Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-16T07:27:01.573Z Has data issue: false hasContentIssue false
  • English
  • Français

Is the burden of late hypertension and cardiovascular target organ damage in children and adolescents with coarctation of the aorta after early successful repair different to healthy controls?

Published online by Cambridge University Press:  22 July 2020

Ayşe Ağbaş Open the ORCID record for Ayşe Ağbaş [Opens in a new window] ,
Selman Gökalp Open the ORCID record for Selman Gökalp [Opens in a new window] ,
Nur Canpolat ,
Salim Çalışkan  and
Funda Öztunç
Ayşe Ağbaş*
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Selman Gökalp
Affiliation:
Department of Pediatric Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Nur Canpolat
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Salim Çalışkan
Affiliation:
Department of Pediatric Nephrology, Istanbul University-Cerrahpasa, Istanbul, Turkey
Funda Öztunç
Affiliation:
Department of Pediatric Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
*
Author for correspondence: A. Ağbaş, MD, Istanbul University-Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey. Tel: +905053171245; Fax: +902126328633. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Cardiovascular morbidity is high in patients with coarctation of aorta even after successful repair. This study aimed to assess the frequency of late hypertension and the relationship between ambulatory hypertension and cardiovascular target organ damage in children and adolescents after early and successful repair of coarctation of the aorta.

Methods:

Twenty-five children and adolescents (mean age 13.5 ± 3.43 years) with repaired coarctation of the aorta (median age at repair 4 months, arm–leg gradient <20 mmHg) and 16 healthy controls were included. Office and ambulatory blood pressure, pulse wave velocity, and left ventricular mass index were assessed.

Results:

Both day- and night-time systolic blood pressure standard deviation score and left ventricular mass index were significantly higher in patients compared to controls (p ≤ 0.001 for all), whereas pulse wave velocity did not differ. The prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy were 40, 28, and 24%, respectively. Left ventricular mass index was higher in patients with sustained hypertension, masked hypertension, and normotension compared to controls (p < 0.05). In multivariate analysis, higher night-time systolic blood pressure standard deviation score was the only independent predictor of left ventricular mass index.

Conclusion:

The present study reveals a high prevalence of masked hypertension, isolated nocturnal hypertension, and left ventricular hypertrophy in children and adolescents with coarctation of the aorta even after early and successful repair. Ambulatory blood pressure monitoring should be considered to diagnose hypertension. All coarctation of aorta patients should be followed up lifelong and encouraged to establish a healthy lifestyle starting from childhood.

Keywords

Coarctation of aortahypertensiontarget organ damageleft ventricular hypertrophyambulatory blood pressure monitoring
Type
Original Article
Information
Cardiology in the Young , Volume 30 , Issue 9 , September 2020 , pp. 1305 - 1312
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bower, C, Ramsay, JM. Congenital heart disease: a 10 year cohort. J Paediatr Child Health 1994; 30: 414–418. doi: 10.1111/j.1440-1754.1994.tb00691.xCrossRefGoogle ScholarPubMed
Campbell, M. Natural history of coarctation of the aorta. Br Heart J 1970; 32: 633–640. doi: 10.1136/hrt.32.5.633CrossRefGoogle ScholarPubMed
Vigneswaran, TV, Sinha, MD, Valverde, I, Simpson, JM, Charakida, M. Hypertension in coarctation of the aorta: challenges in diagnosis in children. Pediatr Cardiol 2018; 39: 1–10. doi: 10.1007/s00246-017-1739-xCrossRefGoogle ScholarPubMed
Bocelli, A, Favilli, S, Pollini, I, et al.Prevalence and long-term predictors of left ventricular hypertrophy, late hypertension, and hypertensive response to exercise after successful aortic coarctation repair. Pediatr Cardiol 2013; 34: 620–629. doi: 10.1007/s00246-012-0508-0CrossRefGoogle ScholarPubMed
Kenny, D, Polson, JW, Martin, RP, et al.Relationship of aortic pulse wave velocity and baroreceptor reflex sensitivity to blood pressure control in patients with repaired coarctation of the aorta. Am Heart J 2011; 162: 398–404. doi: 10.1016/j.ahj.2011.03.029CrossRefGoogle ScholarPubMed
Lee, MG, Kowalski, R, Galati, JC, et al.Twenty-four-hour ambulatory blood pressure monitoring detects a high prevalence of hypertension late after coarctation repair in patients with hypoplastic arches. J Thorac Cardiovasc Surg 2012; 144: 1110–1116. doi: 10.1016/j.jtcvs.2012.08.013CrossRefGoogle ScholarPubMed
O’Sullivan, JJ, Derrick, G, Darnell, R. Prevalence of hypertension in children after early repair of coarctation of the aorta: a cohort study using casual and 24 hour blood pressure measurement. Heart 2002; 88: 163–166. doi: 10.1136/heart.88.2.163CrossRefGoogle ScholarPubMed
Canniffe, C, Ou, P, Walsh, K, Bonnet, D, Celermajer, D. Hypertension after repair of aortic coarctation--a systematic review. Int J Cardiol 2013; 167: 2456–2461. doi: 10.1016/j.ijcard.2012.09.084CrossRefGoogle ScholarPubMed
de Divitiis, M, Pilla, C, Kattenhorn, M, et al.Vascular dysfunction after repair of coarctation of the aorta: impact of early surgery. Circulation 2001; 104: I165–I170. doi: 10.1161/hc37t1.094900CrossRefGoogle ScholarPubMed
Gardiner, HM, Celermajer, DS, Sorensen, KE, et al.Arterial reactivity is significantly impaired in normotensive young adults after successful repair of aortic coarctation in childhood. Circulation 1994; 89: 1745–1750. doi: 10.1161/01.cir.89.4.1745CrossRefGoogle ScholarPubMed
Meyer, AA, Joharchi, MS, Kundt, G, et al.Predicting the risk of early atherosclerotic disease development in children after repair of aortic coarctation. Eur Heart J 2005; 26: 617–622. doi: 10.1093/eurheartj/ehi037CrossRefGoogle ScholarPubMed
Ou, P, Bonnet, D, Auriacombe, L, et al.Late systemic hypertension and aortic arch geometry after successful repair of coarctation of the aorta. Eur Heart J 2004; 25: 1853–1859. doi: 10.1016/j.ehj.2004.07.021CrossRefGoogle ScholarPubMed
Parker, FB Jr., Streeten, DH, Farrell, B, et al.Preoperative and postoperative renin levels in coarctation of the aorta. Circulation 1982; 66: 513–514. doi: 10.1161/01.cir.66.3.513CrossRefGoogle ScholarPubMed
Polson, JW, McCallion, N, Waki, H, et al.Evidence for cardiovascular autonomic dysfunction in neonates with coarctation of the aorta. Circulation 2006; 113: 2844–2850. doi: 10.1161/CIRCULATIONAHA.105.602748CrossRefGoogle ScholarPubMed
Stout, KK, Daniels, CJ, Aboulhosn, JA, et al.2018 AHA/ACC guideline for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 2019; 139: e698–e800. doi: 10.1161/CIR.0000000000000603Google Scholar
Flynn, JT, Kaelber, DC, Baker-Smith, CM, et al.Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140: e20171904. doi: 10.1542/peds.2017-1904CrossRefGoogle ScholarPubMed
Flegal, KM, Cole, TJ. Construction of LMS parameters for the Centers for Disease Control and Prevention 2000 growth charts. Natl Health Stat Report 2013; 63: 1–3.Google Scholar
Flynn, JT, Daniels, SR, Hayman, LL, et al.Update: ambulatory blood pressure monitoring in children and adolescents: a scientific statement from the American Heart Association. Hypertension 2014; 63: 1116–1135. doi: 10.1161/HYP.0000000000000007CrossRefGoogle ScholarPubMed
Wuhl, E, Witte, K, Soergel, M, et al.Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions. J Hypertens 2002; 20: 1995–2007. doi: 10.1097/00004872-200210000-00019CrossRefGoogle ScholarPubMed
Thurn, D, Doyon, A, Sozeri, B, et al.Aortic Pulse Wave Velocity in Healthy Children and Adolescents: Reference Values for the Vicorder Device and Modifying Factors. Am J Hypertens 2015; 28: 1480–1488. doi: 10.1093/ajh/hpv048CrossRefGoogle ScholarPubMed
Lopez, L, Colan, SD, Frommelt, PC, et al.Recommendations for quantification methods during the performance of a pediatric echocardiogram: a report from the Pediatric Measurements Writing Group of the American Society of Echocardiography Pediatric and Congenital Heart Disease Council. J Am Soc Echocardiogr 2010; 23: 465–495; quiz 576-467. doi: 10.1016/j.echo.2010.03.019CrossRefGoogle ScholarPubMed
Kampmann, C, Wiethoff, CM, Wenzel, A, et al.Normal values of M mode echocardiographic measurements of more than 2000 healthy infants and children in central Europe. Heart 2000; 83: 667–672. doi: 10.1136/heart.83.6.667CrossRefGoogle ScholarPubMed
Devereux, RB, Alonso, DR, Lutas, EM, et al.Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol 1986; 57: 450–458. doi: 10.1016/0002-9149(86)90771-xCrossRefGoogle ScholarPubMed
Khoury, PR, Mitsnefes, M, Daniels, SR, Kimball, TR. Age-specific reference intervals for indexed left ventricular mass in children. J Am Soc Echocardiogr 2009; 22: 709–714. doi: 10.1016/j.echo.2009.03.003CrossRefGoogle ScholarPubMed
Presbitero, P, Demarie, D, Villani, M, et al.Long term results (15-30 years) of surgical repair of aortic coarctation. Br Heart J 1987; 57: 462–467. doi: 10.1136/hrt.57.5.462CrossRefGoogle ScholarPubMed
Vriend, JW, Zwinderman, AH, de Groot, E, et al.Predictive value of mild, residual descending aortic narrowing for blood pressure and vascular damage in patients after repair of aortic coarctation. Eur Heart J 2005; 26: 84–90. doi: 10.1093/eurheartj/ehi004CrossRefGoogle ScholarPubMed
Trojnarska, O, Mizia-Stec, K, Gabriel, M, et al.Parameters of arterial function and structure in adult patients after coarctation repair. Heart Vessels 2011; 26: 414–420. doi: 10.1007/s00380-010-0063-7CrossRefGoogle ScholarPubMed
Mizia-Stec, K, Trojnarska, O, Szczepaniak-Chichel, L, et al.Asymmetric dimethylarginine and vascular indices of atherosclerosis in patients after coarctation of aorta repair. Int J Cardiol 2012; 158: 364–369. doi: 10.1016/j.ijcard.2011.01.037CrossRefGoogle ScholarPubMed
Luijendijk, P, Lu, H, Heynneman, FB, et al.Increased carotid intima-media thickness predicts cardiovascular events in aortic coarctation. Int J Cardiol 2014; 176: 776–781. doi: 10.1016/j.ijcard.2014.07.090CrossRefGoogle ScholarPubMed
Dempsey, AA, Parraga, G, Altamirano-Diaz, L, et al.Increased blood pressure is associated with increased carotid artery intima-media thickness in children with repaired coarctation of the aorta. J Hypertens 2019; 37: 1689–1698. doi: 10.1097/HJH.0000000000002077CrossRefGoogle ScholarPubMed
Di Salvo, G, Castaldi, B, Baldini, L, et al.Masked hypertension in young patients after successful aortic coarctation repair: impact on left ventricular geometry and function. J Hum Hypertens 2011; 25: 739–745. doi: 10.1038/jhh.2010.118CrossRefGoogle ScholarPubMed
Nur, N, Cetinkaya, S, Yilmaz, A, et al.Prevalence of hypertension among high school students in a middle Anatolian province of Turkey. J Health Popul Nutr 2008; 26: 88–94.Google Scholar
Bald, M, Neudorf, U. Arterial hypertension in children and adolescents after surgical repair of aortic coarctation defined by ambulatory blood pressure monitoring. Blood Press Monit 2000; 5: 163–167. doi: 10.1097/00126097-200006000-00004CrossRefGoogle ScholarPubMed
Giordano, U, Matteucci, MC, Calzolari, A, et al.Ambulatory blood pressure monitoring in children with aortic coarctation and kidney transplantation. J Pediatr 2000; 136: 520–523. doi: 10.1016/s0022-3476(00)90016-7CrossRefGoogle ScholarPubMed
Rinnstrom, D, Dellborg, M, Thilen, U, et al.Poor blood pressure control in adults with repaired coarctation of the aorta and hypertension: a register-based study of associated factors. Cardiol Young 2017; 27: 1708–1715. doi: 10.1017/S1047951117001020CrossRefGoogle ScholarPubMed
Sehested, J, Baandrup, U, Mikkelsen, E. Different reactivity and structure of the prestenotic and poststenotic aorta in human coarctation. Implications for baroreceptor function. Circulation 1982; 65: 1060–1065. doi: 10.1161/01.cir.65.6.1060CrossRefGoogle ScholarPubMed
Khoury, M, Urbina, EM. Cardiac and vascular target organ damage in pediatric hypertension. Front Pediatr 2018; 6: 148. doi: 10.3389/fped.2018.00148CrossRefGoogle ScholarPubMed
Voges, I, Jerosch-Herold, M, Hedderich, J, et al.Normal values of aortic dimensions, distensibility, and pulse wave velocity in children and young adults: a cross-sectional study. J Cardiovasc Magn Reson 2012; 14: 77. doi: 10.1186/1532-429X-14-77CrossRefGoogle Scholar
Jesus, CA, Assef, JE, Pedra, SR, et al.Serial assessment of arterial structure and function in patients with coarctation of the aorta undergoing stenting. Int J Cardiovasc Imaging 2016; 32: 729–739. doi: 10.1007/s10554-015-0827-3CrossRefGoogle ScholarPubMed
Ou, P, Celermajer, DS, Mousseaux, E, et al.Vascular remodeling after “successful” repair of coarctation: impact of aortic arch geometry. J Am Coll Cardiol 2007; 49: 883–890. doi: 10.1016/j.jacc.2006.10.057CrossRefGoogle ScholarPubMed
Voges, I, Kees, J, Jerosch-Herold, M, et al.Aortic stiffening and its impact on left atrial volumes and function in patients after successful coarctation repair: a multiparametric cardiovascular magnetic resonance study. J Cardiovasc Magn Reson 2016; 18: 56. doi: 10.1186/s12968-016-0278-6CrossRefGoogle ScholarPubMed
Schafer, M, Morgan, GJ, Mitchell, MB, et al.Impact of different coarctation therapies on aortic stiffness: phase-contrast MRI study. Int J Cardiovasc Imaging 2018; 34: 1459–1469. doi: 10.1007/s10554-018-1357-6CrossRefGoogle ScholarPubMed
Lee, MGY, Hemmes, RA, Mynard, J, et al.Elevated sympathetic activity, endothelial dysfunction, and late hypertension after repair of coarctation of the aorta. Int J Cardiol 2017; 243: 185–190. doi: 10.1016/j.ijcard.2017.05.075CrossRefGoogle ScholarPubMed
Lombardi, KC, Northrup, V, McNamara, RL, Sugeng, L, Weismann, CG. Aortic stiffness and left ventricular diastolic function in children following early repair of aortic coarctation. Am J Cardiol 2013; 112: 1828–1833. doi: 10.1016/j.amjcard.2013.07.052CrossRefGoogle ScholarPubMed
Murakami, T, Takeda, A, Yamazawa, H, et al.Aortic pressure wave reflection in patients after successful aortic arch repair in early infancy. Hypertens Res 2013; 36: 603–607. doi: 10.1038/hr.2013.1CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Ağbaş et al. supplementary material

Tables S1-S2

Download Ağbaş et al. supplementary material(PDF)
PDF 199.2 KB