Assessment of blood pressures and gradients by automated blood pressure device compared to invasive measurements in patients previously operated on for coarctation of the aorta

1992 ◽  
Vol 12 (2) ◽  
pp. 155-162 ◽  
Author(s):  
H. Wendel ◽  
D. Teien ◽  
D. G. Human ◽  
M. A. Nanton
Keyword(s):  
Blood Pressure ◽  
Coarctation Of The Aorta ◽  
Blood Pressures ◽  
Blood Pressure Device

Unmasking the borderline coarctation: the utility of isoproterenol in the paediatric cardiac catheterisation laboratory

2018 ◽  
Vol 28 (6) ◽  
pp. 804-810 ◽  
Author(s):  
Neil D. Patel ◽  
Patrick M. Sullivan ◽  
Cheryl M. Takao ◽  
Sarah Badran ◽  
Joseph Ahdoot ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Coarctation Of The Aorta ◽  
Cardiac Catheterisation ◽  
Blood Pressure Cuff ◽  
Post Intervention ◽  
Arterial Blood ◽  
Pressure Cuff ◽  
Blood Pressures ◽  
The Mean ◽  
The Impact

AbstractBackgroundOne indication for intervention in coarctation of the aorta is a peak-to-peak gradient >20 mmHg. Gradients may be masked in patients under general anaesthesia and may be higher during exercise. Isoproterenol was given during cardiac catheterisation to simulate a more active physiologic state.ObjectivesWe aimed to describe the haemodynamic effects of isoproterenol in patients with coarctation and the impact of intervention on the elicited gradients.MethodsA retrospective study was performed on two-ventricle patients who underwent cardiac catheterisation for coarctation with isoproterenol testing.Results25 patients received isoproterenol before and after intervention. With isoproterenol, the mean diastolic (p=0.0015) and mean arterial (p=0.0065) blood pressures proximal to the coarctation decreased significantly. The mean systolic, diastolic, and mean arterial blood pressures distal to the coarctation decreased significantly (p<0.0001). In patients with a baseline gradient ⩽20 mmHg (n=17) at catheterisation, the median gradient increased from 10 (0–20) to 30 (15–50) mmHg (p<0.0001) with isoproterenol. Of these, 15 patients developed a gradient >20 mmHg. Post intervention, the median gradient decreased to 2 (0–29) mmHg, versus baseline, p=0.005, and with isoproterenol it decreased to 8 (0–27) mmHg, versus pre-intervention isoproterenol, p<0.0001. There were significant improvements in the gradients by Doppler (<0.0001) and by blood pressure cuff (p=0.0313). The gradients on isoproterenol best correlated with gradients by blood pressure cuff in the awake state (R2=0.76, p<0.0001).ConclusionsIsoproterenol can be a useful tool to assess the significance of a coarctation and the effectiveness of an intervention. Percutaneous interventions can effectively reduce the gradients elicited by isoproterenol.

High prevalence of ascending aortic dilation in adults with repaired coarctation of the aorta

2021 ◽  
pp. 1-6
Author(s):  
Daniel Rinnström ◽  
Mikael Dellborg ◽  
Ulf Thilén ◽  
Peder Sörensson ◽  
Niels-Erik Nielsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Valve Disease ◽  
Aortic Dilation ◽  
Factors Associated ◽  
High Prevalence ◽  
Life Threatening

Abstract Background: Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients. Methods and results: From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]). Conclusions: Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

Role of Autonomic Nervous System in Maintenance of Cerebral and Renal Hypertension

1957 ◽  
Vol 188 (2) ◽  
pp. 371-374 ◽  
Author(s):  
Sol Rothman ◽  
Douglas R. Drury
Keyword(s):  
Blood Pressure ◽  
Nervous System ◽  
Autonomic Nervous System ◽  
Renal Hypertension ◽  
The Other ◽  
Peripheral Vasculature ◽  
Blood Pressures ◽  
Sympathetic Nervous ◽  
Blood Pressure Responses

The blood pressure responses to various drugs were investigated in renal hypertensive, cerebral hypertensive and normotensive rabbits. Hexamethonium bromide and Dibenamine reduced the blood pressures of renal and cerebral hypertensives. Effects in the normal were insignificant. The cerebral hypertensive's blood pressure was slightly affected by benzodioxane. Blood pressure was not reduced at all in the other groups. Blood pressure of the renal hypertensive rabbit was greatly reduced by Veriloid and dihydroergocornine. Blood pressures of cerebral and normal animals were affected to a lesser degree. The results suggest that maintenance of hypertension in the cerebral hypertensive rabbit depends on an overactive sympathetic nervous system, possibly due to the release of medullary pressor centers from inhibitory impulses originating in higher centers; whereas, the maintenance of hypertension in the renal hypertensive rabbit may be attributed to an increased reactivity of the peripheral vasculature to a normal sympathetic tone.

Physical exercise and blood pressure with reference to the angiotensinogen M235T polymorphism

2002 ◽  
Vol 10 (2) ◽  
pp. 71-77 ◽  
Author(s):  
Rainer Rauramaa ◽  
Raimo Kuhanen ◽  
Timo A. Lakka ◽  
Sari B. Väisänen ◽  
Pirjo Halonen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Reference Group ◽  
Controlled Trial ◽  
Exercise Group ◽  
Moderate Intensity ◽  
Moderate Intensity Exercise ◽  
Blood Pressures ◽  
Agt Gene ◽  
M235t Polymorphism

We investigated the role of the angiotensinogen (AGT) gene M235T polymorphism in determining blood pressure (BP) response to moderate intensity exercise in a 6-yr randomized controlled trial in 140 middle-aged men. Sitting, supine, and standing blood pressures were measured annually. Of the randomized men, 86% participated in the trial for 6 yr. Submaximal cardiorespiratory fitness increased by 16% in the exercise group. In the M homozygotes, sitting systolic BP decreased by 1.0 mmHg in the exercise but increased by 14.6 mmHg in the reference group ( P = 0.007 for net effect). Sitting and supine diastolic BP decreased by 6.2 and 3.3 mmHg in the exercise but increased by 2.8 and 3.2 mmHg in the reference group ( P = 0.026 and 0.024 for net effects), respectively. Regular moderate intensity exercise attenuates aging-related increase in systolic BP and decreases diastolic BP among the M homozygotes of the AGT gene M235T polymorphism.

Antenatal corticosteroid therapy and blood pressure at 14 years of age in preterm children

2000 ◽  
Vol 98 (2) ◽  
pp. 137-142 ◽  
Author(s):  
L. W. DOYLE ◽  
G. W. FORD ◽  
N. M. DAVIS ◽  
C. CALLANAN
Keyword(s):  
Blood Pressure ◽  
Corticosteroid Therapy ◽  
Animal Species ◽  
Antenatal Corticosteroid ◽  
Antenatal Corticosteroids ◽  
Preterm Children ◽  
Clinical Hypertension ◽  
Blood Pressures ◽  
The Relationship ◽  
Mercury Sphygmomanometer

Antenatal corticosteroid therapy substantially improves the survival rate of preterm infants, with few side effects. Higher blood pressure in adulthood has been described in several animal species after exposure to antenatal corticosteroids, but there are no similar reports in humans. The objective of the present study was to determine the relationship between exposure to antenatal corticosteroid therapy and blood pressure at 14 years of age. This was a cohort study of 210 preterm survivors with birthweights of < 1501 g born in the Royal Women's Hospital, Melbourne, between 1 January 1977 and 31 March 1982. Blood pressure was measured in 177 subjects (84.3%) at 14 years of age with a standard mercury sphygmomanometer. Children exposed to antenatal corticosteroids (n = 89) had higher systolic and diastolic blood pressures than those not exposed to corticosteroids (n = 88) [mean difference (95% confidence interval) (mmHg): systolic, 4.1 (0.1–8.0); diastolic, 2.8 (0.05–5.6)]. However, few had blood pressure in the hypertensive range. It is concluded that antenatal corticosteroid therapy is associated with higher systolic and diastolic blood pressures in adolescence, and might lead to clinical hypertension in survivors well beyond birth.

scholarly journals Effects of Experimental Coarctation of the Aorta on the Blood Pressure of Sheep

1959 ◽  
Vol 7 (1) ◽  
pp. 147-150 ◽  
Author(s):  
F. R. MAGAREY ◽  
W. E. STEHBENS ◽  
ALAN SHARP
Keyword(s):  
Blood Pressure ◽  
Coarctation Of The Aorta

scholarly journals Determining which automatic digital blood pressure device performs adequately: a systematic review

2010 ◽  
Vol 24 (7) ◽  
pp. 431-438 ◽  
Author(s):  
Y Wan ◽  
C Heneghan ◽  
R Stevens ◽  
R J McManus ◽  
A Ward ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Blood Pressure Device

Effect of alcohol withdrawal on blood pressure, plasma renin activity, aldosterone, cortisol and dopamine β-hydroxylase

1984 ◽  
Vol 66 (6) ◽  
pp. 659-663 ◽  
Author(s):  
L. T. Bannan ◽  
J. F. Potter ◽  
D. G. Beevers ◽  
J. B. Saunders ◽  
J. R. F. Walters ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Plasma Renin Activity ◽  
Alcohol Withdrawal ◽  
Diastolic Pressure ◽  
Urine Volume ◽  
Plasma Renin ◽  
Renin Activity ◽  
Withdrawal Symptoms ◽  
Urinary Volume ◽  
Blood Pressures

1. Sixty-five alcoholic patients admitted for detoxification had blood pressure, withdrawal symptoms, plasma cortisol (PC) and plasma aldosteron (PA) levels, plasma renin activity (PRA), and serum dopamin β-hydroxylase (DBH) levels measured on the first and fourth days after admission. 2. On the morning after admission blood pressure was elevated (>140/90) in 32 patients (49%) and was 160/95mmHg or more in 21 (32%). PRA was initially elevated in 41 patients, PA levels in 14, and 13 patients had raised PC levels. By the fourth day, blood pressure and bio-chemical measures had fallen significantly while urine volume and sodium output, low on admission, had increased significantly. On admission urinary metanephrine levels were raised in four out of the 31 patients who had them measured. 3. The height of both the systolic and diastolic blood pressures was significantly related to the severity of the alcohol. withdrawal symptoms. Of the biochemical parameters measured, PC level correlated with systolic but not diastolic pressure, and urinary volume was inversely correlated with the height of the diastolic pressure. No relationship was found between blood pressure and PRA or PA level. 4. The pressor effect of alcohol withdrawal could be due to sympathetic nervous system overactivity, or possibly to hypercortisolaemia. The first hypothesis seems more likely.

Letters to the Editor

PEDIATRICS ◽  
1980 ◽  
Vol 66 (6) ◽  
pp. 1033-1034
Author(s):  
M. De Swiet ◽  
E. A. Shinebourne ◽  
P. M. Fayers
Keyword(s):  
Blood Pressure ◽  
Study Group ◽  
Letters To The Editor ◽  
Entire Study ◽  
Blood Pressures

We agree with Dr Gillum that omission of some of the readings made at ages 6 months and 1 year could have produced bias in the results that we have quoted for blood pressure at these ages. However, the 5-cm cuff whose results were omitted was one of the middle sized cuffs and therefore the weights of the infants whose blood pressures were omitted were in the middle of the distribution at each age. As the Table shows, their blood pressures when measured on other occasions were also not significantly different from the blood pressures of the entire study group.

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