Document Detail

Myocardial performance after successful intervention for native aortic coarctation.
MedLine Citation:
PMID:  20067654     Owner:  NLM     Status:  MEDLINE    
Coarctation of the aorta is associated with increased risk for hypertension in adulthood, despite successful repair. The intrinsic mechanisms underscoring hypertension and left ventricular performance in these patients, however, remains to be determined. Our objective was to evaluate left ventricular performance by means of echocardiographic and biochemical parameters at midterm follow-up in normotensive children who have had undergone successful surgical or catheter interventional treatment of coarctation with a residual gradient of less than 20 mmHg at rest. We studied prospectively 14 patients with native aortic coarctation who underwent surgery or balloon angioplasty, the cohort made up of equal numbers of boys and girls, and having a mean age of 8.5 plus or minus 4 years. We also studied 30 age-matched healthy subjects, measuring mitral inflow pulsed wave signals, isovolumic relaxation and contraction times, myocardial performance index parameters, and levels of B-type natriuretic peptide and endothelin-1 in both groups. We found no differences in systolic blood pressure at rest between the patients and their controls. The ventricular septal diastolic dimensions, left ventricular posterior wall dimensions, mitral valve E wave, deceleration time, isovolumic relaxation time, isovolumic contraction time and myocardial performance index were all significantly increased in the patients. Levels of plasma B-type natriuretic peptide and endothelin-1 were also significantly higher in the patients when compared to the control group. We conclude that aortic coarctation is a chronic disease characterized by persistency of myocardial and vascular alterations. The elevated levels of plasma b-type natriuretic peptide and endothelin-1 may be indicative of late onset hypertension after successful treatment of native coarctation in early childhood.
Vedide Tavli; Turkay Saritas; Baris Guven; Faik Okur; Berna Cevik Saylan; Talat Tavli; Bekir Sami Uyanik; Zeki Ari; Banu Isbilen
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2010-01-13
Journal Detail:
Title:  Cardiology in the young     Volume:  20     ISSN:  1467-1107     ISO Abbreviation:  Cardiol Young     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-07-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9200019     Medline TA:  Cardiol Young     Country:  England    
Other Details:
Languages:  eng     Pagination:  33-8     Citation Subset:  IM    
Izmir Dr Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
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MeSH Terms
Angioplasty, Balloon / adverse effects,  methods*
Aortic Coarctation / therapy*,  ultrasonography
Biological Markers / blood
Blood Pressure Determination
Cardiac Surgical Procedures / adverse effects,  methods
Diastole / physiology
Echocardiography, Doppler
Endothelin-1 / blood*
Endothelium, Vascular / pathology
Follow-Up Studies
Heart Catheterization / methods
Heart Function Tests
Hypertrophy, Left Ventricular / etiology,  ultrasonography*
Myocardial Contraction / physiology*
Natriuretic Peptide, Brain / blood*
Observer Variation
Prospective Studies
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/Endothelin-1; 114471-18-0/Natriuretic Peptide, Brain

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