Coarctation of aorta is associated with left ventricular stiffness, left atrial dysfunction and pulmonary hypertension.
Coarctation of aorta is associated with left ventricular stiffness, left atrial dysfunction and pulmonary hypertension.
复制标题
DOI：
10.1016/j.ahj.2021.07.005
复制
发表时间：
2021-11
影响因子：
4.8
通讯作者：
Borlaug BA
中科院分区：
文献类型：
--
作者：
Egbe AC;Miranda WR;Connolly HM;Borlaug BA
Brachial systolic blood pressure (BP) is the most commonly used metric for monitoring hypertension. However, recent studies suggest that brachial systolic BP underestimates LV systolic load in patients with coarctation of aorta (COA). Since brachial systolic BP is used as a surrogate of arterial afterload in clinical practice, it is important to determine how well it correlates with LV remodeling and stiffness in patients with COA as compared to patients with idiopathic hypertension. This is cross-sectional study of COA patients with hypertension (COA group) and adults with idiopathic hypertension (control group). Both groups were matched 1:1 based on age, sex, BMI and systolic BP. We hypothesized that the COA group will have higher LV systolic and diastolic stiffness, and more advanced left atrial (LA) remodeling and pulmonary hypertension. We assessed LV systolic stiffness using end-systolic elastance (Ees), and diastolic stiffness using LV stiffness constant (β) and chamber capacitance (LV-end-diastolic volume at an end-diastolic pressure of 20mmHg, LVEDVI20) There were 112 patients in each group. Although both groups had similar systolic BP, the COA group had a higher Ees (2.37±0.74 vs 2.11±0.54 mmHg/ml, p=0.008), higher β (6.91±0.81 vs 5.93±0.79, p=0.006) and lower LVEDVI20 (58±9 vs 67±11 ml/m, p<0.001). Additionally, the COA group had more advanced LA remodeling and higher pulmonary artery pressures which is corroborating evidence of high LV filling pressure. COA patients have more LV stiffness and abnormal hemodynamics compared to non-COA patients with similar systolic BP, suggesting that systolic BP may underestimate LV systolic load in this population. Further studies are required to determine whether the observed LV stiffness and dysfunction translates to more cardiovascular events during follow-up, and whether adopting a stricter systolic BP target in clinical practice or changing threshold for COA intervention will lead to less LV stiffness and better clinical outcomes.
登录
查看更多内容
影响因子：
37.8
作者：
Muntner P;Carey RM;Gidding S;Jones DW;Taler SJ;Wright JT Jr;Whelton PK
通讯作者：
Whelton PK
DOI：
10.1161/hypertensionaha.116.08763
发表时间：
2017-03
期刊：
Hypertension (Dallas, Tex. : 1979)
影响因子：
--
作者：
Quail MA;Short R;Pandya B;Steeden JA;Khushnood A;Taylor AM;Segers P;Muthurangu V
通讯作者：
Muthurangu V
影响因子：
120.7
作者：
Redfield, MM;Jacobsen, SJ;Rodeheffer, RJ
通讯作者：
Rodeheffer, RJ
影响因子：
37.8
作者：
Kawaguchi, M;Hay, I;Kass, DA
通讯作者：
Kass, DA
影响因子：
6.2
作者：
Lang, Roberto M.;Badano, Luigi P.;Voigt, Jens-Uwe
通讯作者：
Voigt, Jens-Uwe