Myocardial performance after successful intervention for native aortic coarctation.
Vedide Tavli1, Turkay Saritas, Baris Guven
1Izmir Dr Behcet Uz Children's Hospital, Pediatric Cardiology, Izmir, Turkey.
Cardiology in the Young
|January 14, 2010
Summary
Children treated for coarctation of the aorta show persistent myocardial and vascular changes. Elevated B-type natriuretic peptide and endothelin-1 levels suggest a risk for future hypertension.
Area of Science:
- Cardiology
- Pediatric Medicine
- Vascular Biology
Background:
- Coarctation of the aorta (CoA) repair in childhood is linked to adult hypertension.
- Underlying mechanisms of hypertension and impaired left ventricular (LV) function post-CoA repair remain unclear.
Purpose of the Study:
- To assess LV performance using echocardiographic and biochemical markers in children with successfully treated CoA.
- Evaluate midterm outcomes in normotensive children post-CoA intervention with residual gradient < 20 mmHg.
Main Methods:
- Prospective study of 14 children (mean age 8.5 ± 4 years) post-CoA repair (surgery/angioplasty) and 30 age-matched healthy controls.
- Echocardiography measured mitral inflow, isovolumic times, and myocardial performance index (MPI).
- Assessed plasma B-type natriuretic peptide (BNP) and endothelin-1 (ET-1) levels.
Main Results:
- No significant difference in resting systolic blood pressure between CoA patients and controls.
- Increased ventricular septal and LV posterior wall dimensions observed in CoA patients.
- Elevated mitral E wave, prolonged deceleration time, isovolumic relaxation time, isovolumic contraction time, and MPI in CoA patients.
- Significantly higher plasma BNP and ET-1 levels in CoA patients compared to controls.
Conclusions:
- Coarctation of the aorta is a chronic condition with persistent myocardial and vascular alterations post-treatment.
- Elevated plasma BNP and ET-1 may indicate a predisposition to late-onset hypertension after successful early childhood CoA treatment.
Related Concept Videos
01:25Aortic Regurgitation III: Medical Management
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
01:17Aortic Regurgitation IV: Nursing Management
A nurse managing a patient with aortic regurgitation begins with a comprehensive assessment, including a review of the patient's medical history, family history, and lifestyle factors. During the cardiac examination, the nurse listens for heart sounds and checks for signs of valve abnormalities. The nurse also observes for symptoms such as dyspnea, orthopnea, and paroxysmal nocturnal dyspnea and assesses the patient's endurance and daily activity tolerance.Based on the findings, the nurse...
01:27Coronary Artery Disease V: Interprofessional Care
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...