Background The majority of the patients after successful operation of coarctation of the aorta (CoAo) suffer from arterial hypertension (AH) and some from exercise induced arterial hypertension (AHex). The aim of the study was evaluate exercise capacity in cardiopulmonary exercise test and left ventricular mass on echocardiography examination in adult patients after surgical repair of CoAo according to presence of AH and AHex.
Material and methods the analysis of 74 patients (29 females) aged 31.2 ± 9.8 years operated at mean age 10.4 ± 6.6 years. Control group: 30 volunteers (12 females) aged 32.2 ± 6.6 years. On echocardiography LV mass (LVM) and LV mass index (LVMI) were calculated. All patients performed a maximal, symptom-limited treadmill exercise test according to modified Bruce protocol. The maximal oxygen consumption (peak VO₂), ventilation/carbon dioxide slope (VE/ /VCO₂) were measured. Arterial hypertension was measured at rest and during max. exercise. AHex was defined as systolic pressure at peak exercise > 200 mm Hg in patients with initially normal blood pressure. Results without AH (AH–) - 32 patients, AH - 31 patients, AHex - 10 patients. AHex patients had lower peak VO₂ (p = 0.01), higher VE/VCO2 (p = 0.01) than AH(–) LVM and LVMI in AHex group were greater than in AH(–) group (respectively p = 0.03 and p = 0.04).
Conclusions 1. Adult patients after operation of CoAo with AHex have similar negative risk factors: lower exercise capacity and LV enlargement of as patients with persistent AH.
2. Above results suggest that patients after operation of CoAo with AHex need special insightful observation. Additionary research are necessary to establish potential indication for early antihypertension treatment in this group of patients.