Key result
Asymptomatic AAA linked to ~5% higher central augmentation index versus controls, indicating increased arterial stiffness.
Why the study?
Abdominal aortic aneurysm alters aortic geometry and wall stiffness, potentially modifying the central blood pressure wave and reflected wave.
Does the presence of an asymptomatic abdominal aortic aneurysm alter indices of arterial stiffness compared to matched controls?
Case-Control (n=138)
No
Does the presence of an asymptomatic abdominal aortic aneurysm alter indices of arterial stiffness compared to matched controls?
Asymptomatic abdominal aortic aneurysm is associated with altered central blood pressure variables indicative of increased arterial stiffness and altered left ventricular afterload.
Answers are grounded in this paper and cite their sources.
May inform vascular risk assessment in asymptomatic AAA; leaves open whether stiffness-targeted interventions improve outcomes.
Background: Abdominal aortic aneurysm (AAA), forming a blood reservoir alters the geometry of the aorta, which along with increased stiffness of the aortic wall modifies central blood pressure wave, especially the reflected wave. The aim of the study was to compare indices of arterial stiffness recorded by pulse wave analysis (PWA) between patients with AAA and controls. Material and methods: Sixty-nine patients (from 75 originally included) with asymptomatic AAA and 69 (from 74) age-, sex- and body mass index (BMI)-matching patients as a control group were analysed. The following variables of PWA recorded by applanation tonometry were evaluated: central pulse pressure (CPP), central systolic (CSBP) and diastolic (CDBP) blood pressure, central augmentation index (CAIx), the time from the beginning of a pulse wave to: the first systolic peak (CT1), to the beginning of the reflected wave (CT1R) and to the second systolic peak pressure (CT2). Results: Patients with AAA had higher CAIx [33% (12) vs. 28% (20); p < 0.001] than in the control group, lower CPP [36 mm Hg (10) vs. 45 mm Hg (24); p < 0.001), higher CDBP [79 mm Hg (14) vs. 73 mm Hg (13); p = 0.017) and no significant difference in CSBP [115 mm Hg (15) vs. 119 mm Hg (23); NS). Shorter CT1 [102 ms (9) vs. 106 ms (12); p = 0.004) and CT1R [133 ms (11) vs. 138 ms (13.5); p = 0.04) and longer CT2 (232 ms (36) vs. 217 ms (35); p = 0.007) were observed in patients with AAA. Data are presented as median with interquartile range. Conclusion: Differences of central blood pressure variables suggest increased arterial stiffness in patients with AAA. Despite lower values of pulse pressure, overall pressure load of the returning wave is higher, which affect the afterload of the heart.
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Nawrocka et al. (2023) conducted a case-control in Abdominal aortic aneurysm (n=138). Abdominal aortic aneurysm vs. Matched controls with normal abdominal aorta was evaluated on Central augmentation index (CAIx) (p=<0.001). Patients with asymptomatic abdominal aortic aneurysm had significantly higher central augmentation index (33% vs 28%, p<0.001) compared to matched controls, indicating increased arterial stiffness.
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