Abstract Background Patients with cyanosis secondary to congenital heart disease (CHD) are characterized by erythrocytosis and increased blood viscosity, which contributes to endothelial dysfunction that is associated with an increased risk of atherosclerosis. Flow-mediated dilatation (FMD) is a phenomenon associated with NO release that indirectly assesses endothelium function. The intima-media complex measured in the carotid artery indicates the severity of atherosclerosis. Aim The aim of this study is to evaluate the intima-media complex and flow mediated dilation and demonstrate their potential relationship with the clinical presentation in cyanotic population. Methods A cross-sectional study including 36 adult CHD cyanotic patients [(12 males)(39 median, 19-73 years)] with arterial blood oxygen saturation less than 92% and 30 healthy controls [(11 males)(38.5 median, 26-59 years)] was performed. All patients underwent clinical examination, blood testing, and echocardiography. Endothelial function was assessed using intima-media thickness and flow-mediated dilatation during ultrasonography. Lipid profile, erythrocytosis indicators, as well as inflammatory and vascular markers, including sphingosine-1-phosphate, were measured. Results We did not demonstrate any difference between CHD patients and the control group in the intima-media complex, flow-mediated dilatation, and the size of the brachial artery after ischemia. Among the laboratory indicators of erythrocytosis, atherosclerosis, and inflammation, the size of the brachial artery after ischemia correlated positively with the level of erythrocytes (p=0.008), hemoglobin (p=0.02), hematocrit (p=0.03), LDL cholesterol (p=0.01), and negatively with d-dimer (p=0.003). Flow-mediated dilation correlated positively only with HDL cholesterol (p=0.02) concentration. The intima-media complex correlates positively only with body mass index (p=0.04). Conclusions Endothelial function assessed by FMD and the severity of atherosclerosis assessed by IMT do not appear to be abnormal in patients with cyanosis secondary to CHD. Endothelial dysfunction Logistic regression for FMD<7%
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