Key result
Aortic diameter ≥45 mm in hypertensives is linked to an ~80% rate of impaired Beta-stiffness index.
Why the study?
Little is known about the elastic properties of the ascending aorta in hypertensive patients with ascending aorta dilatation, and echo-based transverse aortic strain analysis has never been applied in this population.
Is ascending aorta dilatation associated with impaired local transversal aortic strain in hypertensive patients?
Cross-Sectional (n=100)
Is ascending aorta dilatation associated with impaired local transversal aortic strain in hypertensive patients?
Absolute Event Rate: 80% vs 18.2%
p-value: p=<0.05
Ascending aorta dilatation in hypertensive patients is associated with increased local aortic stiffness, which correlates with greater left ventricular mass and pulse wave velocity.
Aortic dilatation may mark stiffness in hypertension; hypothesis-generating, does not yet inform practice.
BACKGROUND: Ascending aorta dilatation is found in 13% of hypertensive patients. Little is known about elastic properties of ascending aorta in such patients. Echo-based transverse aortic strain analysis can describe mechanical properties of ascending aorta but has never been applied to patients with ascending aorta dilatation. AIM: To assess mechanical properties of ascending aorta by transverse aortic strain analysis (as β2-stiffness index) in hypertensive patients with ascending aorta dilatation and association between mechanical properties of ascending aorta and cardiovascular damage. METHODS: A total of 100 hypertensive outpatients underwent transthoracic echocardiography and assessment of pulse wave velocity (PWV). Strain analysis of ascending aorta was performed with echocardiographic speckle-tracking software. Patients were divided in three groups based on ascending aorta diameter: less than 40, 40-45, and at least 45 mm. RESULTS: Beta-SI increased exponentially with ascending aorta dimensions (P < 0.001). Patients with ascending aorta dilatation had Beta-SI significantly higher than those with normal ascending aorta diameter. A greater proportion of patient with impaired (i.e., elevated) Beta-SI was present in groups with larger ascending aorta (18.2 vs. 48.4 vs. 80%, respectively, P < 0.05). On multivariate logistic regression only impaired Beta-SI predicted ascending aorta dilatation (P < 0.001). Beta-SI was related to cardiovascular damage in terms of left ventricular (LV) mass (LV mass indexed to BSA, P = 0.030) and PWV (P = 0.028). Patients with high Beta-SI had greater LV mass indexed to BSA (117 ± 47 vs. 94 ± 24 g/m2; P = 0.010) and PWV (10.20 ± 2.99 vs. 8.63 ± 1.88 m/s; P = 0.013). CONCLUSION: Ascending aorta dilatation is associated with increased local aortic stiffness in hypertensive patients. Strain analysis adds functional information to the mere morphological evaluation of aortic diameter and could be a useful tool to better define cardiovascular risk in this population.
No takes yet. Share an insight, caveat, or question.
Cesareo et al. (2021) conducted a cross-sectional in Hypertension with ascending aorta dilatation (n=100). Ascending aorta diameter ≥45 mm vs. Ascending aorta diameter <40 mm was evaluated on Impaired Beta-stiffness index (Beta-SI) (p=<0.05). Ascending aorta diameter ≥45 mm in hypertensive patients was associated with a higher rate of impaired Beta-stiffness index compared to diameter <40 mm (80% vs 18.2%; P<0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: