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NR 3/2004
SUPLEMENT
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Epidemiologia
retinopatii nadci¶nieniowej u młodych pacjentów po leczeniu
koarktacji aorty
Epidemiology of hypertensive
retinopathy in young patients after coarctation of the aorta
repair
Krystyna Raczyńska1, Piotr
Potaż2, Janina Aleszewicz-Baranowska2
1Z Katedry i Kliniki Chorób Oczu Akademii Medycznej w
Gdańsku
Kierownik: prof. dr hab. n. med. Barbara
Iwaszkiewicz-Bilikiewicz
2Z Kliniki Kardiologii Dziecięcej i Wad Wrodzonych
Serca Akademii Medycznej w Gdańsku
Kierownik: prof. dr hab. n. med. Jan Ereciński |
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| Summary: |
Purpose:
Coarctation of the aorta is a cause of childhood
hypertension. In some patients hypertension persists
after coarctation repair. We evaluated hypertensive
retinopathy in patients after coarctation repair,
factors correlated with retinopathy, specificity of
retinal findings.
Material and methods: 54 patients (mean age of
surgery 6 years, mean follow-up time 10 years), were
studied. Hypertension was present in all subjects prior
to operation. We used ambulatory blood pressure
monitoring (ABPM) to follow blood pressure evaluation
after repair. Direct ophtalmoscopy was performed in all
subjects.
Results: Subjects were divided into two groups
according to current blood pressure values: group I –
normotensive – 34 pts, group II – hypertensive – 20 pts.
Hypertensive angiopathy (I-II K-W) was found in 30%
patients (9% in group I and 65% in group II). Subjects
with angiopathy were mean 7 years older and had higher
blood pressure values (24h mean systolic and load), than
those without retinal changes. Patients with and without
angiopathy did not differ significantly in preoperative
blood pressure values. 81% subjects with angiopathy were
hypertensive and 86% patients without retinal changes
were normotensive. The most common fundus pathologies
were arteriolar tortuosity (35%) and narrowing (28%).
Conclusions: 1. There were no signs of persistent
angiopathy in most normotensive patients, even though
all of them suffered from hypertension in childhood. 2.
In our study hypertensive angiopathy corresponded with
present blood pressure values and patient's age. 3. All
abnormalities were mild (I-II degree K-W), which also
caused some diagnostic difficulties to distinguish
between normal and pathological subjects. |
| Słowa kluczowe: |
retinopatia
nadci¶nieniowa, nadci¶nienie tętnicze, zwężenie cie¶ni
aorty. |
| Key words: |
hypertensive retinopathy,
arterial hypertension, coarctation of the aorta. |
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