Daniel Rinnström1, Mikael Dellborg2, Ulf Thilén3, Peder Sörensson4, Niels-Eric Nielsen5, Christina Christersson6, Bengt Johansson7. 1. Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden. 2. Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden. 3. Department of Cardiology, Clinical Sciences, Lund University, Sweden. 4. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. 5. Department of Medical and Health Sciences, Linköping University, Sweden. 6. Department of Clinical Sciences, Uppsala University, Sweden. 7. Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Sweden. Electronic address: bengt.johansson@umu.se.
Abstract
BACKGROUND: Arterial hypertension is common in adults with repaired coarctation of the aorta (CoA). The associations between the diagnosis of hypertension, actual blood pressure, other factors affecting left ventricular overload, and left ventricular hypertrophy (LVH) are not yet fully explored in this population. MATERIAL AND RESULTS: From the national register for congenital heart disease, 506 adult patients (≥18years old) with previous repair of CoA were identified (37.0% female, mean age 35.7±13.8years, with an average of 26.8±12.4years post repair). Echocardiographic data were available for all patients, and showed LVH in 114 (22.5%) of these. Systolic blood pressure (SBP) (mmHg) (OR 1.02, CI 1.01-1.04), aortic valve disease, (OR 2.17, CI 1.33-3.53), age (years) (OR 1.03, CI 1.01-1.05), diagnosis of arterial hypertension (OR 3.02, CI 1.81-5.02), and sex (female) (OR 0.41, CI 0.24-0.72) were independently associated with LVH. There was an association with LVH at SBP within the upper reference limits [130, 140] mmHg (OR 2.23, CI 1.05-4.73) that further increased for SBP>140mmHg (OR 8.02, CI 3.76-17.12). CONCLUSIONS: LVH is common post repair of CoA and is associated with SBP even below the currently recommended target level. Lower target levels may therefore become justified in this population.
BACKGROUND:Arterial hypertension is common in adults with repaired coarctation of the aorta (CoA). The associations between the diagnosis of hypertension, actual blood pressure, other factors affecting left ventricular overload, and left ventricular hypertrophy (LVH) are not yet fully explored in this population. MATERIAL AND RESULTS: From the national register for congenital heart disease, 506 adult patients (≥18years old) with previous repair of CoA were identified (37.0% female, mean age 35.7±13.8years, with an average of 26.8±12.4years post repair). Echocardiographic data were available for all patients, and showed LVH in 114 (22.5%) of these. Systolic blood pressure (SBP) (mmHg) (OR 1.02, CI 1.01-1.04), aortic valve disease, (OR 2.17, CI 1.33-3.53), age (years) (OR 1.03, CI 1.01-1.05), diagnosis of arterial hypertension (OR 3.02, CI 1.81-5.02), and sex (female) (OR 0.41, CI 0.24-0.72) were independently associated with LVH. There was an association with LVH at SBP within the upper reference limits [130, 140] mmHg (OR 2.23, CI 1.05-4.73) that further increased for SBP>140mmHg (OR 8.02, CI 3.76-17.12). CONCLUSIONS: LVH is common post repair of CoA and is associated with SBP even below the currently recommended target level. Lower target levels may therefore become justified in this population.
Authors: Iris D Noordman; Zina Fejzic; Melanie Bos; Anthonie L Duijnhouwer; Gert Weijers; Marlies Kempers; Remy Merkx; Janiëlle A E M van der Velden; Livia Kapusta Journal: Am J Med Genet A Date: 2021-05-10 Impact factor: 2.802