Predictors of blood pressure and hypertension long-term after treatment of isolated coarctation of the aorta in children-a population-based study.

Autor:	Ylinen MK; Department of Pediatric Cardiology, New Children's hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Pihkala JI; Department of Pediatric Cardiology, New Children's hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Salminen JT; Department of Pediatric Surgery, New Children's hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Sarkola T; Department of Pediatric Cardiology, New Children's hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.; Minerva Foundation Institute for Medical Research, Helsinki, Finland.
Jazyk:	angličtina
Zdroj:	Interactive cardiovascular and thoracic surgery [Interact Cardiovasc Thorac Surg] 2022 Aug 03; Vol. 35 (3).
DOI:	10.1093/icvts/ivac212
Abstrakt:	Objectives: The aim of this study was to assess predictors of BP and hypertension and relations between BP and LV mass in a population-based retrospective study of repaired isolated coarctation of aorta. Methods: We collected follow-up data until 2018 of 284/304 (93%) patients with coarctation treated by surgery (n = 235) or balloon angioplasty/stent (n = 37/12) in our unit 2000-2012. Systolic hypertension was defined as systolic BP (SBP) z-score ≥+2 standard deviation (SD) or regular use of BP medication. LV hypertrophy was defined as LV mass z-score ≥+2 SD or LV mass index g/m2.7 ≥95th percentile. Results: The median (25-75th percentiles) follow-up time and age at follow-up were 9.7 years (6.9-13.2) and 11.8 years (7.9-16.0), respectively. Age at first procedure (P = 0.011) and systolic arm-leg-gradient (P = 0.007) were positively and transverse arch (P = 0.007) and isthmus diameter (P = 0.001) z-scores at follow-up were negatively associated with SBP z-score adjusted for age at follow-up and need for reintervention for coarctation. Systolic hypertension was present in 53/284 (18.7%) and related with increasing age at first procedure (median 33.2 vs 0.6 months; P < 0.001) and arm-leg-gradient at follow-up (mean ± SD, -0.3 ± 14.6 vs -6.4 ± 11.6 mmHg; P = 0.047) adjusted for reintervention for coarctation and age at follow-up. LV hypertrophy was present in 20/227 (9.3%) and related with SBP z-score. Conclusions: Higher SBP and hypertension in repaired coarctation of aorta are related with increasing age at first procedure and arm-leg-gradient at follow-up. Transverse arch and isthmus diameters at follow-up are inversely related with SBP. (© The Author(s) 2022. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery.)
Databáze:	MEDLINE
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