scholarly journals Diastolic velocity half time is associated with aortic coarctation gradient at catheterization independent of echocardiographic and clinical blood pressure gradients

2018 ◽  
Vol 13 (5) ◽  
pp. 713-720
Author(s):  
Adam B. Christopher ◽  
Abraham Apfel ◽  
Tao Sun ◽  
Jackie Kreutzer ◽  
David S. Ezon
Keyword(s):  
Blood Pressure ◽  
Aortic Coarctation ◽  
Pressure Gradients ◽  
Half Time ◽  
Diastolic Velocity ◽  
Clinical Blood Pressure

scholarly journals Accuracy of Current Non-invasive Methods in Estimating Aortic Coarctation Gradients

2020 ◽  
pp. 47-57
Author(s):  
Wejdan Khaled Ba- Atiyah ◽  
Riad Abou Zahr ◽  
Zaheer Ahmad ◽  
Yahia Mohamed El Mahdi ◽  
Mohammed Omar Galal
Keyword(s):  
Blood Pressure ◽  
Retrospective Study ◽  
Pressure Gradient ◽  
Cardiac Catheterization ◽  
Doppler Echocardiography ◽  
Aortic Coarctation ◽  
Cuff Pressure ◽  
Pressure Gradients ◽  
Significant Difference ◽  
Cardiac Catheterizations

Aims: To understand the accuracy of non-invasively obtained blood pressure gradients (cuff vs Doppler gradient) with an invasively measured pressure gradient. Study Design:  Retrospective study. Place and Duration of Study: Department of Pediatrics, Section of Pediatric Cardiology, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia, between Jan, 2010 till Jan, 2020. Methodology: A retrospective study of patients with CoA who underwent cardiac catheterization between Jan, 2010 till Jan, 2020 was performed. Cuff BP gradients and Doppler echocardiography were measured prior to cardiac catheterization and afterwards, when an intervention was performed. Student t test and Bland-Altman analysis were performed. Results: 55 patients with aortic coarctation underwent 92 cardiac catheterizations. Among them 75 needed interventions. This resulted in a total of 162 cardiac catheterizations (cath), from them 67 pressure gradients included in the analysis. There was no statistically significant difference between mean Doppler measurements and invasively derived catheter gradients (p=0.12). In contrast peak Doppler measurement (p < 0.00001) and cuff blood pressure gradients (p=0.03) showed significant differences to the cath gradient. We found that cuff blood pressure gradients accurately reflected cath measurement in native COA (p=0.40) and in those who weigh less than 10 kg (p=0.67). Mean Doppler measurements had a small tendency for underestimation. Peak Doppler gradient and cuff pressure gradient usually overestimated cath measurement.  Conclusion: The mean Doppler echocardiography seems to be the most accurate among the other noninvasive methods in use to estimate severity of aortic coarctation. It provided reasonable agreement with the invasively obtained aortic coarctation gradient. 

P5.06INCREASED ARTERIAL STIFFNESS AND SYSTOLIC BLOOD PRESSURE FOLLOWING SUBCLAVIAN FLAP REPAIR FOR AORTIC COARCTATION IN INFANCY

2009 ◽  
Vol 3 (4) ◽  
pp. 175
Author(s):  
D. Kenny ◽  
J. Polson ◽  
J.R. Cockcroft ◽  
R. Martin ◽  
J. Paton ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Stiffness ◽  
Systolic Blood Pressure ◽  
Aortic Coarctation ◽  
Flap Repair

scholarly journals Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034853
Author(s):  
Niky Ghorbani ◽  
Vivek Muthurangu ◽  
Abbas Khushnood ◽  
Leonid Goubergrits ◽  
Sarah Nordmeyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Arterial Hypertension ◽  
Aortic Coarctation ◽  
Cross Sectional Study ◽  
Ascending Aorta ◽  
Uncontrolled Hypertension ◽  
Specific Reference ◽  
Sectional Study ◽  
Cross Sectional ◽  
Descending Aorta

ObjectiveWe aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation.DesignCross-sectional study.SettingThe study was conducted at two university medical centres, located in Berlin and London.ParticipantsA total of 121 patients with aortic coarctation (ages 1–71 years) underwent cardiac MRI, echocardiography and blood pressure measurements.Outcome measuresCross-sectional diameters of the ascending and descending aortas were assessed to compute aortic area distensibility. Findings were compared with age-specific reference values. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology statement and reporting guidelines.ResultsImpaired distensibility (below fifth percentile) was seen in 37% of all patients with coarctation in the ascending aorta and in 43% in the descending aorta. BAVD (43%) and arterial hypertension (72%) were present across all ages. In patients >10 years distensibility impairment of the ascending aorta was predominantly associated with BAVD (OR 3.1, 95% CI 1.33 to 7.22, p=0.009). Distensibility impairment of the descending aorta was predominantly associated with arterial hypertension (OR 2.8, 95% CI 1.08 to 7.2, p=0.033) and was most pronounced in patients with uncontrolled hypertension despite antihypertensive treatment.ConclusionFrom early adolescence on, both arterial hypertension and BAVD have a major impact on aortic distensibility. Their specific effects differ in strength and localisation (descending vs ascending aorta). Moreover, adequate blood pressure control is associated with improved distensibility. These findings could contribute to the understanding of cardiovascular complications and the management of patients with aortic coarctation.

Factors affecting left ventricular remodelling and mechanics in the long-term follow-up after successful repair of aortic coarctation

2005 ◽  
Vol 15 (2) ◽  
pp. 160-167 ◽  
Author(s):  
Roberto Crepaz ◽  
Roberto Cemin ◽  
Cristina Romeo ◽  
Edoardo Bonsante ◽  
Lino Gentili ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Coarctation ◽  
Surgical Repair ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Ventricular Remodelling ◽  
Left Ventricular Remodelling ◽  
Ventricular Geometry ◽  
Blood Pressures ◽  
Successful Repair

Aims: To identify factors predisposing to abnormal left ventricular geometry and mechanics in 52 patients after successful repair of aortic coarctation. Methods and results: We evaluated left ventricular remodelling, systolic midwall mechanics, and isthmic gradient by echo-Doppler, systemic blood pressure at rest/exercise and by ambulatory blood pressure monitoring, and the aortic arch by magnetic resonance imaging. Echocardiographic findings were compared with those of 142 controls. The patients with aortic coarctation showed an increased indexed left ventricular end-diastolic volume, increased mass index, increased ratio of mass to volume and systolic chamber function. The contractility, estimated at midwall level, was increased in 21 percent of the patients. In 26 (50 percent) of the patients, we found abnormal left ventricular geometry, with 9 percent showing concentric remodelling, 33 percent eccentric hypertrophy, and 8 percent concentric hypertrophy. These patients were found to be older, underwent a later surgical repair, and to have higher systolic blood pressures at rest and exercise as well as during ambulatory monitoring. The relative mural thickness and mass index of the left ventricle showed a significant correlation with different variables on uni- and multivariate analysis. Age and diastolic blood pressure at rest are the only factors associated with abnormal left ventricular remodelling. Conclusions: Patients who have undergone a seemingly successful surgical repair of aortic coarctation may have persistently abnormal geometry with a hyperdynamic state of the left ventricle. This is more frequent in older patients, and in those with higher diastolic blood pressures.

Clinical Blood-Pressure in Anxiety

1955 ◽  
Vol 101 (425) ◽  
pp. 893-894 ◽  
Author(s):  
G. De M. Rudolf
Keyword(s):  
Blood Pressure ◽  
Normal Blood ◽  
Normal Blood Pressure ◽  
Fear And Anxiety ◽  
Clinical Blood Pressure

That variations of blood-pressure are found in states of emotion is commonplace knowledge; that rises may take place with temporary fear and anxiety is also well known, but that anxiety occurs with a reduced or normal blood-pressure is not perhaps so well appreciated.The purpose of the present investigation was to determine whether the blood-pressure remains high when the patient with anxiety is in a state of overt placidity and calmness.

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