| Ventricular-vascular stiffening in patients with repaired coarctation of aorta: integrated pathophysiology of hypertension. | |
| | |
MedLine Citation:
|
PMID: 18824754 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Despite successful repair, patients with coarctation of the aorta (COA) often show persistent hypertension at rest and/or during exercise. Previous studies indicated that the hypertension is mainly due to abnormalities in the arterial bed and its regulatory systems. We hypothesized that ventricular systolic stiffness also contributes to the hypertensive state in these patients in addition to increased vascular stiffness. METHODS AND RESULTS: The study involved 43 patients with successfully repaired COA and 45 age-matched control subjects. Ventricular systolic stiffness (end systolic elastance) and arterial stiffness (effective arterial elastance) were measured invasively by ventricular pressure-area relationship during varying preload before and after beta-adrenergic stimulation. The mean systolic blood pressure was significantly higher with concomitant increases in both end systolic elastance and effective arterial elastance in patients with COA compared with control subjects (113.2+/-16.8 versus 91.0+/-9.1 mm Hg, 44.5+/-17.0 versus 19.2+/-6.7 mm Hg/mL/m(2), and 27.8+/-11.4 versus 20.2+/-4.8 mm Hg/mL/m(2), respectively; P<0.01 for each). End systolic elastance and effective arterial elastance of patients with COA showed exaggerated responses to beta-adrenergic stimulation, further amplifying blood pressure elevation. Quantification analyses assuming that ventricular systolic stiffness of patients with COA is equal to that of the control revealed that ventricular systolic stiffness accounts for approximately 50% to 70% of the elevated blood pressure in patients with COA. Furthermore, combined ventricular-arterial stiffening amplified systolic pressure sensitivity to increased preload during abdominal compression and limited stroke volume gain/relaxation improvement induced by beta-adrenergic stimulation. CONCLUSIONS: Increased ventricular systolic stiffness, coupled with increased arterial stiffness, plays important roles in hypertension in patients with repaired COA. Thus, ventricular systolic stiffness is a potentially suitable target for reduction of blood pressure and improvement of prognosis of patients with COA. |
| | |
Authors:
|
Hideaki Senzaki; Yoichi Iwamoto; Hirotaka Ishido; Satoshi Masutani; Mio Taketazu; Toshiki Kobayashi; Toshiyuki Katogi; Shunei Kyo |
Related Documents
:
|
2386114 - Preservation of left ventricular performance with reduced ischemic dysfunction by intra... 18334894 - Patch size, shape and orientation affect geometrical outcomes of surgical anterior vent... 3993514 - Right ventricular outflow pouch associated with double-chambered right ventricle. 2387944 - Pressure-volume analysis as a method for quantifying simultaneous drug (amrinone) effec... 16302584 - Comparison of right atrial pressure and central venous pressures measured at various an... 11268234 - High-normal serum creatinine concentration is a predictor of cardiovascular risk in ess... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't; Retracted Publication |
Journal Detail:
|
Title: Circulation Volume: 118 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2008 Sep |
Date Detail:
|
Created Date: 2008-09-30 Completed Date: 2008-10-23 Revised Date: 2012-08-07 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
|
Languages: eng Pagination: S191-8 Citation Subset: AIM; IM |
Affiliation:
|
Department of Pediatric Cardiology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama, 350-1298 Japan. hsenzaki@saitama-med.ac.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adrenergic beta-Agonists / diagnostic use Aortic Coarctation / complications, physiopathology*, surgery* Arteries / physiopathology* Blood Pressure Child Child, Preschool Dobutamine / diagnostic use Echocardiography Elasticity Humans Hypertension / diagnosis, etiology, physiopathology* Infant Stroke Volume Systole Vascular Resistance* Ventricular Function* Ventricular Pressure |
| Chemical | |
Reg. No./Substance:
|
0/Adrenergic beta-Agonists; 34368-04-2/Dobutamine |
| Comments/Corrections | |
Retraction In:
|
Circulation. 2012 Jun 12;125(23):e1020
[PMID:
22689940
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Biventricular response after pulmonary valve replacement for right ventricular outflow tract dysfunc...
Next Document: Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention...