BACKGROUND: Increased aortic stiffness and reduced baroreceptor reflex sensitivity have been described independently after coarctation of the aorta (CoA) repair. This study sought to determine the relationship between these variables and blood pressure control in adolescents after early CoA repair. METHODS: Spontaneous baroreceptor reflex sensitivity (sBRS) and aortic pulse wave velocity (PWV) were measured in 29 adolescents after CoA repair and compared with 20 age-matched controls. Patients treated for hypertension or having residual aortic narrowing were excluded. Ambulatory blood pressure (ABP), heart rate variability, and cardiac output were also recorded. After ABP measurement, CoA subjects were classified as normotensive or hypertensive. RESULTS: Nine patients (31%) were hypertensive according to standard definitions, and this subgroup had higher aortic PWV than the normotensive subgroup (P = .004). There was a significant positive correlation between ABP and PWV seen in the whole CoA group (r(2) = 0.5, P < .01). The normotensive subgroup had increased sBRS compared with controls (P = .02). This difference was not seen between the hypertensive subgroup and controls. There was a significant inverse relationship between sBRS and aortic PWV in the whole CoA group (r(2) = 0.25, P = .01). The normotensive subgroup had a significant reduction in stroke index compared with controls (P = .02), which was not seen in the hypertensive subgroup (P = .96). CONCLUSIONS: Adolescents with hypertension after CoA repair have increased aortic PWV and a relative reduction in sBRS compared with normotensive CoA patients. Thus, failure of the baroreceptor reflex to compensate for increasing arterial stiffness may herald the onset of hypertension in these patients.
BACKGROUND: Increased aortic stiffness and reduced baroreceptor reflex sensitivity have been described independently after coarctation of the aorta (CoA) repair. This study sought to determine the relationship between these variables and blood pressure control in adolescents after early CoA repair. METHODS: Spontaneous baroreceptor reflex sensitivity (sBRS) and aortic pulse wave velocity (PWV) were measured in 29 adolescents after CoA repair and compared with 20 age-matched controls. Patients treated for hypertension or having residual aortic narrowing were excluded. Ambulatory blood pressure (ABP), heart rate variability, and cardiac output were also recorded. After ABP measurement, CoA subjects were classified as normotensive or hypertensive. RESULTS: Nine patients (31%) were hypertensive according to standard definitions, and this subgroup had higher aortic PWV than the normotensive subgroup (P = .004). There was a significant positive correlation between ABP and PWV seen in the whole CoA group (r(2) = 0.5, P < .01). The normotensive subgroup had increased sBRS compared with controls (P = .02). This difference was not seen between the hypertensive subgroup and controls. There was a significant inverse relationship between sBRS and aortic PWV in the whole CoA group (r(2) = 0.25, P = .01). The normotensive subgroup had a significant reduction in stroke index compared with controls (P = .02), which was not seen in the hypertensive subgroup (P = .96). CONCLUSIONS: Adolescents with hypertension after CoA repair have increased aortic PWV and a relative reduction in sBRS compared with normotensive CoA patients. Thus, failure of the baroreceptor reflex to compensate for increasing arterial stiffness may herald the onset of hypertension in these patients.
Authors: Raymond R Townsend; Ian B Wilkinson; Ernesto L Schiffrin; Alberto P Avolio; Julio A Chirinos; John R Cockcroft; Kevin S Heffernan; Edward G Lakatta; Carmel M McEniery; Gary F Mitchell; Samer S Najjar; Wilmer W Nichols; Elaine M Urbina; Thomas Weber Journal: Hypertension Date: 2015-07-09 Impact factor: 10.190
Authors: Adelaide de Vecchi; Rachel E Clough; Nicholas R Gaddum; Marcel C M Rutten; Pablo Lamata; Tobias Schaeffter; David A Nordsletten; Nicolas P Smith Journal: IEEE Trans Biomed Eng Date: 2014-06 Impact factor: 4.538
Authors: Jonathan C L Rodrigues; Matthew F R Jaring; Melissa C Werndle; Konstantina Mitrousi; Stephen M Lyen; Angus K Nightingale; Mark C K Hamilton; Stephanie L Curtis; Nathan E Manghat; Julian F R Paton; Emma C Hart Journal: J Cardiovasc Magn Reson Date: 2019-11-07 Impact factor: 5.364
Authors: Niky Ghorbani; Vivek Muthurangu; Abbas Khushnood; Leonid Goubergrits; Sarah Nordmeyer; Joao Filipe Fernandes; Chong-Bin Lee; Kilian Runte; Sophie Roth; Stephan Schubert; Sebastian Kelle; Felix Berger; Titus Kuehne; Marcus Kelm Journal: BMJ Open Date: 2020-03-25 Impact factor: 2.692