Aortic surgery is one of the risk factors for enhancement of pressure wave reflection in adult patients with congenital heart disease

•44% of ACHD patients demonstrated high radial augmentation index (rAI).•The risk factors of high rAI were history of AP shunt and direct aortic surgery.•The ACHD patients should be tightly controlled concerning risk factors of CVD.

Background: Excessive aortic pressure wave reflection is one of the risk factors of cardiovascular diseases. In some clinical course of congenital heart diseases, the elevated pressure wave reflection has been reported. The purpose of this study is to elucidate the risk factors of the enhanced pressure wave reflection in adult patients with congenital heart disease.Methods: We enrolled 99 adult (≥ 20 years) patients with congenital heart disease. We measured their radial pressure augmentation index and examined the relationship between it and various clinical variables.Results: The radial pressure augmentation index was 77.1 ± 19.1% and it had a significant correlation with the history of aorto-pulmonary shunt (t = 4.194; p < 0.0001), age (t = 4.091; p < 0.0001), height (t = − 3.580; p = 0.001) and the history of direct aortic surgery (t = 2.253; p = 0.027). Forty-four patients (44.4%) demonstrated high radial augmentation index (> 1 SD of age- and gender matched control) and the determinants of the elevated radial augmentation index were the history of aorto-pulmonary shunt (odds ratio, 21.32; 95% confidence interval, 5.47-83.14; p < 0.0001) and the direct aortic surgery (4.18; 1.38-12.72; p = 0.012).Conclusions: The history of aortic surgeries enhances aortic pressure wave reflection in adult patients with congenital heart disease. The enhanced aortic pressure wave reflection is one of the risk factors for cardiovascular diseases. Therefore, the adult patients with congenital heart disease after aortic surgeries should be carefully observed and tightly controlled concerning the risk factors for cardiovascular diseases.