Vol 10, No 4 (2006)
Original paper
Published online: 2006-08-08
Adult patients after coarctation of the aorta repair - exercise induced hypertension
Nadciśnienie tętnicze 2006;10(4):286-293.
Abstract
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.
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.
Keywords: coarctation of the aortahypertensionphysical exercise