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Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls

(2019) OPEN HEART. 6(2).
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Organization
Abstract
Objective Patients with repaired coarctation (RCoA) remain at higher risk of cardiac dysfunction, initially often only detected during exercise. In this study, haemodynamics of isometric handgrip (HG) and bicycle ergometry (BE) were compared in patients with RCoA and matched controls (MCs). Methods Case-control study of 19 children with RCoA (mean age 12.9 +/- 2.3 years; mean age of repair 7 months) compared with 20 MC. HG with echocardiography followed by BE was performed in both groups. Results During HG (blood pressure) BP increased from 114 +/- 11/64 +/- 4 mm Hg to 132 +/- 14/79 +/- 7 mm Hg, without significant differences. During HG as well as BE, HR increased less in patients with RCoA. There were no significant differences in (left ventricle) LV dimensions or LV mass. The RCoA group had diastolic dysfunction: both at rest and during HG they had significantly higher transmitral E and A velocities and lower tissue Doppler E' and A' velocities. E/E' was higher, reaching statistical significance during HG (p<0001). Conventional parameters of systolic function (FS and EF) were similar at rest and HG. More sensitive tissue Doppler S' was significantly lower at rest in CoA subjects (5.1 +/- 1.5 cm/s vs 6.5 +/- 1 +/- 1 cm/s; p<0.01), decreasing further during HG by 5% in the CoA group (NS) while unchanged in controls. Conclusions We provide first evidence that HG with echocardiography is feasible, easy and patient-friendly. A decreased systolic (tissue Doppler) and impaired diastolic LV function was measured in the RCoA group, a difference that tended to increase during HG.
Keywords
LEFT-VENTRICULAR MASS, TERM-FOLLOW-UP, SURGICAL REPAIR, BLOOD-PRESSURE, ARTERIAL-HYPERTENSION, DIASTOLIC FUNCTION, YOUNG-ADULTS, STIFFNESS, DYSFUNCTION, REACTIVITY

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MLA
Panzer, Joseph, et al. “Echocardiography during Submaximal Isometric Exercise in Children with Repaired Coarctation of the Aorta Compared with Controls.” OPEN HEART, vol. 6, no. 2, 2019, doi:10.1136/openhrt-2019-001075.
APA
Panzer, J., Dequeker, L., Coomans, I., Vandekerckhove, K., Bové, T., De Wolf, D., & Rietzschel, E. (2019). Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls. OPEN HEART, 6(2). https://doi.org/10.1136/openhrt-2019-001075
Chicago author-date
Panzer, Joseph, Laure Dequeker, Ilse Coomans, Kristof Vandekerckhove, Thierry Bové, Daniël De Wolf, and Ernst Rietzschel. 2019. “Echocardiography during Submaximal Isometric Exercise in Children with Repaired Coarctation of the Aorta Compared with Controls.” OPEN HEART 6 (2). https://doi.org/10.1136/openhrt-2019-001075.
Chicago author-date (all authors)
Panzer, Joseph, Laure Dequeker, Ilse Coomans, Kristof Vandekerckhove, Thierry Bové, Daniël De Wolf, and Ernst Rietzschel. 2019. “Echocardiography during Submaximal Isometric Exercise in Children with Repaired Coarctation of the Aorta Compared with Controls.” OPEN HEART 6 (2). doi:10.1136/openhrt-2019-001075.
Vancouver
1.
Panzer J, Dequeker L, Coomans I, Vandekerckhove K, Bové T, De Wolf D, et al. Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls. OPEN HEART. 2019;6(2).
IEEE
[1]
J. Panzer et al., “Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls,” OPEN HEART, vol. 6, no. 2, 2019.
@article{8642408,
  abstract     = {{Objective Patients with repaired coarctation (RCoA) remain at higher risk of cardiac dysfunction, initially often only detected during exercise. In this study, haemodynamics of isometric handgrip (HG) and bicycle ergometry (BE) were compared in patients with RCoA and matched controls (MCs).

Methods Case-control study of 19 children with RCoA (mean age 12.9 +/- 2.3 years; mean age of repair 7 months) compared with 20 MC. HG with echocardiography followed by BE was performed in both groups.

Results During HG (blood pressure) BP increased from 114 +/- 11/64 +/- 4 mm Hg to 132 +/- 14/79 +/- 7 mm Hg, without significant differences. During HG as well as BE, HR increased less in patients with RCoA. There were no significant differences in (left ventricle) LV dimensions or LV mass.

The RCoA group had diastolic dysfunction: both at rest and during HG they had significantly higher transmitral E and A velocities and lower tissue Doppler E' and A' velocities. E/E' was higher, reaching statistical significance during HG (p<0001).

Conventional parameters of systolic function (FS and EF) were similar at rest and HG. More sensitive tissue Doppler S' was significantly lower at rest in CoA subjects (5.1 +/- 1.5 cm/s vs 6.5 +/- 1 +/- 1 cm/s; p<0.01), decreasing further during HG by 5% in the CoA group (NS) while unchanged in controls.

Conclusions We provide first evidence that HG with echocardiography is feasible, easy and patient-friendly. A decreased systolic (tissue Doppler) and impaired diastolic LV function was measured in the RCoA group, a difference that tended to increase during HG.}},
  articleno    = {{e001075}},
  author       = {{Panzer, Joseph and Dequeker, Laure and Coomans, Ilse and Vandekerckhove, Kristof and Bové, Thierry and De Wolf, Daniël and Rietzschel, Ernst}},
  issn         = {{2053-3624}},
  journal      = {{OPEN HEART}},
  keywords     = {{LEFT-VENTRICULAR MASS,TERM-FOLLOW-UP,SURGICAL REPAIR,BLOOD-PRESSURE,ARTERIAL-HYPERTENSION,DIASTOLIC FUNCTION,YOUNG-ADULTS,STIFFNESS,DYSFUNCTION,REACTIVITY}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{8}},
  title        = {{Echocardiography during submaximal isometric exercise in children with repaired coarctation of the aorta compared with controls}},
  url          = {{http://dx.doi.org/10.1136/openhrt-2019-001075}},
  volume       = {{6}},
  year         = {{2019}},
}

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