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Ambulatory blood pressure monitoring and left ventricular mass and function after successful surgical repair of coarctation of the aorta
- Source :
- Journal of the American College of Cardiology. 20(1):197-204
- Publication Year :
- 1992
- Publisher :
- Elsevier BV, 1992.
-
Abstract
- Late cardiovascular morbidity and mortality remain significant despite apparently successful surgical repair of aortic coarctation. Alterations in cardiac function have been reported in normotensive patients who have had successful repair, the reasons for which remain unclear. This study addresses the relation between ambulatory blood pressure measurements and alterations in left ventricular performance in 20 patients with normotension at rest after successful repair of aortic coarctation. Exercise testing, ambulatory blood pressure monitoring and two-dimensional echocardiographic studies in 13 boys and 7 girls (mean age 14.2 ± 2.31 and 14.7 ± 3 years, respectively) who had no evidence of recoarctation were compared with the findings in 20 matched control subjects.No difference was found in systolic blood pressure at rest or peak exercise between patients and control subjects. Male patients developed a significant arm/leg gradient at peak exercise. Systolic ambulatory blood pressure was higher throughout the day in the male group. In the female group, systolic blood pressure was higher only during sleep. No difference was found in diastolic blood pressure or heart rate. The transverse aortic arch was smaller and the left ventricular mass greater in all patients. The relation of wall stress to rate-corrected velocity of shortening was 2 SD above normal in 8 of the 20 patients, suggesting that some have enhanced contractility. The E/A ratio on the atrial echocardiogram was significantly reduced in the patient group.Successfully treated patients who are normotensive at rest after operation are still at risk for developing end organ damage, which is probably explained by incipient mild hypertension documented by ambulatory blood pressure monitoring.
- Subjects :
- Aortic arch
Adult
Male
medicine.medical_specialty
Ambulatory blood pressure
Adolescent
Systole
Diastole
Coarctation of the aorta
Aorta, Thoracic
Aortic Coarctation
Ventricular Function, Left
medicine.artery
Internal medicine
medicine
Ambulatory Care
Humans
Child
Monitoring, Physiologic
Sex Characteristics
business.industry
Blood Pressure Determination
medicine.disease
Blood pressure
Echocardiography
Ambulatory
Cardiology
Aortic pressure
Exercise Test
Female
business
Cardiology and Cardiovascular Medicine
Subjects
Details
- ISSN :
- 07351097
- Volume :
- 20
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Cardiology
- Accession number :
- edsair.doi.dedup.....09abf40746afba5e739cbcb923b17fb2
- Full Text :
- https://doi.org/10.1016/0735-1097(92)90159-k