Document Detail


Impact of aortic stenting on peripheral vascular function and daytime systolic blood pressure in adult coarctation.
MedLine Citation:
PMID:  17686804     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To determine the relation of ambulatory systolic blood pressure to aortic obstruction and more extensive vascular dysfunction, assessed by central aortic, peripheral conduit arterial and resistance vessel function. METHODS: 12 adults (5 native, 7 recoarctation) were studied before, and 2 weeks and 6 months after aortic stenting. Systolic blood pressure was measured during normal daily living by 24-hour ambulatory monitoring. Central aortic function was assessed by pulse wave analysis (augmentation index). Brachial artery flow-mediated dilatation and dilatation in response to 25 mug of sublingual glyceryl trinitrate was assessed by ultrasound to measure peripheral conduit arterial and resistance vessel function. Baseline vascular measures were compared with those of 12 matched controls. RESULTS: Patients had a higher augmentation index, impaired endothelium-dependent and -independent dilatation, and forearm vascular resistance (p<0.02). After successful gradient relief by stenting, daytime ambulatory systolic blood pressure (151 (134, 166) mm Hg vs 138 (130, 150) mm Hg, p = 0.01) and the augmentation index (26 (15, 34) vs 23 (13, 30), p = 0.03) fell progressively over 6 months, but did not completely normalise. Endothelium-dependent and -independent dilatation, and forearm vascular resistance remained unchanged and impaired. CONCLUSION: Relief of aortic obstruction is associated with improvement in central aortic function and results in reduction of daytime ambulatory systolic blood pressure. Peripheral vascular dysfunction, however, remains unchanged and may contribute to residual hypertension.
Authors:
S S M Chen; A E Donald; C Storry; J P Halcox; P Bonhoeffer; J E Deanfield
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-08-08
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  94     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-16     Completed Date:  2008-10-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  919-24     Citation Subset:  AIM; IM    
Affiliation:
Grown-up Congenital Heart Unit, The Heart Hospital, University College London, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aortic Coarctation / complications,  physiopathology,  surgery*
Blood Pressure Monitoring, Ambulatory
Brachial Artery / physiopathology,  ultrasonography
Female
Follow-Up Studies
Forearm / blood supply
Humans
Hypertension / etiology*,  physiopathology
Male
Peripheral Vascular Diseases / etiology*,  physiopathology
Prospective Studies
Stents*
Vascular Resistance
Vasodilation
Grant Support
ID/Acronym/Agency:
//British Heart Foundation
Comments/Corrections
Comment In:
Heart. 2008 Jul;94(7):828-9   [PMID:  18552218 ]

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


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