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Prevalence of arterial hypertension, hemodynamic phenotypes, and left ventricular hypertrophy in children after coarctation repair: a multicenter cross-sectional study

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Abstract

Background

This study aimed to evaluate hemodynamic phenotypes and prevalence of left ventricular hypertrophy in children after coarctation repair with right arm and leg blood pressure difference < 20 mmHg. Secondary objectives were analysis of effects of age at intervention, residual gradient across the descending aorta, and type of correction.

Methods

Blood pressure status and left ventricular hypertrophy were diagnosed according to European Society of Hypertension 2016 guidelines.

Results

Of 90 patients with a median age 12.5 (8.9–15.8) years, 8.5 (6.0–11.8) years after coarctation repair who were included, 42 (46.7%) were hypertensive. Isolated systolic hypertension dominated among 29 hypertensive patients with uncontrolled or masked hypertension (25 of 29; 86.2%). Of the 48 patients with office normotension, 14.6% (7) had masked hypertension, 8.3% (4) had ambulatory prehypertension, and 54.2% (26) were truly normotensive. Left ventricular hypertrophy was diagnosed in 29 patients (32.2%), including 14 of 42 (33.3%) hypertensive and 15 of 48 (31.3%) normotensive patients. The peak systolic gradient across the descending aorta was greater in hypertensive subjects (33.3 ± 12.7 mmHg) compared with normotensive subjects (25 ± 8.2 mmHg, p = 0.0008). Surgical correction was performed earlier than percutaneous intervention (p < 0.0001) and dominated in 40 of 48 (83.3%) normotensive versus 24 of 42 (57.1%) hypertensive patients (p = 0.006).

Conclusions

Arterial hypertension with isolated systolic hypertension as the dominant phenotype and left ventricular hypertrophy are prevalent even after successful coarctation repair. Coarctation correction from the age of 9 years and older was associated with a higher prevalence of hypertension.

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Initial data is not available under open access currently.

Funding

This project was supported by the Association for European Paediatric and Congenital Cardiology (AEPC) junior member research grant.

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Authors and Affiliations

  1. Institute of Clinical Medicine, Vilnius University, Faculty of Medicine, Vilnius, Lithuania

    Skaiste Sendzikaite, Rita Sudikiene, Virgilijus Tarutis & Augustina Jankauskiene

  2. Clinic for Paediatric Cardiology and Cardiac Surgery, Children’s Clinical University Hospital, Stradins University, Riga, Latvia

    Inguna Lubaua & Pauls Silis

  3. Department of Cardiology, The Children’s Memorial Health Institute, Warsaw, Poland

    Agata Rybak

  4. Department of Nephrology and Arterial Hypertension, The Children’s Memorial Health Institute, Warsaw, Poland

    Mieczyslaw Litwin

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  1. Skaiste Sendzikaite
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Correspondence to Skaiste Sendzikaite.

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Sendzikaite, S., Sudikiene, R., Tarutis, V. et al. Prevalence of arterial hypertension, hemodynamic phenotypes, and left ventricular hypertrophy in children after coarctation repair: a multicenter cross-sectional study. Pediatr Nephrol 35, 2147–2155 (2020). https://doi.org/10.1007/s00467-020-04645-w

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