| Abstract [eng] |
Coarctation of the aorta (CoA) is an arteriopathy with life-long sequelae, and a remarkable increase in cardiovascular events in adult CoA patients. A variety of surgical and interventional techniques has been described, each aiming to improve immediate results and long-term outcomes, especially focusing on arterial hypertension (AH). However, AH may still be present or develop de novo even after hemodynamically effective surgery or percutaneous intervention. It is reported that the prevalence of AH in patients after CoA correction ranges between 42–70%. AH in CoA patients is associated with significant morbidity and mortality. However, there are scarce data on the prevalence of AH, blood pressure (BP) phenotype and left ventricular hypertrophy (LVH) in children after different ways of CoA repair. Not only hypertensive but also normotensive patients, following CoA repair, present with premature arteriosclerosis and an increased risk of cardiovascular events. Correction of CoA does not resolve the inborn pathology of the prestenotic aortic vascular bed. Therefore, surrogate markers are being tested for diagnosis of subclinical cardiovascular disease and risk monitoring. There are studies showing that adult CoA patients have impaired endothelial function, increased carotid intima media thickness, decreased distensibility in the carotid arteries and increased levels of proinflammatory cytokines in comparison with healthy controls. However, the data regarding early vascular ageing (EVA) in children following CoA repair are scarce. The present work aims at a comprehensive description of BP status and phenotypes as well as the prevalence of LVH, and unravelling potential changes in arterial wall function and morphology in children following successful CoA repair. The standardized nature of this analysis is expected to provide reliable evidence about the development and relevance of AH, antihypertensive therapy and arterial remodelling in children after successful CoA repair. |
