| Exercise-induced hypertension in the arms due to impaired arterial reactivity after successful coarctation resection. | |
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MedLine Citation:
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PMID: 7717286 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J Guenthard; F Wyler |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 75 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1995 Apr |
Date Detail:
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Created Date: 1995-05-18 Completed Date: 1995-05-18 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 814-7 Citation Subset: AIM; IM |
Affiliation:
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University Children's Hospital of Basel, Department of Cardiology, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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