Document Detail

Evidence for cardiovascular autonomic dysfunction in neonates with coarctation of the aorta.
MedLine Citation:
PMID:  16769911     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coarctation of the aorta (CoA) is associated with hypertension and abnormalities of blood pressure control, which persist after late repair. Assumptions that neonatal repair would prevent development of blood pressure abnormalities have not been supported by recent data. We hypothesized that early pathological adjustment of autonomic cardiovascular function may already be established in the neonate with coarctation. METHODS AND RESULTS: We studied 8 otherwise well neonates with simple CoA and compared measures of spontaneous baroreflex sensitivity, heart rate variability, and blood pressure variability with 13 healthy newborn babies. Spontaneous baroreflex sensitivity was calculated with sequence methodology from an ECG, and noninvasive blood pressure was recorded with a Portapres. Heart rate variability was determined with time- and frequency-domain measures. Blood pressure variability was measured in the frequency domain. In comparison with normal controls, neonates with CoA had raised blood pressure (78.9+/-3.8 versus 67.1+/-2.1 mm Hg), depressed baroreflex sensitivity (8.7+/-1.5 versus 13.8+/-1.1 ms/mm Hg), reduced heart rate variability (total power 16.5+/-3.1 versus 31.5+/-2.2 ms2), and an increase in the high-frequency component of blood pressure variability (3.1+/-0.3 versus 2.2+/-0. 2 mm Hg2). This is not the pattern expected if neonates with CoA simply had subclinical cardiac failure. CONCLUSIONS: These data suggest that infants with CoA already show signs of pathological adjustment of autonomic cardiovascular homeostasis. Further longitudinal studies are required to determine whether these alterations play a role in the increased risk of late hypertension in these patients.
Jaimie W Polson; Naomi McCallion; Hidefumi Waki; Gareth Thorne; Mark A Tooley; Julian F R Paton; Andrew R Wolf
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Validation Studies     Date:  2006-06-12
Journal Detail:
Title:  Circulation     Volume:  113     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-20     Completed Date:  2006-07-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2844-50     Citation Subset:  AIM; IM    
Department of Clinical Sciences at South Bristol, School of Medical Sciences, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.
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MeSH Terms
Aortic Coarctation / complications,  physiopathology*
Autonomic Nervous System / physiopathology*
Autonomic Nervous System Diseases / etiology*,  physiopathology
Baroreflex / physiology
Blood Pressure / physiology
Blood Pressure Determination / instrumentation,  methods
Blood Pressure Monitors
Catheters, Indwelling
Heart Rate / physiology
Hypertension / etiology*,  physiopathology
Infant, Newborn
Pressoreceptors / physiology
Reflex, Abnormal
Reproducibility of Results

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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