1 Department of Paediatric Cardiology and Congenital Heart Disease, Deutsches Herzzentrum München, Technische Universität München, Germany.
2 Institute of Preventive Paediatrics, Technische Universität München, Germany.
Eur J Prev Cardiol. 2018 Jan;25(1):103-109. doi: 10.1177/2047487317737174. Epub 2017 Oct 23.
Objective Central systolic blood pressure (SBP) is a measure of arterial stiffness and strongly associated with atherosclerosis and end-organ damage. It is a stronger predictor of cardiovascular events and all-cause mortality than peripheral SBP. In particular, for children with congenital heart disease, a higher central SBP might impose a greater threat of cardiac damage. The aim of the study was to analyse and compare central SBP in children with congenital heart disease and in healthy counterparts. Patients and methods Central SBP was measured using an oscillometric method in 417 children (38.9% girls, 13.0 ± 3.2 years) with various congenital heart diseases between July 2014 and February 2017. The test results were compared with a recent healthy reference cohort of 1466 children (49.5% girls, 12.9 ± 2.5 years). Results After correction for several covariates in a general linear model, central SBP of children with congenital heart disease was significantly increased (congenital heart disease: 102.1 ± 10.2 vs. healthy reference cohort: 100.4 ± 8.6, p < .001). The analysis of congenital heart disease subgroups revealed higher central SBP in children with left heart obstructions (mean difference: 3.6 mmHg, p < .001), transpositions of the great arteries after arterial switch (mean difference: 2.2 mmHg, p = .017) and univentricular hearts after total cavopulmonary connection (mean difference: 2.1 mmHg, p = .015) compared with the reference. Conclusion Children with congenital heart disease have significantly higher central SBP compared with healthy peers, predisposing them to premature heart failure. Screening and long-term observations of central SBP in children with congenital heart disease seems warranted in order to evaluate the need for treatment.
目的
中心收缩压（SBP）是衡量动脉僵硬程度的指标，与动脉粥样硬化和靶器官损伤密切相关。它是心血管事件和全因死亡率的更强预测因子，比外周 SBP 更强。特别是对于患有先天性心脏病的儿童，较高的中心 SBP 可能会对心脏造成更大的损害威胁。本研究的目的是分析和比较患有先天性心脏病的儿童与健康对照者的中心 SBP。
患者和方法
2014 年 7 月至 2017 年 2 月，使用振荡法测量了 417 名患有各种先天性心脏病的儿童（38.9%为女孩，13.0±3.2 岁）的中心 SBP。将测试结果与最近的健康对照组（1466 名儿童，49.5%为女孩，12.9±2.5 岁）进行比较。
结果
在一般线性模型中对多个协变量进行校正后，先天性心脏病患儿的中心 SBP 显著升高（先天性心脏病组：102.1±10.2 vs. 健康对照组：100.4±8.6，p<.001）。对先天性心脏病亚组的分析显示，左心梗阻患儿的中心 SBP 更高（平均差异：3.6mmHg，p<.001），动脉转换后的大动脉转位（平均差异：2.2mmHg，p=.017）和全腔静脉肺动脉连接后的单心室心脏（平均差异：2.1mmHg，p=.015）与对照组相比。
结论
与健康同龄人相比，患有先天性心脏病的儿童中心 SBP 明显升高，使他们容易发生心力衰竭。对患有先天性心脏病的儿童进行中心 SBP 筛查和长期观察似乎是必要的，以便评估治疗的必要性。
