Daytime ambulatory blood pressure correlates strongly with the echocardiographic diameter of aortic coarctation

Abstract

Objective.-To relate the echocardiographic aortic arch-diameter to ambulatory and clinic blood pressure (BP) in patients with aortic coarctation. Design.-Eighteen adult patients (50% men) were recruited from the coarctation registry of the Linkoping Heart Centre. Biplane-trans-oesophageal echocardiography (TEE) was performed with Acuson XP 128/10, ambulatory BP was recorded with Spacelab models 90202/90205. Results.-Systolic clinic and ambulatory BP levels were higher in patients than in the 36 controls (clinic BP: 146 ± 25 mmHg vs 119 ± 10 mmHg, p = 0.0009, ambulatory BP: 140 ± 18 mmHg vs 124 ± 11 mmHg, p = 0.009). The differences in diastolic BP levels were less obvious (clinic BP: 87 ± 16 mmHg vs 76 ± 8 mmHg, p = 0.02, ambulatory BP: 84 ± 13 mmHg vs 77 ± 9 mmHg, p = 0.052). Daytime ambulatory BP was more strongly related than clinic BP to the coarctation diameter (AD) (systolic BP r = -0.73, p = 0.0006 and r = -0.61, p = 0.007, respectively). In surgically corrected patients (n = 14) only the correlations between ambulatory systolic daytime (r = -0.61, p = 0.02) and night-time (r = -0.58, p = 0.03) BP to AD was statistically significant. Conclusion.-Ambulatory BP correlates strongly with aortic coarctation measured by TEE and would thus be the preferred technique for evaluating BP in this patient category.