Online citations, reference lists, and bibliographies.
← Back to Search

Predictors Of Exaggerated Exercise-induced Systolic Blood Pressures In Young Patients After Coarctation Repair

Peace C. Madueme, P. Khoury, E. Urbina, T. Kimball
Published 2012 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy Visualize in Litmaps
Share
Reduce the time it takes to create your bibliography by a factor of 10 by using the world’s favourite reference manager
Time to take this seriously.
Get Citationsy
Abstract Background In normotensive subjects, an exaggerated blood pressure response to exercise is associated with the development of resting hypertension. We sought to determine the prevalence of elevated blood pressures during exercise in post-operative coarctation patients with normal resting blood pressure, and investigate associations with exercise-induced hypertension in this population. Methods A total of 38 patients were enrolled after end-to-end anastomosis repair and resting normotension. All patients underwent anthropometric and blood pressure measurements, echocardiographic evaluation of function, arterial stiffness assessment by pulse wave velocity, and a graded exercise test. An abnormal response was defined as a maximum systolic blood pressure greater than the 95th percentile of published normal values. Correlation analyses and stepwise regression analyses were performed. Results The mean age was 12.7 years, including 79% male patients. The mean resting systolic blood pressure was 111.3 millimetres of mercury and the mean exercise systolic blood pressure was 178.1 millimetres of mercury. The prevalence of a systolic blood pressure greater than the 95th percentile was 16.7%. In multivariate analysis, the exercise systolic blood pressure index was associated with body mass index, age, aortic valve annulus, shortening fraction, and pulse wave velocity (R2 equal to 0.79, p equal to 0.0009). Estimates of ventricular filling and indexed left ventricular mass were elevated. Conclusions There is a risk of elevated systolic blood pressure during exercise in normotensive patients after coarctation repair. Resting blood pressures are useful but not sufficient. Echocardiography demonstrated abnormalities suggestive of a chronic cardiac burden despite resting normotension. Regular imaging may be necessary to improve long-term outcomes. New paradigms for the continued follow-up of these patients are necessary.
This paper references
10.1161/01.CIR.41.2.231
Direct Blood Pressure Measurements in Brachial and Femoral Arteries in Children
M. Park (1970)
10.1016/S0002-9149(79)80012-0
Exercise-induced hypertension after surgical repair of coarctation of the aorta.
M. Freed (1979)
10.1161/01.CIR.61.5.902
Responses of Normal Children and Young Adults to Controlled Bicycle Exercise
F. James (1980)
10.1016/0002-9149(86)90771-X
Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings.
R. Devereux (1986)
10.1016/0002-8703(87)90277-8
Correlates of resting and maximal exercise systolic blood pressure after repair of coarctation of the aorta: a multivariable analysis.
S. Daniels (1987)
10.1093/AJH/2.3.135
Blood pressure recovery curves after submaximal exercise. A predictor of hypertension at ten-year follow-up.
J. Tanji (1989)
10.1016/0735-1097(92)90385-Z
Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight.
G. de Simone (1992)
10.1016/0735-1097(94)90563-0
Persistent hyperdynamic cardiovascular state at rest and during exercise in children after successful repair of coarctation of the aorta.
T. Kimball (1994)
10.1093/AJH/7.3.234
Exercise blood pressure response and 5-year risk of elevated blood pressure in a cohort of young adults: the CARDIA study.
T. Manolio (1994)
10.1097/00000539-199509000-00068
Critical Heart Disease in Infants and Children
P. Laussen (1995)
10.1136/ADC.75.4.360
Heart Disease in Infants, Children and Adolescents including the Fetus and Young Adult
L. N. Archer (1996)
10.1017/S1047951100009653
Abnormal responses for blood pressure in children and adults with surgically corrected aortic coarctation
M. Hauser (2000)
10.1097/00004872-200210000-00019
Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions.
J. W. Graves (2002)
10.1097/00004872-200210000-00008
Distribution of 24-h ambulatory blood pressure in children: normalized reference values and role of body dimensions
E. Wühl (2002)
10.1016/S0735-1097(03)00480-7
Ambulatory blood pressure, left ventricular mass, and conduit artery function late after successful repair of coarctation of the aorta.
M. de Divitiis (2003)
10.1016/J.ECHO.2003.12.005
Impact of cardiac growth on Doppler tissue imaging velocities: a study in healthy children.
B. Eidem (2004)
10.1016/J.NUMECD.2005.08.002
Arterial hypertension and cardiovascular prognosis after successful repair of aortic coarctation: a clinical model for the study of vascular function.
M. de Divitiis (2005)
10.1161/01.CIR.0000154900.76284.F6
Recommendations for blood pressure measurement in humans and experimental animals: part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research.
T. Pickering (2005)
10.1016/J.ECHO.2006.09.001
Guidelines and standards for performance of a pediatric echocardiogram: a report from the Task Force of the Pediatric Council of the American Society of Echocardiography.
W. Lai (2006)
10.1161/CIRCULATIONAHA.106.174375
Clinical stress testing in the pediatric age group: a statement from the American Heart Association Council on Cardiovascular Disease in the Young, Committee on Atherosclerosis, Hypertension, and Obesity in Youth.
S. Paridon (2006)
Hypertension after coarctation repair force of the pediatric council of the American Society of Echocardiography
Madueme (2006)
10.1016/J.JTCVS.2007.04.027
Coarctation Long-term Assessment (COALA): significance of arterial hypertension in a cohort of 404 patients up to 27 years after surgical repair of isolated coarctation of the aorta, even in the absence of restenosis and prosthetic material.
A. Hager (2007)
10.1016/j.amjcard.2008.02.072
Exercise capacity and exercise hypertension after surgical repair of isolated aortic coarctation.
A. Hager (2008)
10.1016/J.AHJ.2007.09.008
Increased central aortic stiffness and left ventricular mass in normotensive young subjects after successful coarctation repair.
P. Ou (2008)
Ovid Technologies Inc. Moss and Adams' Heart Disease in Infants, Children, and Adolescents Including the Fetus and Young Adult
A J Moss (2008)
10.1016/S0145-4145(08)79353-5
Angular (Gothic) aortic arch leads to enhanced systolic wave reflection, central aortic stiffness, and increased left ventricular mass late after aortic coarctation repair: Evaluation with magnetic resonance flow mapping
T. Graham (2009)
10.1016/j.echo.2009.03.003
Age-specific reference intervals for indexed left ventricular mass in children.
P. Khoury (2009)
10.1111/J.0954-6820.1967.TB12626.X
Perceived Exertion and Pulse Rate during Graded Exercise in Various Age Groups
G. Borg (2009)
10.1097/HJH.0b013e32833a6132
Increased arterial stiffness is found in adolescents with obesity or obesity-related type 2 diabetes mellitus
E. Urbina (2010)
10.1161/HYPERTENSIONAHA.110.152686
Reference Values of Pulse Wave Velocity in Healthy Children and Teenagers
G. Reusz (2010)



This paper is referenced by
10.1016/j.ijcard.2020.08.095
Multimodal assessment of vascular and ventricular function in children and adults with repaired aortic coarctation.
C. Weismann (2020)
10.5114/aic.2019.90220
Long-term observation of adults after successful repair of aortic coarctation
Beata Róg (2019)
10.1007/s00246-019-02173-5
Exercise Capacity in Asymptomatic Adult Patients Treated for Coarctation of the Aorta
E. J. Dijkema (2019)
10.1016/j.hlc.2018.03.015
A Cross-Sectional Study of the Prevalence of Exercise-Induced Hypertension in Childhood Following Repair of Coarctation of the Aorta.
Taryn L. Luitingh (2019)
10.3389/fped.2018.00148
Cardiac and Vascular Target Organ Damage in Pediatric Hypertension
M. Khoury (2018)
10.1007/978-3-319-31420-4_12-1
Exercise Testing in Hypertension and Hypertension in Athletes
C. Baker-Smith (2017)
10.1038/jhh.2017.55
A systematic review and meta-analysis of exercise and exercise hypertension in patients with aortic coarctation
H. Foulds (2017)
10.1007/s00246-017-1739-x
Hypertension in Coarctation of the Aorta: Challenges in Diagnosis in Children
T. Vigneswaran (2017)
10.1080/14779072.2017.1385392
Reference values for blood pressure response to cycle ergometry in the first two decades of life: comparison with patients with a repaired coarctation of the aorta
Mirna Kaafarani (2017)
10.1007/978-3-319-31420-4_53-1
Vascular and Cardiac Imaging Techniques and Their Applicability to Childhood Hypertension
E. Urbina (2017)
10.1007/s00467-015-3188-1
Abnormalities of vascular structure and function in pediatric hypertension
E. Urbina (2015)
10.1111/echo.12868
Right Ventricular Myocardial Motion and Deformation in Adolescents and Young Adults after Repair of Coarctation of the Aorta
V. W. Li (2015)
10.1007/s11906-014-0421-4
Late Hypertension in Patients with Repaired Aortic Coarctation
J. O'Sullivan (2014)
10.1007/s11936-013-0260-7
Intervention and Management of Congenital Left Heart Obstructive Lesions
Amy Schimke (2013)
Semantic Scholar Logo Some data provided by SemanticScholar