Key result
Daytime ambulatory systolic blood pressure correlated more strongly with aortic coarctation diameter than clinic blood pressure (r = -0.73, p = 0.0006).
Why the study?
Does ambulatory blood pressure correlate more strongly with echocardiographic aortic coarctation diameter than clinic blood pressure in adult patients with aortic coarctation?
Case-Control (n=54)
No
Does ambulatory blood pressure correlate more strongly with echocardiographic aortic coarctation diameter than clinic blood pressure in adult patients with aortic coarctation?
Ambulatory blood pressure correlates more strongly with aortic coarctation diameter measured by TEE than clinic blood pressure, suggesting it is the preferred method for BP evaluation in these patients.
Answers are grounded in this paper and cite their sources.
Elevated BP in coarctation may link to arch diameter; case-control data leaves open its prognostic value and needs prospective validation.
OBJECTIVE: To relate the echocardiographic aortic arch-diameter to ambulatory and clinic blood pressure (BP) in patients with aortic coarctation. DESIGN: Eighteen adult patients (50% men) were recruited from the coarctation registry of the Linkoping Heart Centre. Biplane-trans-oesophageal echocardiography (TEE) was performed with Acuson XP 128/10, ambulatory BP was recorded with Spacelab models 90202/90205. RESULTS: Systolic clinic and ambulatory BP levels were higher in patients than in the 36 controls (clinic BP: 146 +/- 25 mmHg vs 119 +/- 10 mmHg, p = 0.0009, ambulatory BP: 140 +/- 18 mmHg vs 124 +/- 11 mmHg, p = 0.009). The differences in diastolic BP levels were less obvious (clinic BP: 87 +/- 16 mmHg vs 76 +/- 8 mmHg, p = 0.02, ambulatory BP: 84 +/- 13 mmHg vs 77 +/- 9 mmHg, p = 0.052). Daytime ambulatory BP was more strongly related than clinic BP to the coarctation diameter (AD) (systolic BP r= -0.73, p = 0.0006 and r = -0.61, p = 0.007, respectively). In surgically corrected patients (n = 14) only the correlations between ambulatory systolic daytime (r = -0.61, p = 0.02) and night-time (r = -0.58, p = 0.03) BP to AD was statistically significant. CONCLUSION: Ambulatory BP correlates strongly with aortic coarctation measured by TEE and would thus be the preferred technique for evaluating BP in this patient category.
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Fredrik Nyström Jan Engvall (2001) conducted a case-control in aortic coarctation (n=54). Aortic coarctation vs. Controls was evaluated on Correlation of daytime ambulatory systolic blood pressure to coarctation diameter (r = -0.73, p=0.0006). Daytime ambulatory systolic blood pressure correlated more strongly with aortic coarctation diameter than clinic blood pressure (r = -0.73, p = 0.0006).
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