Systolic pressure amplification of the aortic pressure in children with congenital heart disease

Joo, Chan Uhng; Lee, Byoung Geun; Kim, Sun Jun; Kim, Jung Soo

Abstract

Direct intraarterial measurement of blood pressure is an important diagnostic procedure in critical patients and premature baby care. Direct measurement was more accepted and confident method in physician than the indirect methods. But the presence of a significant amplification of systolic pressure in peripheral artery may lead to important error. So we have investigated the degree of the systolic pressure amplification from the ascending aorta to the femoral artery in children. Pressure waves recorded in the ascending aorta, aortic arch, diaphragmatic level of the descending aorta, common iliac artery, and femoral artery in 37 patients with congenital heart disease, aged 9 months to 21 years old (mean 7.16 yrs old) during diagnostic cardiac catheterization. The results were as follows 1) Amplification of the systolic pressure increased progressively from the ascending aorta to the femoral artery (16.7%) 2) Diastolic pressure decreased progressively from the ascending aorta to the femoral artery (6.5%) 3) Mean pressure decreased progressively from the ascending aorta to the femoral artery (1.5%) 4) Pulse pressure increased progressively from the ascending aorta to the femoral artery (42.8%) 5) There was significant drop (7%) of the systolic pressure of the ascending aorta compared with that of left ventricle. The results showed that the peripheral amplifications were limited to the systolic and pulse pressure, but the diastolic and mean pressure in peripheral arteries were lower than that of central artery.