rich blood to the body. It is generally present at birth (congenital) and accounts for 5-10% of all congenital heart disease. Despite successful repair of CoA during infancy, the prevalence of high blood pressure later as adults is seen in up to 45% cases. Different mechanisms have been proposed: abnormal signaling pathway in kidneys, brain dysfunction and abnormal vessel wall. This increase in blood pressure can lead to cardiac illness (morbidity) like premature cardiac, coronary, aortic, and cerebrovascular complications, including premature death (mortality).
Furthermore, subjects with normal blood pressure at rest may show abnormal blood pressure values during exercise and daily activities. Exercise can unmask disease at a very early stage before symptoms become readily apparent. There is evidence to suggest that isometric exercise (where our muscles stay the same length but exercise by tensing) is ideal for unmasking blood vessel changes in certain conditions.
We hypothesise that young adults with early CoA repair have a primary arterial wall abnormality rather than a localised residual defect. Hence we plan to carry out an entirely non-invasive study where adults will have a resting Cardiac MRI scan and then perform isometric exercise whilst having a continuous MRI scan. The study aims at characterising blood vessel wall abnormalities by assessing cardiac output (using blood flow), blood pressure changes, heart function, vessel wall stiffness (using pulse-wave velocity) and blood flow to the brain during exercise compared to healthy controls.
REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
15/LO/1605
Date of REC Opinion
14 Oct 2015
REC opinion
Favourable Opinion