The role of increased preoperative ventricular-arterial stiffening in the hypertension of infants with coarctation of the aorta
- VernacularTitle:主动脉缩窄术前心室-动脉僵硬度增加在高血压发生中的作用
- Author:
Hongwei MU
1
,
2
;
Zhongqun ZHU
1
,
2
Author Information
1. Department of Cardiothoracic Surgery, Shanghai Children&rsquo
2. s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200120, P.R.China
- Publication Type:Journal Article
- Keywords:
Coarctation of the aorta;
hypertension;
ventricular-arterial stiffening
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(11):1307-1313
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the role of increased preoperative ventricular-arterial stiffening in hypertensive infants with coarctation of the aorta (CoA). Methods A retrospective study was conducted in 314 infants with CoA (CoA group, 193 males and 121 females, aged 5.4±2.2 months), and 314 infants receiving tumor chemotherapy with normal cardiovascular function and without pneumonia (control group, 189 males and 125 females, aged 4.4±3.8 months), who were admitted to our hospital from 2015 to 2017. The clinical data of the two groups were compared. Results There were statistical differences in effective aortic elastance index (Eai), effective left ventricular end-systolic elasticity index (Eesi), ventricle-artery coupling index (VACi), N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, and ratios of left ventricular hypertrophy, dilation and systolic dysfunction between the two groups (P<0.05). Compared with non-hypertensive CoA infants, CoA infants with hypertension had higher Eai, Eesi, NT-ProBNP level and proportion of left ventricular hypertrophy (P<0.05). Compared with concomitant ventricular septal defect, infants with isolated CoA had higher Eai, Eesi, NT-proBNP level, incidence of hypertension and higher proportion of left ventricular hypertrophy, dilation and systolic dysfunction (P<0.05). Eai and Eesi were positively correlated with NT-proBNP level, left ventricular hypertrophy and fractional shortening of left ventricle (P<0.05), while Eai and Eesi were negatively correlated with left ventricular end diastolic volume index, left ventricular end systolic volume index and concomitant ventricular septal defect (P<0.05). Hypertension was related to preoperative left ventricular hypertrophy, Eai, Eesi and NT-ProBNP. Eai was an independent risk factor for hypertension. Conclusion Preoperative ventricular-arterial stiffening is increased in infants with aortic coarctation, which is related to the occurrence of hypertension. Isolated CoA shows more significant increase in ventricular-arterial stiffening, higher ventricular overload and incidence of hypertension.
