Aortic arch shape is not associated with hypertensive response to exercise in patients with repaired congenital heart diseases

Journal of Cardiovascular Magnetic Resonance

Research

Oliver Tann¹  Alessandro Giardini¹  Graham Derrick¹  Silvia Schievano¹  Claudio Capelli¹  Hopewell N Ntsinjana¹  Giovanni Biglino¹  Andrew M Taylor² 

[1] Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK;Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science & Cardiorespiratory Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK;Cardiorespiratory Unit, Great Ormond Street Hospital for Children, Level 7, Nurses Home, Great Ormond Street, WC1N 3JH, London, UK;

关键词: Coarctation;    Arterial switch operation;    Anatomical models;    Blood pressure;    Exercise test;   

DOI  :  10.1186/1532-429X-15-101

 received in 2013-07-12, accepted in 2013-11-05,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundAortic arch geometry is linked to abnormal blood pressure (BP) response to maximum exercise. This study aims to quantitatively assess whether aortic arch geometry plays a role in blood pressure (BP) response to exercise.Methods60 age- and BSA-matched subjects – 20 post-aortic coarctation (CoA) repair, 20 transposition of great arteries post arterial switch operation (ASO) and 20 healthy controls – had a three-dimensional (3D), whole heart magnetic resonance angiography (MRA) at 1.5 Tesla, 3D geometric reconstructions created from the MRA. All subjects underwent cardiopulmonary exercise test on the same day as MRA using an ergometer cycle with manual BP measurements. Geometric analysis and their correlation with BP at peak exercise were assessed.ResultsArch curvature was similarly acute in both the post-CoA and ASO cases [0.05 ± 0.01 vs. 0.05 ± 0.01 (1/mm/m2); p = 1.0] and significantly different to that of normal healthy controls [0.05 ± 0.01 vs. 0.03 ± 0.01 (1/mm/m2), p < 0.001]. Indexed transverse arch cross sectional area were significantly abnormal in the post-CoA cases compared to the ASO cases (117.8 ± 47.7 vs. 221.3 ± 44.6; p < 0.001) and controls (117.8 ± 47.7 vs. 157.5 ± 27.2 mm2; p = 0.003). BP response to peak exercise did not correlate with arch curvature (r = 0.203, p = 0.120), but showed inverse correlation with indexed minimum cross sectional area of transverse arch and isthmus (r = -0.364, p = 0.004), and ratios of minimum arch area/ descending diameter (r = -0.491, p < 0.001).ConclusionTransverse arch and isthmus hypoplasia, rather than acute arch angulation plays a role in the pathophysiology of BP response to peak exercise following CoA repair.

【 授权许可】

Unknown   
© Ntsinjana et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.