Background: Exercise-induced hypertension following repair of the coarctation of the aorta
(CoA) is a well known phenomenon. The most important functional parameters in the assessment
of the effects of a surgical repair of CoA are the maximal pressure gradient in the
descending aorta (GRAD) and systolic blood pressure (SBP). Results of treadmill exercise test
using the Bruce protocol (treadmill test) and dobutamine stress echocardiography (DSE) were
compared to determine utility of the DSE in the evaluation of the effects of surgical treatment of
CoA in children.
Methods: The study population comprised of 29 patients, including 20 males and 9 females
(mean age 12 years) who underwent a surgical repair of CoA. Changes of the cardiovascular
parameters including SBP, GRAD and heart rate (HR) during the treadmill test and DSE
were compared.
Results: During the treadmill test, SBP at peak exercise ranged from 120 to 230 (mean
163.7) mm Hg, GRAD ranged from 29 to 109 (mean 59.8) mm Hg, and HR ranged from
140 to 188 (mean 169) bpm. At the end of DSE, SBP ranged from 123 to 215 (mean 164.7) mm Hg,
GRAD ranged from 29 to 113 (mean 55.4) mm Hg, and HR ranged from 76 to 155 (mean 111) bpm.
We found positive correlations of SBP (r = 0.68, p < 0.001) and GRAD (r = 0.82,
p < 0.001) values during both tests but no significant correlation for HR (r = 0.42, p = NS).
Conclusions: Dobutamine stress echocardiography is useful in the evaluation of the effects of
surgical repair of CoA in children
