Abstract 2998: Aortic Root Dilatation in Children with Systemic Hypertension
Background: Systemic hypertension (HTN) is associated with target organ damage and aortic root dilatation has been described in adults with HTN with a prevalence of 4–10%. The aim of the study was to determine the prevalence of aortic root dilatation in children with uncomplicated HTN.
Methods: Children aged 1 to 19 years (mean 12.4 years, n = 143, males 77) previously untreated for the HTN underwent a pediatric echocardiogram for evaluation of end-organ damage and size of their aorta per standard protocol. Infants and preterm children were excluded from the study. HTN was defined as blood pressure above the 95th percentile based on the Fourth Working Group criteria confirmed by 24-hour ambulatory BP monitoring. The aorta was measured by a transthoracic echocardiogram in the parasternal long-axis view at the sinus of Valsalva, supra-aortic ridge and the ascending aorta. The dilation was based on the normative data (Roman MJ, et al) available in children for the given body surface area.
Results: Aortic root dilatation was detected in 3 (2.1%, all females, mean age 16.7 years) of the 143 consecutive children evaluated. The ascending aorta in the 3 patients measured 30–35mm, the supra-aortic ridge was 27–30mm and the sinus of Valsalva was 31–33 mm in diameter. All 3 children with aortic root dilatation had a normal aortic valve apparatus without any stenosis as determined by an echocardiogram. Trace aortic insufficiency was seen in 6 (4.2%) children with HTN of which one had a dilated aortic root. None had a positive family history of Marfan syndrome, aneurysm or sudden death. One child had Turner syndrome and the other 2 were non-syndromic females.
Conclusions: Aortic root dilatation was seen in 2.1% children with HTN. Children with HTN who undergo evaluation for end-organ damage by an echocardiogram may also benefit from routine measurements of their aortic root. Aortic root dilatation has been reported in children with Turners syndrome without the presence of hypertension. In the other 2 girls, the cause of the dilatation remains unknown at present. Controlling the blood pressure may be beneficial in preventing further stress on the dilated aortas.