Pedretti E, Raisaro A, Lanza S, Bassanetti F
Divisione Pediatrica Piacenza, Italia.
Pediatr Med Chir. 1993 Jan-Feb;15(1):37-43.
Persistent hypertension is one of the causes of sudden death which sometimes happens in patients operated on for coarctation of the aorta. Seven patients operated on for coarctation of the aorta were examined using exercise testing (Treadmill-Bruce), Echo-Doppler and NMR. Pressure gradients between the right upper and lower limbs were compared with those of normal young people and evaluated using NMR. The authors conclude that the patients operated on have resting blood pressure and pressure gradients, both resting and during exercise, greater than normal. Some patients operated on, with normal resting blood pressure and a slight gradient, can develop hypertension during exercise and a significant pressure gradient. Significant gradients during exercise are correlated to isthmic obstruction which is visible on the NMR. Follow-up after surgical repair of coarctation of the aorta cannot exclude measurement of exercise pressure gradients. This gives more physiological information compared with pressure gradients measured at rest.
持续性高血压是主动脉缩窄手术患者有时会发生猝死的原因之一。对7例接受主动脉缩窄手术的患者进行了运动试验（跑步机-布鲁斯方案）、超声多普勒和核磁共振检查。将右上和下肢之间的压力梯度与正常年轻人的压力梯度进行比较，并使用核磁共振进行评估。作者得出结论，接受手术的患者静息血压以及静息和运动时的压力梯度均高于正常水平。一些静息血压正常且梯度轻微的接受手术的患者，在运动期间可能会出现高血压和显著的压力梯度。运动期间的显著梯度与核磁共振上可见的峡部梗阻相关。主动脉缩窄手术修复后的随访不能排除运动压力梯度的测量。与静息时测量的压力梯度相比，这能提供更多的生理信息。
