Usefulness of cardiopulmonary exercise testing to predict the development of arterial hypertension in adult patients with repaired isolated coarctation of the aorta.

Buys, Roselien; Van De Bruaene, Alexander; Müller, Jan; Hager, Alfred; Khambadkone, Sachin; Giardini, Alessandro; Cornelissen, Véronique; Budts, Werner; Vanhees, Luc

doi:10.1016/j.ijcard.2013.01.171

journal article

Title:: Usefulness of cardiopulmonary exercise testing to predict the development of arterial hypertension in adult patients with repaired isolated coarctation of the aorta.
Document type:: Journal Article
Author(s):: Buys, Roselien; Van De Bruaene, Alexander; Müller, Jan; Hager, Alfred; Khambadkone, Sachin; Giardini, Alessandro; Cornelissen, Véronique; Budts, Werner; Vanhees, Luc
Abstract:: Patients who underwent surgery for aortic coarctation (COA) have an increased risk of arterial hypertension. We aimed at evaluating (1) differences between hypertensive and non-hypertensive patients and (2) the value of cardiopulmonary exercise testing (CPET) to predict the development or progression of hypertension.Between 1999 and 2010, CPET was performed in 223 COA-patients of whom 122 had resting blood pressures of <140/90 mmHg without medication, and 101 were considered hypertensive. Comparative statistics were performed. Cox regression analysis was used to assess the relation between demographic, clinical and exercise variables and the development/progression of hypertension.At baseline, hypertensive patients were older (p=0.007), were more often male (p=0.004) and had repair at later age (p=0.008) when compared to normotensive patients. After 3.6 ± 1.2 years, 29/120 (25%) normotensive patients developed hypertension. In normotensives, VE/VCO2-slope (p=0.0016) and peak systolic blood pressure (SBP; p=0.049) were significantly related to the development of hypertension during follow-up. Cut-off points related to higher risk for hypertension, based on best sensitivity and specificity, were defined as VE/VCO2-slope >= 27 and peak SBP >= 220 mmHg. In the hypertensive group, antihypertensive medication was started/extended in 48/101 (48%) patients. Only age was associated with the need to start/extend antihypertensive therapy in this group (p=0.042).Higher VE/VCO2-slope and higher peak SBP are risk factors for the development of hypertension in adults with COA. Cardiopulmonary exercise testing may guide clinical decision making regarding close blood pressure control and preventive lifestyle recommendations.
Journal title abbreviation:: Int J Cardiol
Year:: 2013
Journal volume:: 168
Journal issue:: 3
Pages contribution:: 2037-41
Language:: eng
Fulltext / DOI:: doi:10.1016/j.ijcard.2013.01.171
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/23453442
Print-ISSN:: 0167-5273
TUM Institution:: Klinik für Kinderkardiologie und angeborene Herzfehler (Prof. Hess)
BibTeX

Occurrences:

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Kinderkardiologie und angeborene Herzfehler (DHM) (Prof. Ewert)2013