title: Aortic surgery is one of the risk factors for enhancement of pressure wave reflection in adult patients with congenital heart disease.
abstract: BACKGROUND
  Excessive aortic pressure wave reflection is one of the risk factors of cardiovascular diseases. In some clinical course of congenital heart diseases, the elevated pressure wave reflection has been reported. The purpose of this study is to elucidate the risk factors of the enhanced pressure wave reflection in adult patients with congenital heart disease.
  
  
  METHODS
  We enrolled 99 adult (≥20 years) patients with congenital heart disease. We measured their radial pressure augmentation index and examined the relationship between it and various clinical variables.
  
  
  RESULTS
  The radial pressure augmentation index was 77.1 ± 19.1% and it had a significant correlation with the history of aorto-pulmonary shunt (t=4.194; p<0.0001), age (t=4.091; p<0.0001), height (t=-3.580; p=0.001) and the history of direct aortic surgery (t=2.253; p=0.027). Forty-four patients (44.4%) demonstrated high radial augmentation index (>1SD of age- and gender matched control) and the determinants of the elevated radial augmentation index were the history of aorto-pulmonary shunt (odds ratio, 21.32; 95% confidence interval, 5.47-83.14; p<0.0001) and the direct aortic surgery (4.18; 1.38-12.72; p=0.012).
  
  
  CONCLUSIONS
  The history of aortic surgeries enhances aortic pressure wave reflection in adult patients with congenital heart disease. The enhanced aortic pressure wave reflection is one of the risk factors for cardiovascular diseases. Therefore, the adult patients with congenital heart disease after aortic surgeries should be carefully observed and tightly controlled concerning the risk factors for cardiovascular diseases.
authors.affiliation: Department of Cardiology, Chiba Children's Hospital, Japan. Electronic address: murat@seagreen.ocn.ne.jp.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Tateno
authors.affiliation: Department of Adult Congenital Heart Disease and Pediatric Cardiology, Chiba Cardiovascular Center, Japan.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Kawasoe
authors.affiliation: Department of Cardiology, St. Luke's International Hospital, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Niwa
mesh_terms: D000328:Adult; D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D063177:Pulse Wave Analysis / Q000639:trends*; D012307:Risk Factors; D055815:Young Adult
keywords: Adult congenital heart disease; Aorta; Central hemodynamics; Pressure wave reflection