P6311The impact of overweight in a paediatric population after Aortic Coarctation repair

Abstract

Background: Arterial hypertension and atherosclerosis are the main predictors of unfavourable prognosis after Coarctation of the Aorta (CoA) successful surgical repair. Additionally, overweight and obesity are known to increase long-term cardiovascular morbidity and mortality. Purpose(s): This study aims to investigate the relationship between overweight and vascular stiffness, arterial hypertension incidence and exercise capacity in children after early CoA repair. Method(s): A cross-sectional study was conducted considering all successful surgical CoA correction performed in a tertiary centre during children's first year of life, between 1996 and 2009. We excluded children with other cardiac structural lesions. Clinical analysis, stress test, ambulatory blood pressure (ABP) and aortic pulse wave velocity (PWV) were done between 2014 and 2016. These data were retrospectively collected and body mass index (BMI) was calculated, considering overweight according to Portuguese General Health Department (>85 Percentile). Fisher's Exact Test and Mann-Whitney test were used to compare categorical and continuous data between normal BMI and overweight children. Result(s): We included 42 children (26 presenting with bicuspid aortic valve and 7 with restrictive ventricular septal defect) with mean age, at evaluation time, of 12+/-4 years and 28 (66.7%) being male. An end to end anastomosis was applied in 80.5% patients and Waldhausen procedure in 19.5% children. At collection data time, 9 (22.0%) children were overweight. The prevalence of arterial hypertension was similar between normal BMI and overweight groups (28.1% vs. 44.4%, p=0.429), but the latter presented higher BNP values (median 24.9, 10.5 to 76.9 vs. 10.0, 3.8 to 82.9, p=0.020) and more frequently higher PWV values (100.0% vs. 50.0%, p=0.013). In stress tests, overweight children presented lower metabolic equivalent median (10.9, 9.9 to 12.8 vs. 12.8, 9.0 to 20.5, p=0.021) and shorter exercise duration (median 10.0, 9.0 to 12.0 vs. 12.0, 8.0 to 20.0, p=0.029). Conclusion(s): This study shows that overweight significantly impacts children's vascular stiffness and exercise capacity after early-age successful repair of CoA.