P1036Relation between left ventricular tissue doppler imaging and ambulatory blood pressure monitoring parameters in children after cardiosurgery for aortic coarctation


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Abstract

Left ventricular dysfunction due to elevated blood pressure may be observed in children after aortic coarctation (CoA).The aim of the study was to analyze correlations between left ventricular systolic and diastolic function parameters evaluated by Tissue Doppler Imaging (TDI) and selected Ambulatory Blood Pressure Monitoring (ABPM) measurements in children after surgical repair of CoA.Methods: The study group consisted of 32 patients with the mean age 12,01±4,24 years and mean follow-up 8,17±2,39 years. 34 healthy children served as controls. In all children ABPM with systolic/diastolic pressure load (SPL, DPL), mean blood pressure (MBP), pulse pressure (PP), systolic/diastolic pressure variability (SPV, DPV) and TDI with systolic, early diastolic and late diastolic velocity of mitral annulus motion (S',E',A'), ratio E'/A', systolic strain and strain rate (SS, SSR), early diastolic strain and strain rate (ES, ESR), late diastolic strain and strain rate (AS, ASR), ESR/ASR ratio and ES/AS ratio were performed. Pearson's correlation coefficients were calculated.Results: The mean values of S', SS, SSR were statistically higher in the study group than in controls (6,9±0,7 cm/s vs 6,4±0,8 cm/s, p<0,05; -28,7±6,0% vs. 22,5±6,4%, p<0,001; 3,2±0,8 1/s vs. 2,49±0,5 1/s, p<0,001) and mean values of E'/A', ES/AS, ESR/ASR were lower in the study group (1,7±0,6 vs. 2,1±0,4, p<0,001; 1,2±0,5 vs. 3,4±1,3, p<0,001; 1,8±0,6 vs. 3,7±1,5, p<0,001). The mean values of SPL, MBP, PP and SPV were significantly higher in the study group compared to controls. Results of correlations between TDI and ABPM parameters are presented in the table.Conclusions: 1. Increased systolic pressure load is observed in children with impaired left ventricular diastolic mechanics. 2. High systolic pressure variability and elevated pulse pressure in patients after CoA may suggest left ventricular dysfunction.

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