Introduction: We have previously shown that normotensive patients with successful coarctation repair (SCR) have decreased distensibility of the upper body and increased distensibility of the lower body arteries. Aortic stiffness and wave reflections are implicated in the pathogenesis of hypertension. In this study we aimed at assessing whether aortic stiffness and wave reflections are influenced in this category of patients.

Methods: 19 normotensive, asymptomatic patients 26±7 years old, and age at surgery 15±9 years with SCR and gradient <25 mmHg, and 19 age, gender, height, weight, smoking status, lipid profile adjusted controls were studied. Carotid-femoral pulse wave velocity (PWV) was measured as an index of the stiffness of the whole aorta using a validated non-invasive device (Complior^®). Wave reflections resulting from the whole body were studied using a validated system (SphygmoCor^®) that employs high-fidelity arterial tonometry for the non-invasive registration of radial pulse waveform and appropriate computer software for pulse wave analysis. Aortic pressure waveform was synthesized from the radial waveform using a generalized transfer function. Augmentation index (AIx) was measured as an index of wave reflections.

Results: SCR patients had higher systolic, pulse and mean pressure than controls, while diastolic pressures did not differ. PWV and AIx were not different among the two groups (table).

Conclusions: Despite the fact that SCR patients had higher systolic and pulse pressures, PWV and AIx were not different than controls, possibly because these indices are influenced by the elastic properties of both the pre- and post-coarctation part of the arterial tree.