Document Detail


Exercise-induced hypertension in the arms due to impaired arterial reactivity after successful coarctation resection.
MedLine Citation:
PMID:  7717286     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Exercise-induced hypertension of the arms is a well-known late complication after coarctation repair. Residual narrowing at the anastomosis site as well as abnormalities of the precoarctation arterial system may be the cause of this problem. Blood pressure response to exercise and flow-mediated arterial dilatation of the arms and legs were studied in 29 young adults after successful coarctectomy in childhood and compared with 13 control subjects. Peak exercise systolic blood pressure was significantly higher in patients than in control subjects: 238 versus 199 mm Hg (p = 0.007). Both groups had a positive systolic arm-leg gradient during exercise: 59 versus 37 mm Hg (p = 0.05). Flow-mediated dilatation of the brachial artery was significantly reduced in patients compared with that in control subjects: 4.2% (range 0% to 9.4%) versus 9.4% (range 3.7% to 16%) (p < 0.0001). Flow-mediated dilatation of the femoral artery was similar in both groups. Dilatation of the brachial artery was inversely correlated to peak exercise systolic pressure in the study patients (r = -0.427, p = 0.02). A positive arm-leg exercise gradient partly represents physiologic circulatory adaptation to ergometry and is therefore not appropriate for evaluation of residual narrowing. Exercise-induced hypertension of the arms late after coarctation repair is caused by impaired arterial reactivity, which results from structural or functional abnormality, or both.
Authors:
J Guenthard; F Wyler
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  75     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1995 Apr 
Date Detail:
Created Date:  1995-05-18     Completed Date:  1995-05-18     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  814-7     Citation Subset:  AIM; IM    
Affiliation:
University Children's Hospital of Basel, Department of Cardiology, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anastomosis, Surgical / adverse effects
Aortic Coarctation / physiopathology,  surgery*
Arm / blood supply*
Blood Pressure / physiology
Brachial Artery / physiopathology*
Case-Control Studies
Constriction, Pathologic / etiology
Ergometry
Exercise Test
Femoral Artery / physiopathology
Humans
Hyperemia / physiopathology
Hypertension / etiology*,  physiopathology
Leg / blood supply
Physical Exertion / physiology*
Regional Blood Flow / physiology
Systole
Vasodilation / physiology
Vasomotor System / physiopathology*

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


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