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The cardiovascular phenotype of childhood hypertension: a cardiac magnetic resonance study

Cheang, MH; Kowalik, GT; Quail, MA; Steeden, JA; Hothi, D; Tullus, K; Muthurangu, V; (2019) The cardiovascular phenotype of childhood hypertension: a cardiac magnetic resonance study. Pediatric Radiology , 49 (6) pp. 727-736. 10.1007/s00247-019-04393-6. Green open access

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Abstract

BACKGROUND: The cardiovascular phenotype is poorly characterized in treated pediatric hypertension. Cardiovascular magnetic resonance imaging (MRI) can be used to better characterize both cardiac and vascular phenotype in children with hypertension. OBJECTIVE: To use MRI to determine the cardiac and vascular phenotypes of different forms of treated hypertension and compare the results with those of healthy children. MATERIALS AND METHODS: Sixty children (15 with chronic renal disease with hypertension, 15 with renovascular hypertension, 15 with essential hypertension and 15 healthy subjects) underwent MRI with noninvasive blood pressure measurements. Cardiovascular parameters measured include systemic vascular resistance, total arterial compliance, left ventricular mass and volumetric data, ejection fraction and myocardial velocity. Between-group comparisons were used to investigate differences in the hypertension types. RESULTS: Renal hypertension was associated with elevated vascular resistance (P≤0.007) and normal arterial compliance. Conversely, children with essential hypertension had normal resistance but increased compliance (P=0.001). Renovascular hypertension was associated with both increased resistance and compliance (P≤0.03). There was no difference in ventricular volumes, mass or cardiac output between groups. Children with renal hypertension also had lower systolic and diastolic myocardial velocities. CONCLUSION: Cardiovascular MRI may identify distinct vascular and cardiac phenotypes in different forms of treated childhood hypertension. Future studies are needed to investigate how this may inform further optimisation of blood pressure treatment in different types of hypertension.

Type: Article
Title: The cardiovascular phenotype of childhood hypertension: a cardiac magnetic resonance study
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00247-019-04393-6
Publisher version: https://doi.org/10.1007/s00247-019-04393-6
Language: English
Additional information: Copyright © The Author(s) 2019. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Aortic stiffness, Child, Chronic kidney disease, Hypertension, Magnetic resonance imaging, Renal artery stenosis, Systemic vascular resistance
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Childrens Cardiovascular Disease
URI: https://discovery.ucl.ac.uk/id/eprint/10074180
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