Circulation, Vol 65, 1060-1065, Copyright © 1982 by American Heart Association
J Sehested, U Baandrup and E Mikkelsen
In eight humans with coarctation, fresh aortic tissue was examined
pharmacodynamically. In four of these patients, and in 12 additional
patients, the aorta above and below the coarctation was studied
morphologically and compared with eight control aortas. By in vitro
stimulation with potassium (127 mM), noradrenaline (18 microM), and
prostaglandin F2 alpha (28 microM), postcoarctational aortic ring
preparations showed a significantly greater contractility than
precoarctational rings (p less than 0.05). Volumetric analysis showed
significantly more collagen (P less than 0.01) and les smooth muscle mass
(p less than 0.01) in the aorta above than below the coarctation. No
significant differences were found between sections from the arch and
distal to the ligamentum arteriosum in the normal aortas. We conclude that
the precoarctational aortic wall is more rigid than the postcoarctational
wall. This may influence baroreceptors in the upper vascular bed in such a
way as to tolerate a higher pressure. This would explain the preoperative
proximal hypertension, the paradoxic hypertension and the frequent lack of
normalization of blood pressure postoperatively.
ARTICLES
Different reactivity and structure of the prestenotic and poststenotic aorta in human coarctation. Implications for baroreceptor function
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