1
|
Lee MGY, Allen SL, Koleff J, Brink J, Konstantinov IE, Cheung MMH, Brizard CP, d’Udekem Y. Impact of arch reobstruction and early hypertension on late hypertension after coarctation repair†. Eur J Cardiothorac Surg 2017; 53:531-537. [DOI: 10.1093/ejcts/ezx360] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2017] [Accepted: 09/11/2017] [Indexed: 11/14/2022] Open
Affiliation(s)
- Melissa G Y Lee
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Sarah L Allen
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Jane Koleff
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Cardiology, The Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Johann Brink
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Igor E Konstantinov
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Michael M H Cheung
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
- Department of Cardiology, The Royal Children’s Hospital, Melbourne, VIC, Australia
| | - Christian P Brizard
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Yves d’Udekem
- Department of Cardiac Surgery, The Royal Children’s Hospital, Melbourne, VIC, Australia
- Heart Research, Murdoch Children's Research Institute, Melbourne, VIC, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
2
|
Luitingh T, Lee M, Jones B, Koleff J, Aguero SW, Kowalski R, Cheung M, d’Udekem Y. Effectiveness of Exercise-Testing to Detect Late Hypertension in Children Following Coarctation Repair. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
3
|
Lee MGY, Allen SL, Kawasaki R, Kotevski A, Koleff J, Kowalski R, Cheung MMH, Konstantinov IE, Brizard CP, d'Udekem Y. High Prevalence of Hypertension and End-Organ Damage Late After Coarctation Repair in Normal Arches. Ann Thorac Surg 2015; 100:647-53. [PMID: 26138761 DOI: 10.1016/j.athoracsur.2015.03.099] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Revised: 03/24/2015] [Accepted: 03/30/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND To (1) determine the prevalence of hypertension late after coarctation repair in patients with normal-sized transverse arches, and (2) evaluate the potential for end-organ damage related to hypertension after coarctation repair. There are no studies specifically investigating end-organ damage and hypertension after coarctation repair using noninvasive techniques. METHODS Eighty-two patients aged 10 years or greater with a coarctation repair and a normal-sized arch operated on between 1978 and 2010, underwent a transthoracic echocardiogram, 24-hour blood pressure (BP) monitoring, and retinal imaging. Median age at repair was 1 year (interquartile range, 0 to 6); 45% (37 of 82) were operated in the first year of life. RESULTS After a follow-up of 24 ± 7 years, 27% (22 of 82) and 50% (41 of 82) suffered resting hypertension and resting prehypertension, respectively. On 24-hour BP monitoring, 61% (49 of 80) and 21% (17 of 80) suffered hypertension and prehypertension, respectively. Arch reobstruction (echo gradient > 25 mm Hg) was present in only 15% (12 of 82), and in only 15% (7 of 47) with 24-hour hypertension. Resting hypertension was associated with a smaller central retinal artery equivalent (average width of arterioles) and central retinal vein equivalent (average width of venules) (p = 0.0006 and p = 0.003, respectively). Left ventricular hypertrophy on echocardiography was present in 63% (31 of 49) with 24-hour hypertension compared with only 42% (13 of 31) with normal 24-hour BP (p = 0.06). CONCLUSIONS There is a high rate of hypertension late after coarctation repair, even in patients with unobstructed arches. The presence of retinal imaging abnormalities and left ventricular hypertrophy signals the presence of end-organ damage in this young adult population. Regular follow-up with 24-hour BP monitoring is warranted.
Collapse
Affiliation(s)
- Melissa G Y Lee
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Sarah L Allen
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Ryo Kawasaki
- Department of Public Health, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Aneta Kotevski
- Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Jane Koleff
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
| | - Remi Kowalski
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia
| | - Michael M H Cheung
- Department of Cardiology, The Royal Children's Hospital, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Igor E Konstantinov
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Christian P Brizard
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Yves d'Udekem
- Department of Cardiac Surgery, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Australia; Heart Research Group, Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Australia.
| |
Collapse
|
4
|
McCloskey K, Ponsonby AL, Carlin JB, Jachno K, Cheung M, Skilton MR, Koleff J, Vuillermin P, Burgner D. Reproducibility of aortic intima-media thickness in infants using edge-detection software and manual caliper measurements. Cardiovasc Ultrasound 2014; 12:18. [PMID: 24894574 PMCID: PMC4061507 DOI: 10.1186/1476-7120-12-18] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Accepted: 05/09/2014] [Indexed: 11/15/2022] Open
Abstract
Background Aortic intima-media thickness measured by transabdominal ultrasound (aIMT) is an intermediate phenotype of cardiovascular risk. We aimed to (1) investigate the reproducibility of aIMT in a population-derived cohort of infants; (2) establish the distribution of aIMT in early infancy; (3) compare measurement by edge-detection software to that by manual sonographic calipers; and (4) assess the effect of individual and environmental variables on image quality. Methods Participants were term infants recruited to a population-derived birth cohort study. Transabdominal ultrasound was performed at six weeks of age by one of two trained operators. Thirty participants had ultrasounds performed by both operators on the same day. Data were collected on environmental (infant sleeping, presence of a sibling, use of sucrose, timing during study visit) and individual (post-conception age, weight, gender) variables. Two readers assessed image quality and measured aIMT by edge-detection software and a subset by manual sonographic calipers. Measurements were repeated by the same reader and between readers to obtain intra-observer and inter-observer reliability. Results Aortic IMT was measured successfully using edge-detection in 814 infants, and 290 of these infants also had aIMT measured using manual sonographic calipers. The intra-reader intra-class correlation (ICC) (n = 20) was 0.90 (95% CI 0.76, 0.96), mean difference 1.5 μm (95% LOA −39, 59). The between reader ICC using edge-detection (n = 20) was 0.92 (95% CI 0.82, 0.97) mean difference 2 μm (95% LOA −45.0, 49.0) and with manual caliper measurement (n = 290) the ICC was 0.84 (95% CI 0.80, 0.87) mean difference 5 μm (95% LOA −51.8, 61.8). Edge-detection measurements were greater than those from manual sonographic calipers (mean aIMT 618 μm (50) versus mean aIMT 563 μm (49) respectively; p < 0.001, mean difference 44 μm, 95% LOA −54, 142). With the exception of infant crying (p = 0.001), no associations were observed between individual and environmental variables and image quality. Conclusion In a population-derived cohort of term infants, aIMT measurement has a high level of intra and inter-reader reproducibility. Measurement of aIMT using edge-detection software gives higher inter-reader ICC than manual sonographic calipers. Image quality is not substantially affected by individual and environmental factors.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Peter Vuillermin
- Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Australia.
| | | | | |
Collapse
|
5
|
Liu JYJ, Jones B, Cheung MMH, Galati JC, Koleff J, Konstantinov IE, Grigg LE, Brizard CP, d'Udekem Y. Favourable anatomy after end-to-side repair of interrupted aortic arch. Heart Lung Circ 2013; 23:256-64. [PMID: 24060690 DOI: 10.1016/j.hlc.2013.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 07/13/2013] [Accepted: 08/09/2013] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate cardiovascular outcomes in patients with aortic arch repair and their possible correlation with arch geometry. METHODS Ten patients who underwent end-to-side repair for aortic arch interruption (IAA), older than 10 years were compared to a cohort of 10 post coarctation (CoA) repair patients matched for age, sex and age at repair. Mean age at operation was 9.7±6.5 days. Patients underwent a resting and 24 h blood pressure measurements, exercise study, MRI, transthoracic echocardiography and vascular studies. RESULTS Seven patients developed hypertension, two from IAA group and five from CoA group. Nine patients (45%) had gothic arch geometry, three from IAA group and six from CoA group. Despite differences in arch geometry, both groups had normal LV mass, LV function and vascular function. CONCLUSION No differences in functional or morphologic outcomes could be demonstrated between the end-to-side repair of the arch by sternotomy and the conventional coarctation repair by thoracotomy. A favourable arch geometry can be achieved after the end-to-side repair of the aortic arch. In the present study, we could not correlate adverse arch geometry with any adverse cardio-vascular outcomes. After neonatal arch repair, the contributive role of aortic arch geometry to late hypertension remains uncertain.
Collapse
Affiliation(s)
- Jessamine Y J Liu
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Bryn Jones
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - Michael M H Cheung
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - John C Galati
- Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Australia
| | - Jane Koleff
- Department of Cardiology, Royal Children's Hospital, Melbourne, Australia
| | - Igor E Konstantinov
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Leeanne E Grigg
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Australia
| | - Christian P Brizard
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia
| | - Yves d'Udekem
- Department of Cardiac Surgery, Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Children Research Institute, Melbourne, Australia.
| |
Collapse
|
6
|
Lee MGY, Kowalski R, Galati JC, Cheung MMH, Jones B, Koleff J, d'Udekem Y. Twenty-four-hour ambulatory blood pressure monitoring detects a high prevalence of hypertension late after coarctation repair in patients with hypoplastic arches. J Thorac Cardiovasc Surg 2012; 144:1110-6. [PMID: 22980064 DOI: 10.1016/j.jtcvs.2012.08.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 07/10/2012] [Accepted: 08/01/2012] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine by 24-hour blood pressure monitoring the risk of hypertension late after coarctation repair in patients with arch hypoplasia. METHODS Sixty-two of 116 consecutive patients (age, ≥10 years) who had coarctation repair and were quoted subjectively by the surgeon or the cardiologist to have arch hypoplasia at the time of the repair underwent a transthoracic echocardiogram and 24-hour blood pressure monitoring. Median age at repair was 11 days (range, 6-48 days). Mean preoperative z score of the proximal transverse arch was -2.43 ± 0.46. Eight patients had a repair via sternotomy (6 end-to-side anastomoses, 2 patch repairs) and 54 had a conventional repair via thoracotomy. RESULTS After a follow-up of 18 ± 5 years, 27% of the patients (17/62) had resting hypertension and 60% (37/62) had abnormal ambulatory blood pressure. Sensitivity of high resting blood pressure in detecting an abnormal 24-hour ambulatory blood pressure was 41%. Twenty patients had arch obstruction at last follow-up. Eighteen of them (90%) had abnormal ambulatory blood pressure. None of the patients operated on with end-to-side repair via sternotomy had reobstruction compared with 33% (18/54) of those repaired via thoracotomy. CONCLUSIONS Patients with a hypoplastic arch operated via thoracotomy have an alarming prevalence of hypertension. Regular follow-up with 24-hour ambulatory blood pressure monitoring is warranted, especially in patients who have had a smaller aortic arch at the time of the initial operation.
Collapse
Affiliation(s)
- Melissa G Y Lee
- Department of Cardiac Surgery, The Royal Children's Hospital, Department of Paediatrics, University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
| | | | | | | | | | | | | |
Collapse
|
7
|
Kowalski R, Beare R, Koleff J, Doyle L, Smolich J, Cheung M. Early Increases in Wave Reflection in Ex-Premature Adolescents as Assessed by Wave Intensity Analysis. Heart Lung Circ 2012. [DOI: 10.1016/j.hlc.2012.05.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
Rotstein A, Davis A, Kamberi S, Scicluna D, Koleff J, Cheung M, Weintaub R, Pflaumer A. QRS Duration and Long Term Benefit of Cardiac Resynchronisation Therapy—A Single Paediatric Centre Experience. Heart Lung Circ 2011. [DOI: 10.1016/j.hlc.2011.05.586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Sieswerda E, Wilkinson L, Koleff J, Newman Y, Vidmar S, Smibert E, Sjoberg G, Cheung MM, Weintraub RG. Assessment of Left Ventricular Systolic Function Late After Anthracycline Administration in Childhood. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2008.05.462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|