The influence of autonomic nervous system and elastic properties of the aortic wall on arterial hypertension progression in patients after surgical correction of coarctation of the aorta

Aim: To assess sensitivity of the baroreceptors and elastic properties of the aortic wall in patients who underwent surgical correction of coarctation of the aorta. Methods: In this prospective cohort study focus was placed on the evaluation of baroreceptors function and elastic properties of the aorta in 26 young patients who underwent surgical repair of coarctation of the aorta by using end-to-end extended anastomosis (Group I). The evaluation data obtained was then compared with that of the control group consisting of 26 healthy children without any congenital heart defects (Group II). Results: Follow-up period was 25 (21 ;30) months. The spontaneous sensitivity of baroreceptors varied between the groups and was significantly higher in Group I 11.6 (10.5;12.6) versus 8.8 (8.1 ;9.9) in Group II, p=0.01. The velocity of pulsatile blood flow was higher in Group I 7.7 (5.8;9) (m/s) -1 versus 5.9 (4.8;7.1 ) (m/s) -1 in Group II, with a statistically significant difference between them (p = 0.003). The elastic properties of the aortic wall in Group I also considerably differed from those in the control group. Conclusion: A high baroreceptors sensitivity and aortic wall stiffness in patients after surgical repair of coarctation of the aorta are direct predictors of arterial hypertension progression. However, it is important to assess the influence of the stroke volume on the rate of arterial hypertension incidence in patients who underwent surgical repair of coarctation of the aorta.