TY - JOUR
T1 - Hypertensive response to exercise in adult patients with repaired aortic coarctation
AU - Meijs, Timion A.
AU - Muller, Steven A.
AU - Minderhoud, Savine C. S.
AU - de Winter, Robbert J.
AU - Mulder, Barbara J. M.
AU - van Melle, Joost P.
AU - Hoendermis, Elke S.
AU - van Dijk, Arie P. J.
AU - Zuithoff, Nicolaas P. A.
AU - Krings, Gregor J.
AU - Doevendans, Pieter A.
AU - Spiering, Wilko
AU - Witsenburg, Maarten
AU - Roos-Hesselink, Jolien W.
AU - van den Bosch, Annemien E.
AU - Bouma, Berto J.
AU - Voskuil, Michiel
PY - 2022/1/5
Y1 - 2022/1/5
N2 - Objective The clinical and prognostic implications of a hypertensive response to exercise after repair of coarctation of the aorta (CoA) remain controversial. We aimed to determine the prevalence of a hypertensive response to exercise, identify factors associated with peak exercise systolic blood pressure (SBP) and explore the association of peak exercise SBP with resting blood pressure and cardiovascular events during follow-up. Methods From the Dutch national CONgenital CORvitia (CONCOR) registry, adults with repaired CoA who underwent exercise stress testing were included. A hypertensive response to exercise was defined as a peak exercise SBP >= 210 mm Hg in men and >= 190 mm Hg in women. Cardiovascular events consisted of coronary artery disease, stroke, aortic complications and cardiovascular death. Results Of the original cohort of 920 adults with repaired CoA, 675 patients (median age 24 years (range 16-72 years)) underwent exercise stress testing. Of these, 299 patients (44%) had a hypertensive response to exercise. Mean follow-up duration was 10.1 years. Male sex, absence of a bicuspid aortic valve and elevated resting SBP were independently associated with increased peak exercise SBP. Peak exercise SBP was positively predictive of office SBP (beta=0.11, p
AB - Objective The clinical and prognostic implications of a hypertensive response to exercise after repair of coarctation of the aorta (CoA) remain controversial. We aimed to determine the prevalence of a hypertensive response to exercise, identify factors associated with peak exercise systolic blood pressure (SBP) and explore the association of peak exercise SBP with resting blood pressure and cardiovascular events during follow-up. Methods From the Dutch national CONgenital CORvitia (CONCOR) registry, adults with repaired CoA who underwent exercise stress testing were included. A hypertensive response to exercise was defined as a peak exercise SBP >= 210 mm Hg in men and >= 190 mm Hg in women. Cardiovascular events consisted of coronary artery disease, stroke, aortic complications and cardiovascular death. Results Of the original cohort of 920 adults with repaired CoA, 675 patients (median age 24 years (range 16-72 years)) underwent exercise stress testing. Of these, 299 patients (44%) had a hypertensive response to exercise. Mean follow-up duration was 10.1 years. Male sex, absence of a bicuspid aortic valve and elevated resting SBP were independently associated with increased peak exercise SBP. Peak exercise SBP was positively predictive of office SBP (beta=0.11, p
KW - heart defects
KW - congenital
KW - aortic coarctation
KW - hypertension
KW - GUIDELINES
KW - CAPACITY
U2 - 10.1136/heartjnl-2021-320333
DO - 10.1136/heartjnl-2021-320333
M3 - Article
JO - Heart
JF - Heart
SN - 1355-6037
ER -