Banaszak Paweł, Szkutnik Małgorzata, Kusa Jacek, Banaszak Beata, Białkowski Jacek
Silesian Medical University, Silesian Center for Heart Diseases Congenital Heart Diseasesand Pediatric Cardiology Department, Zabrze, Poland.
Cardiol J. 2009;16(1):20-5.
Exercise-induced hypertension following repair of the coarctation of the aorta (CoA) is a well known phenomenon. The most important functional parameters in the assessment of the effects of a surgical repair of CoA are the maximal pressure gradient in the descending aorta (GRAD) and systolic blood pressure (SBP). Results of treadmill exercise test using the Bruce protocol (treadmill test) and dobutamine stress echocardiography (DSE) were compared to determine utility of the DSE in the evaluation of the effects of surgical treatment of CoA in children.
The study population comprised of 29 patients, including 20 males and 9 females (mean age 12 years) who underwent a surgical repair of CoA. Changes of the cardiovascular parameters including SBP, GRAD and heart rate (HR) during the treadmill test and DSE were compared.
During the treadmill test, SBP at peak exercise ranged from 120 to 230 (mean 163.7) mm Hg, GRAD ranged from 29 to 109 (mean 59.8) mm Hg, and HR ranged from 140 to 188 (mean 169) bpm. At the end of DSE, SBP ranged from 123 to 215 (mean 164.7) mm Hg, GRAD ranged from 29 to 113 (mean 55.4) mm Hg, and HR ranged from 76 to 155 (mean 111) bpm. We found positive correlations of SBP (r = 0.68, p < 0.001) and GRAD (r = 0.82, p < 0.001) values during both tests but no significant correlation for HR (r = 0.42, p = NS).
Dobutamine stress echocardiography is useful in the evaluation of the effects of surgical repair of CoA in children.
主动脉缩窄（CoA）修复术后运动诱发的高血压是一种众所周知的现象。评估CoA手术修复效果的最重要功能参数是降主动脉的最大压力梯度（GRAD）和收缩压（SBP）。比较了使用布鲁斯方案的跑步机运动试验（跑步机试验）和多巴酚丁胺负荷超声心动图（DSE）的结果，以确定DSE在评估儿童CoA手术治疗效果中的效用。
研究人群包括29例接受CoA手术修复的患者，其中男性20例，女性9例（平均年龄12岁）。比较了跑步机试验和DSE期间心血管参数（包括SBP、GRAD和心率（HR））的变化。
在跑步机试验期间，运动高峰时的SBP范围为120至230（平均163.7）mmHg，GRAD范围为29至109（平均59.8）mmHg，HR范围为140至188（平均169）次/分钟。在DSE结束时，SBP范围为123至215（平均164.7）mmHg，GRAD范围为29至113（平均55.4）mmHg，HR范围为76至155（平均111）次/分钟。我们发现两次测试期间SBP（r = 0.68，p < 0.001）和GRAD（r = 0.82，p < 0.001）值呈正相关，但HR无显著相关性（r = 0.42，p =无统计学意义）。
多巴酚丁胺负荷超声心动图有助于评估儿童CoA手术修复的效果。
