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Evidence for cardiovascular autonomic dysfunction in neonates with coarctation of the aorta

Jaimie W Polson1, Naomi McCallion, Hidefumi Waki

  • 1Department of Clinical Sciences at South Bristol, School of Medical Sciences, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom.

Circulation
|June 14, 2006
PubMed

Insights

Neonates with coarctation of the aorta (CoA) exhibit abnormal autonomic cardiovascular function, including higher blood pressure and reduced baroreflex sensitivity. These early autonomic changes may contribute to later hypertension risks.

Area of Science:

  • Cardiovascular Physiology
  • Neonatal Medicine
  • Autonomic Nervous System Function

Background:

  • Coarctation of the aorta (CoA) is linked to persistent hypertension and blood pressure control issues post-repair.
  • Neonatal repair of CoA has not prevented subsequent blood pressure abnormalities.
  • Early pathological adjustments in autonomic cardiovascular function may occur in neonates with CoA.

Purpose of the Study:

  • To investigate whether neonates with coarctation of the aorta exhibit early signs of autonomic cardiovascular dysfunction.
  • To compare autonomic cardiovascular function in neonates with CoA versus healthy newborns.

Main Methods:

  • Studied 8 neonates with simple CoA and 13 healthy controls.
  • Measured spontaneous baroreflex sensitivity using ECG and sequence methodology.
  • Assessed heart rate variability (time- and frequency-domain) and blood pressure variability (frequency-domain) using noninvasive blood pressure monitoring.

Main Results:

  • Neonates with CoA had elevated blood pressure compared to controls (78.9 vs. 67.1 mm Hg).
  • CoA infants showed depressed baroreflex sensitivity (8.7 vs. 13.8 ms/mm Hg) and reduced heart rate variability (16.5 vs. 31.5 ms2).
  • Increased high-frequency component of blood pressure variability was observed in neonates with CoA (3.1 vs. 2.2 mm Hg2).

Conclusions:

  • Infants with coarctation of the aorta display pathological adjustments in autonomic cardiovascular homeostasis.
  • These findings suggest that autonomic alterations in neonates with CoA may precede later hypertension.
  • Further longitudinal studies are needed to confirm the role of these alterations in the risk of developing hypertension.
Abstract

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