title: Hypertension after heart and heart/lung transplantation in childhood--study on the evolution of short-term blood pressure regulation.
abstract: Arterial hypertension complicates the follow-up of heart- and heart/lung-transplanted children. We investigated the evolution of BRS as short-time BP regulation mechanism and BP after heart and heart/lung transplantation. Twenty patients (15 males; mean age 15.1 ± 4.3 yr) were studied twice at intervals of 2.96 ± 0.87 yr. BRS was calculated using non-invasive beat-to-beat BP measurement system. HRV was calculated (LF, sympathetic influence; HF, parasympathetic influence). BRS increased in 10 patients (3.67 ± 1.43 ms/mmHg vs. 7.59 ± 3.40 mmHg, p = 0.005) (group 1). Six of 10 patients received antihypertensive medication. BRS decreased or remained unchanged in 10 patients (8.93 ± 7.9 ms/mmHg vs. 5.32 ± 6.6 ms/mmHg, p = 0.008) (group 2) with 9/10 patients necessitating antihypertensive medication. Group 1 showed LF/HF increase (LF/HF 1.03 ± 0.9 vs. 4.36 ± 2.32, p = 0.03); group 2 showed LF/HF decrease (LF/HF 3.7 ± 2.1 vs. 1.84 ± 1.1, p = 0.023). Evolution of BRS after heart and heart/lung transplantation in childhood seems to influence the necessity of antihypertensive medication. With time, increasing short-time BP regulation involving sympathetic reinnervation may improve BP.
authors.affiliation: Departments of Pediatric Cardiology             Neonatology             Cardiac Surgery, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Kohler
authors.forename: Judith
authors.initials: J
authors.lastname: Reisner
authors.forename: Rainer
authors.initials: R
authors.lastname: Kozlik-Feldmann
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Januszewska
authors.forename: Heinrich
authors.initials: H
authors.lastname: Netz
authors.forename: Robert
authors.initials: R
authors.lastname: Dalla Pozza
mesh_terms: D000293:Adolescent; D000959:Antihypertensive Agents / Q000627:therapeutic use; D017704:Baroreflex; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate; D016027:Heart Transplantation / Q000009:adverse effects* / Q000502:physiology; D016041:Heart-Lung Transplantation / Q000009:adverse effects* / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D008297:Male
chemical_list: D000959:Antihypertensive Agents