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Rinnström, Daniel
Publications (10 of 12) Show all publications
Rinnström, D., Dellborg, M., Thilén, U., Sörensson, P., Nielsen, N.-E., Christersson, C., . . . Johansson, B. (2017). Poor blood pressure control in adults with repaired coarctation of the aorta and hypertension: a register-based study of associated factors. Cardiology in the Young, 27(9), 1708-1715
Open this publication in new window or tab >>Poor blood pressure control in adults with repaired coarctation of the aorta and hypertension: a register-based study of associated factors
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2017 (English)In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 27, no 9, p. 1708-1715Article in journal (Other academic) Published
Abstract [en]

Arterial hypertension is common in adults with repaired coarctation of the aorta, and is associated with several severe complications.

This study aimed to investigate the prevalence of poorly controlled (⩾140/90 mmHg) blood pressure among patients with diagnosed hypertension and to identify associated factors.

In the national register for CHD, adults with repaired coarctation of the aorta and diagnosed hypertension – defined as a registry diagnosis and/or use of anti-hypertensive prescription medication – were identified. Logistic regression analysis was used to identify variables associated with poorly controlled blood pressure.

Of the 243 included patients, 27.2% were female, the mean age was 45.4±15.3 years, and 52.3% had poorly controlled blood pressure at the last registration. In a multivariable model, age (years) (OR 1.03, CI 1.01–1.06, p=0.008) was independently associated with poorly controlled blood pressure and so was systolic arm–leg blood pressure gradient in the ranges [10, 20] mmHg (OR 4.92, CI 1.76–13.79, p=0.002) to >20 mmHg (OR 9.93, CI 2.99–33.02, p<0.001), in comparison with the reference interval [0, 10] mmHg. Patients with poorly controlled blood pressure had, on average, more types of anti-hypertensive medication classes prescribed (1.9 versus 1.5, p=0.003).

Poorly controlled blood pressure is common among patients with repaired coarctation of the aorta and diagnosed hypertension, despite what seems to be more intensive treatment. A systolic arm–leg blood pressure gradient is associated with poorly controlled blood pressure, even at low levels usually not considered for intervention, and may be an indicator of hypertension that is difficult to treat.

Place, publisher, year, edition, pages
Cambridge University Press, 2017
Keywords
Coarctation of the aorta, hypertension, adult CHD, register
National Category
Public Health, Global Health, Social Medicine and Epidemiology Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-126424 (URN)10.1017/S1047951117001020 (DOI)000412664000009 ()28703088 (PubMedID)
Note

Originally published in thesis in manuscript form.

Available from: 2016-10-05 Created: 2016-10-05 Last updated: 2018-06-09Bibliographically approved
Rinnström, D. (2016). Coarctation of the aorta: register and imaging studies. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Coarctation of the aorta: register and imaging studies
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background Coarctation of the aorta (CoA) constitutes 5-8 % of all congenital heart disease (CHD) and is associated with long-term complications such as hypertension (HTN) and left ventricular hypertrophy (LVH). Factors associated with HTN, LVH, and diffuse myocardial fibrosis, are not yet fully explored in this population.

Methods Papers I-III: The Swedish national register of congenital heart disease (SWEDCON) was used to identify adult patients with repaired CoA.

Paper IV: Data on 2,424 adult patients with CHD was extracted from SWEDCON and compared to controls (n = 4,605) regarding height, weight and body mass index (BMI).

Paper V: Adults with CoA (n = 21, age 28.5 (19.1-65.1) years, 33.3 % female) referred for CMR were investigated with T1 mapping to determine left ventricular extracellular volume fraction (ECV).

Results Papers I-II: Out of 653 patients, 344 (52.7 %) had HTN. In a multivariable model, age (years) (OR 1.07, CI 1.05-1.10), sex (male) (OR 3.35, CI 1.98-5.68) and BMI (kg/m2) (OR 1.09, CI 1.03-1.16) were associated with having HTN, and so was systolic arm-leg blood pressure (BP) gradient where an association was found at the ranges (10, 20] mmHg (OR 3.58, CI 1.70-7.55) and > 20 mmHg (OR 11.38, CI 4.03-32.11), in comparison to the range [0, 10] mmHg.

When investigating 243 patients with diagnosed HTN, 127 (52.3 %) had elevated BP (≥ 140/90 mmHg). Age (years) (OR 1.03, CI 1.01-1.06) was associated with elevated BP, and so was systolic arm-leg BP gradient in the ranges (10, 20] mmHg (OR 4.92, CI 1.76-13.79), and > 20 mmHg (OR 9.93, CI 2.99-33.02), in comparison to the reference interval [0, 10] mmHg.

Patients with elevated BP had more classes of anti-hypertensive medication classes prescribed (1.9 vs 1.5, p = 0.003).

Paper III: Out of 506 patients, 114 (22.5 %) were found to have LVH. Systolic BP (mmHg) (OR 1.02, CI 1.01-1.04), aortic valve disease, (OR 2.17, CI 1.33–3.53), age (years) (OR 1.03, CI 1.01–1.05), and HTN (OR 3.02, CI 1.81-5.02), were associated with LVH, while sex (female) (OR 0.41, CI 0.24-0.72) was negatively associated with LVH.

Paper IV: There was no difference in height, weight, or BMI between patients with CoA (n = 414) and the reference population.

Paper V: In the population of 21 patients, an increased left ventricular myocardial ECV was found in 6 cases (28.6 %). Of the patients with increased ECV, 5/6 (83.3 %) were female (p = 0.002). Patients with increased ECV did not otherwise differ from the rest of the study population. iv

Conclusions In adults with repaired CoA, HTN and LVH were common, and many patients with HTN had elevated BP despite treatment. The potentially modifiable factors BMI and systolic arm-leg BP gradient were associated with HTN, and the gradient was also associated with elevated BP among patients with diagnosed HTN. The gradient’s significance remained even within what the current guidelines consider acceptable ranges. Potentially modifiable factors associated with LVH were systolic BP and aortic valve disease. We found no general difference in height, weight, or BMI between patients with CoA and the reference population. While LVH was more common among men, increased myocardial ECV was more common among women.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2016. p. 60
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1842
Keywords
coarctation of the aorta, adult congenital heart disease, hypertension, left ventricular hypertrophy, body mass index, height, weight, register, CMR
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126428 (URN)978-91-7601-557-5 (ISBN)
Public defence
2016-10-28, Hörsal B Unod T 9, Norrlands Universitetssjukhus, 13:00 (English)
Opponent
Supervisors
Available from: 2016-10-07 Created: 2016-10-05 Last updated: 2018-06-09Bibliographically approved
Berglund, E., Johansson, B., Dellborg, M., Sörensson, P., Christersson, C., Nielsen, N.-E., . . . Thilén, U. (2016). High incidence of infective endocarditis in adults with congenital ventricular septal defect. Heart, 102(22), 1835-1839
Open this publication in new window or tab >>High incidence of infective endocarditis in adults with congenital ventricular septal defect
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2016 (English)In: Heart, ISSN 1355-6037, E-ISSN 1468-201X, Vol. 102, no 22, p. 1835-1839Article in journal (Refereed) Published
Abstract [en]

Objective: Ventricular septal defects (VSDs), if haemodynamically important, are closed whereas small shunts are left without intervention. The long-term prognosis in congenital VSD is good but patients are still at risk for long-term complications. The aim of this study was to clarify the incidence of infective endocarditis (IE) in adults with VSD. Methods: The Swedish registry for congenital heart disease (SWEDCON) was searched for adults with VSD. 779 patients were identified, 531 with small shunts and 248 who had the VSD previously closed. The National Patient Register was then searched for hospitalisations due to IE in adults during a 10-year period. Results: Sixteen (2%) patients were treated for IE, 6 men and 10 women, with a mean age of 46.3 +/- 12.2 years. The incidence of IE was 1.7-2.7/1000 years in patients without previous intervention, 20-30 times the risk in the general population. Thirteen had small shunts without previous intervention. There was no mortality in these 13 cases. Two patients had undergone repair of their VSD and also aortic valve replacement before the episode of endocarditis and a third patient with repaired VSD had a bicuspid aortic valve, all of these three patients needed reoperation because of their IE and one patient died. No patient with isolated and operated VSD was diagnosed with IE. Conclusions: A small unoperated VSD in adults carries a substantially increased risk of IE but is associated with a low risk of mortality.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2016
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-130102 (URN)10.1136/heartjnl-2015-309133 (DOI)000387065200013 ()
Available from: 2017-01-13 Created: 2017-01-11 Last updated: 2018-06-09Bibliographically approved
Rinnström, D., Dellborg, M., Thilén, U., Sörensson, P., Nielsen, N.-E., Christina, C. & Johansson, B. (2016). Hypertension in adults with repaired coarctation of the aorta. American Heart Journal, 181, 10-15
Open this publication in new window or tab >>Hypertension in adults with repaired coarctation of the aorta
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2016 (English)In: American Heart Journal, ISSN 0002-8703, E-ISSN 1097-6744, Vol. 181, p. 10-15Article in journal (Refereed) Published
Abstract [en]

Aims: In adults with coarctation of the aorta (CoA), hypertension (HTN) is a common long-term complication. We investigated the prevalence of HTN and analyzed factors associated with HTN.

Methods and results: In the national register for congenital heart disease, 653 adults with repaired CoA were identified (mean age 36.9 ± 14.4 years); 344 (52.7%) of them had HTN, defined as either an existing diagnosis or blood pressure (BP) ≥140/90 mmHg at the clinical visit. In a multivariable model, age (years) (odds ratio [OR] 1.07, CI 1.05-1.10), sex (male) (OR 3.35, CI 1.98-5.68), and body mass index (kilograms per square meter) (OR 1.09, CI 1.03-1.16) were independently associated with having HTN, and so was systolic arm-leg BP gradient where an association with HTN was found at the ranges of (10, 20] and N20 mmHg, in comparison to the interval ≤10 mmHg (OR 3.58, CI 1.70-7.55, and OR 11.38, CI 4.03-32.11). This model remained valid when all patients who had increased BP (≥140/90 mmHg) without having been diagnosed with HTN were excluded from the analyses.

Conclusions: Hypertension is common in patients with previously repaired CoA and is associated with increasing age, male sex, and elevated body mass index. There is also an association with arm-leg BP gradient, starting at relatively low levels that are usually not considered for intervention.

Place, publisher, year, edition, pages
Elsevier, 2016
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-126422 (URN)10.1016/j.ahj.2016.07.012 (DOI)000387253900004 ()27823680 (PubMedID)
Available from: 2016-10-05 Created: 2016-10-05 Last updated: 2018-06-09Bibliographically approved
Rinnström, D., Dellborg, M., Thilen, U., Sorensson, P., Nielsen, N. E., Christersson, C. & Johansson, B. (2016). Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta: association with systolic blood pressure in the high normal range. Paper presented at Congress of the European-Society-of-Cardiology (ESC), AUG 27-31, 2016, Rome, ITALY. European Heart Journal, 37, 369-369
Open this publication in new window or tab >>Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta: association with systolic blood pressure in the high normal range
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2016 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 37, p. 369-369Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2016
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-129752 (URN)000383869501562 ()
Conference
Congress of the European-Society-of-Cardiology (ESC), AUG 27-31, 2016, Rome, ITALY
Note

Supplement: 1

Meeting Abstract: P1796

Available from: 2017-01-10 Created: 2017-01-09 Last updated: 2018-06-09Bibliographically approved
Rinnström, D., Dellborg, M., Thilén, U., Sörensson, P., Nielsen, N.-E., Christersson, C. & Johansson, B. (2016). Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta: association with systolic blood pressure in the high normal range. International Journal of Cardiology, 218, 59-64
Open this publication in new window or tab >>Left ventricular hypertrophy in adults with previous repair of coarctation of the aorta: association with systolic blood pressure in the high normal range
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 218, p. 59-64Article in journal (Refereed) Published
Abstract [en]

Background: Arterial hypertension is common in adults with repaired coarctation of the aorta (CoA). The associations between the diagnosis of hypertension, actual blood pressure, other factors affecting left ventricular overload, and left ventricular hypertrophy (LVH) are not yet fully explored in this population.

Material and results: From the national register for congenital heart disease, 506 adult patients (≥18 years old) with previous repair of CoA were identified (37.0% female, mean age 35.7 ± 13.8 years, with an average of 26.8 ± 12.4 years post repair). Echocardiographic data were available for all patients, and showed LVH in 114 (22.5%) of these. Systolic blood pressure (SBP) (mm Hg) (OR 1.02, CI 1.01–1.04), aortic valve disease, (OR 2.17, CI 1.33–3.53), age (years) (OR 1.03, CI 1.01–1.05), diagnosis of arterial hypertension (OR 3.02, CI 1.81–5.02), and sex (female) (OR 0.41, CI 0.24–0.72) were independently associated with LVH. There was an association with LVH at SBP within the upper reference limits [130, 140] mm Hg (OR 2.23, CI 1.05–4.73) that further increased for SBP N 140 mm Hg (OR 8.02, CI 3.76–17.12).

Conclusions: LVH is common post repair of CoA and is associatedwith SBP even belowthe currently recommended target level. Lower target levels may therefore become justified in this population.

Keywords
CoA, Hypertension, Left ventricular hypertrophy, Adult congenital heart disease
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-126425 (URN)10.1016/j.ijcard.2016.05.033 (DOI)000377856300010 ()27232912 (PubMedID)
Available from: 2016-10-05 Created: 2016-10-05 Last updated: 2018-06-09Bibliographically approved
Andersson, J., Mellberg, C., Otten, J., Ryberg, M., Rinnström, D., Larsson, C., . . . Olsson, T. (2016). Left ventricular remodelling changes without concomitant loss of myocardial fat after long-term dietary intervention. International Journal of Cardiology, 216, 92-96
Open this publication in new window or tab >>Left ventricular remodelling changes without concomitant loss of myocardial fat after long-term dietary intervention
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2016 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 216, p. 92-96Article in journal (Refereed) Published
Abstract [en]

Background: Accumulation of myocardial triglycerides (MTG) is associated with impaired left ventricular (LV) remodelling and function in obese and diabetic subjects. The role of MTG accumulation in development of heart failure in this group of patients is unknown. Short-term studies suggest that diets that lead to weight loss could mobilize MTG, with a favourable effect on cardiac remodelling. In a 24-month, randomized, investigator-blinded study, we assessed the effect of two different diets and subsequent weight loss on cardiac function and MTG in postmenopausal women. Methods: Sixty-eight healthy postmenopausal women with body mass index [BMI] >= 27 kg/m(2) were randomized to an ad libitum Palaeolithic diet (PD) or a Nordic Nutrition Recommendation (NNR) diet for 24 months. Morphology, cardiac function, and MTG levels were measured using magnetic resonance (MR) scanning, including proton spectroscopy at baseline and 6 and 24 months. Results: Despite mean weight losses of 4.9 (1.0) kg (NNR) and 7.8 (1.1) kg (PD), the MTG content did not change over time (p = 0.98 in the NNR and p = 0.11 in the PD group at 24 months). Reduced left ventricular mass was observed in both diet groups over 24 months. Blood pressure was reduced at 6 months, but returned to baseline levels at 24 months. End diastolic volume, stroke volume, and cardiac output decreased over time. No differences between diet groups were observed. Conclusions: Diet intervention and moderate weight loss over 24 months improved LV remodelling but did not alter MTG levels in overweight/obese postmenopausal women.

Keywords
Cardiac Magnetic Resonance (CMR) imaging, Diet, Metabolic heart disease, Obesity, Weight reduction
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-123040 (URN)10.1016/j.ijcard.2016.04.050 (DOI)000376820700015 ()27149238 (PubMedID)
Available from: 2016-08-26 Created: 2016-06-27 Last updated: 2018-06-07Bibliographically approved
Sandberg, C., Rinnström, D., Dellborg, M., Thilén, U., Sörensson, P., Nielsen, N.-E., . . . Johansson, B. (2015). Height, weight and body mass index in adults with congenital heart disease. International Journal of Cardiology, 187, 219-226
Open this publication in new window or tab >>Height, weight and body mass index in adults with congenital heart disease
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2015 (English)In: International Journal of Cardiology, ISSN 0167-5273, E-ISSN 1874-1754, Vol. 187, p. 219-226Article in journal (Refereed) Published
Abstract [en]

Background: High BMI is a risk factor for cardiovascular disease and, in contrast, low BMI is associated with worse prognosis in heart failure. The knowledge on BMI and the distribution in different BMI-classes in adults with congenital heart disease (CHD) are limited. Methods and results: Data on 2424 adult patients was extracted from the Swedish Registry on Congenital Heart Disease and compared to a reference population (n = 4605). The prevalence of overweight/obesity (BMI >= 25) was lower in men with variants of the Fontan procedure, pulmonary atresia (PA)/double outlet right ventricle (DORV) and aortic valve disease (AVD) (Fontan 22.0% and PA/DORV 15.1% vs. 43.0%, p = 0.048 and p < 0.001) (AVD 37.5% vs. 49.3%, p < 0.001). Overt obesity (BMI >= 30) was only more common in women with AVD (12.8% vs. 9.0%, p = 0.005). Underweight (BMI < 18.5) was generally more common in men with CHD (complex lesions 4.9% vs. 0.9%, p < 0.001 and simple lesions 3.2% vs. 0.6%, <0.001). Men with complex lesions were shorter than controls in contrast to females that in general did not differ from controls. Conclusion: Higher prevalence of underweight in men with CHD combined with a lower prevalence of over-weight/obesity in men with some complex lesions indicates that men with CHD in general has lower BMI compared to controls. In women, only limited differences between those with CHD and the controls were found. The complexity of the CHD had larger impact on height in men. The cause of these gender differences as well as possible significance for prognosis is unknown.

Place, publisher, year, edition, pages
Elsevier, 2015
Keywords
congenital heart disease, body mass index, height, weight, adult
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-105260 (URN)10.1016/j.ijcard.2015.03.153 (DOI)000354905600063 ()25838217 (PubMedID)
Available from: 2015-06-22 Created: 2015-06-22 Last updated: 2018-06-07Bibliographically approved
Rinnström, D., Engström, K. G. & Johansson, B. (2014). Subtypes of bicuspid aortic valves in coarctation of the aorta. Heart and Vessels, 29(3), 354-363
Open this publication in new window or tab >>Subtypes of bicuspid aortic valves in coarctation of the aorta
2014 (English)In: Heart and Vessels, ISSN 0910-8327, E-ISSN 1615-2573, Vol. 29, no 3, p. 354-363Article in journal (Refereed) Published
Abstract [en]

Bicuspid aortic valves (BAVs) represent a wide morphologic and functional spectrum. In coarctation of the aorta, BAVs are common, but the proportion of BAV subtypes and their relation to aortic dimensions and development of late valve dysfunction are unknown. Sixty-two cardiovascular magnetic resonance investigations of patients with coarctation of the aorta were reviewed with respect to aortic valve morphology, aortic valve function, and aortic dimensions. BAVs were identified in 45 patients (72.6 %), of which 13 (20.9 %) were type-0 (two commissures), 28 (45.1 %) type-1 (three commissures but fusion of one commissure with a raphe) and 4 (6.5 %) valves were bicuspid but not possible to classify further. Patients with BAVs type-0 had larger dimensions in their sinus of Valsalva (35.5 ± 6.8 vs. 29.7 ± 2.7 mm, p = 0.002), ascending aorta (33.1 ± 6.2 vs. 26.0 ± 4.3 mm, p = 0.005) and sino-tubular junction (29.3 ± 7.4 vs. 24.2 ± 3.5 mm, p = 0.040) compared with tricuspid aortic valves (TAVs). Moderate and severe aortic valve disease was more common in BAV type-0 compared with BAV type-1 (p = 0.030) and TAV (p = 0.016). In a multivariate linear regression model BAV type-0 (p = 0.005), BAV type-1 (p = 0.011), age (p < 0.001), patient height (p = 0.009), and aortic valve disease (p = 0.035) were independently associated with increased diameter of the ascending aorta (R (2) of the model 0.54, p < 0.001). BAV type-0 is relatively common in coarctation of the aorta. Both BAV type-0 and type-1 are associated with increased diameter of the ascending aorta but this association is stronger for BAV type-0. Development of aortic valve disease is more common in BAV type-0 than in BAV type-1. Discrimination between BAV subtypes may potentially provide clinical and prognostic information in patients with coarctation of the aorta.

Keywords
Coarctation of the aorta, Bicuspid aortic valves, Congenital heart disease, Cardiovascular magnetic resonance, Cardiovascular imaging
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-82728 (URN)10.1007/s00380-013-0370-x (DOI)000335732700009 ()23748371 (PubMedID)
Available from: 2013-11-07 Created: 2013-11-07 Last updated: 2018-06-08Bibliographically approved
Rinnström, D., Engström, G., Ugander, M. & Johansson, B. (2013). Factors associated with left ventricular hypertrophy in adults with surgically repaired coarctation of the aorta. International Cardiovascular Forum Journal, 1(2), 79-83
Open this publication in new window or tab >>Factors associated with left ventricular hypertrophy in adults with surgically repaired coarctation of the aorta
2013 (English)In: International Cardiovascular Forum Journal, ISSN 2410-2636, Vol. 1, no 2, p. 79-83Article in journal (Refereed) Published
Abstract [en]

Introduction: Most patients with repaired coarctation of the aorta (CoA) live normal lives and have good physical performance. However, even after a successful surgical intervention, long-term cardiovascular risks including left ventricular hypertrophy remain. The aim of the study was to identify factors associated with increased left ventricular mass (LVM) in patients with surgically repaired CoA.

Methods: Consecutive cardiovascular magnetic resonance investigations in 51 patients with surgically repaired CoA (age 37+/-15 years, age at intervention 9.7 ± 6.8 years, 45% female) were reviewed. LVM was measured and indexed to body surface area. The association between increased LVM index and clinical, anatomic and functional variables was investigated with logistic regression analysis.

Results: In this population, 14/51 (27%) patients had a LVM index above normal limits. Factors associated with an increased LVM index in univariate analysis were higher systolic blood pressure (odds ratio (OR) = 1.04, 95 % confidence interval(CI) 1.00-1.08, p = 0.03), descending aortic diameter (OR = 1.48, CI 1.14-1.90, p = 0.003) and more than mild aortic valve disease or previous aortic valve intervention (OR = 15.1, CI 2.50-48.4, p=0.002), but not diastolic blood pressure, diameter of ascending aorta, diameter or ratio of CoA, velocity in descending aorta, smoking or bicuspid aortic valve (p > 0.05 for all). In multivariate analysis, only systolic blood pressure (p = 0.05) and aortic valve disease (p = 0.006) remained significant, yielding R2 = 0.47, p = 0.002 for the model.

Conclusion: Increased LVM is a common late finding after surgically repaired CoA. This study showed that LVM was associated with modifiable factors; systolic blood pressure and aortic valve disease. As most patients are young, and increased LVM will eventually affect ventricular function, close attention to blood pressure optimization may be of particular importance in the surgically repaired CoA population.

Place, publisher, year, edition, pages
Barcaray International Publishing, 2013
Keywords
CoA, left ventricular mass, congenital heart disease, cardiovascular magnetic resonance, cardiovascular imaging, aortic valve disease
National Category
Cardiac and Cardiovascular Systems
Identifiers
urn:nbn:se:umu:diva-107628 (URN)10.17987/icfj.v1i2.25 (DOI)
Available from: 2015-08-25 Created: 2015-08-25 Last updated: 2018-06-07Bibliographically approved
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