title: Development of exercise-induced arm-leg blood pressure gradient and abnormal arterial compliance in patients with repaired coarctation of the aorta.
abstract: Often, the lack of systemic arterial hypertension and the lack of a resting arm-leg blood pressure gradient are used to assess the adequacy of the anatomic result after intervention for coarctation of the aorta (CoA). Some patients with no arm-leg gradient at rest may develop a gradient with exercise, leading caregivers to question the success of the repair. It is not clear what the prevalence is of patients who have undergone a successful intervention for CoA and have no arm-leg gradient at rest but develop a significant gradient with exercise and which factors may predict the development of an arm-leg gradient with exercise. This study evaluates the prevalence and predictors of an exercise-induced arm-leg gradient in subjects who have undergone an apparently successful intervention for CoA.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA. larry.markham@cchmc.org
authors.forename: Larry W
authors.initials: LW
authors.lastname: Markham
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Knecht
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Daniels
authors.forename: Wayne A
authors.initials: WA
authors.lastname: Mays
authors.forename: Philip R
authors.initials: PR
authors.lastname: Khoury
authors.forename: Timothy K
authors.initials: TK
authors.lastname: Knilans
mesh_terms: D000293:Adolescent; D001017:Aortic Coarctation / Q000503:physiopathology* / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000209:etiology / Q000503:physiopathology; D001132:Arm / Q000098:blood supply*; D001158:Arteries / Q000503:physiopathology; D001794:Blood Pressure / Q000502:physiology*; D006348:Cardiac Surgical Procedures; D002648:Child; D002669:Child Welfare; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male; D009200:Myocardial Contraction / Q000502:physiology; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000503:physiopathology*; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013223:Statistics as Topic; D016896:Treatment Outcome