Department of Cardiology, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, NE7 7DN, England, UK,
Curr Hypertens Rep. 2014 Mar;16(3):421. doi: 10.1007/s11906-014-0421-4.
Coarctation of the aorta represents more than a simple obstructive lesion, as there is often evidence of hypertension and vascular dysfunction despite successful surgery at an early age. There are ample data showing that a large proportion of patients develop arterial hypertension, and this appears to increase with age. Our understanding of the pathogenesis of late hypertension is incomplete, and there is limited information on which drugs are most appropriate. Increased arterial rigidity is now well described in this patient group, although it is not known how this should influence therapy. The increase in afterload associated with this increased rigidity has been found to have an impact on the left ventricle at an early stage, and the interaction between the vascular dysfunction and the ventricle is an area of interest and active research. This article reviews some recent studies and highlights areas where research questions remain.
主动脉缩窄不仅仅是一种单纯的阻塞性病变，即使在早期成功进行了手术，仍常常存在高血压和血管功能障碍的证据。有大量数据表明，很大一部分患者会出现动脉高血压，而且随着年龄的增长，这种情况似乎会增加。我们对晚期高血压发病机制的了解并不完全，也没有关于哪种药物最适合的信息。尽管目前尚不清楚这将如何影响治疗，但该患者群体的动脉僵硬程度增加已得到充分描述。与这种刚性增加相关的后负荷增加已在早期阶段对左心室产生影响，血管功能障碍和心室之间的相互作用是一个研究兴趣点和活跃的研究领域。本文综述了一些最近的研究，并强调了仍存在研究问题的领域。
