Central aortic pressure in aortic aneurysm and aortic dissection: a novel prognostic marker

Q: What are the key findings of this study?

Central aortic systolic pressure (112.7 vs. 104.3 mm Hg, P<0.05) and augmentation index (33.4% vs. 23.4%, P<0.05) were significantly higher in AA/AD patients with disease progression.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Aortic aneurysm or aortic dissection (n=56). Intervention: Central aortic systolic pressure and aortic augmentation index vs. Patients without disease progression. Primary outcome: Central aortic systolic pressure in patients with vs. without disease progression (p=< 0.05).

Q: What does this research mean for the field?

Elevated central aortic systolic pressure and aortic augmentation index are significantly associated with disease progression in patients with aortic aneurysm or aortic dissection despite well-controlled brachial blood pressure. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To evaluate the prognostic utility of central aortic pressure parameters in predicting disease progression among patients with aortic aneurysm or aortic dissection.

Jeonggeun Moon; Sang‐Hak Lee; Young‐Guk Ko; Yangsoo Jang; Won‐Heum Shim; Donghoon Choi

doi:10.2143/ac.65.3.2050346

June 28, 2010Acta CardiologicaOpen Access

Central aortic pressure in aortic aneurysm and aortic dissection: a novel prognostic marker

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Key result

Higher central aortic systolic pressure is linked to disease progression in aortic aneurysm or dissection.

P<0.05
n=56

Why the study?

In some patients with aortic aneurysm or aortic dissection, disease progression occurs despite well-controlled brachial blood pressure, prompting evaluation of the prognostic value of central aortic pressure.

Key Points

To evaluate the prognostic utility of central aortic pressure parameters in predicting disease progression among patients with aortic aneurysm or aortic dissection.
Enrolled 56 newly diagnosed aortic aneurysm or aortic dissection patients (37 men, mean age 60.3 ± 12.9 years) not needing urgent surgical or interventional treatment.
Achieved brachial systolic blood pressure ≤120 mm Hg on beta-blocker therapy within 1 month, then noninvasively measured central aortic pressure via radial tonometry with follow-up between 6 months and 5 years.
Disease progression occurred in 23 of 56 patients despite well-controlled brachial blood pressure, while 33 patients remained stable without progression.
Central aortic systolic pressure was significantly higher in patients with disease progression compared to those without progression (112.7 ± 3.5 mm Hg vs. 104.3 ± 7.5 mm Hg, P < 0.05).
Aortic augmentation index was significantly elevated in the disease progression group compared to the stable group (33.4 ± 13.5% vs. 23.4 ± 8.7%, P < 0.05).

Study Design

Type

Cohort (n=56)

PICO

P

Population

56 newly diagnosed aortic aneurysm or dissection patients (mean age 60.3 years, 33.9% female) with well-controlled brachial SBP <= 120 mm Hg on beta-blockers, followed for 6 months to 5 years.

E

Exposure / Comparator

Central aortic systolic pressure and aortic augmentation index vs Patients without disease progression

O

Primary Outcome

Central aortic systolic pressure in patients with vs. without disease progression, p=< 0.05

Main Result

Absolute Event Rate: 112.7% vs 104.3%

p-value: p=< 0.05

Implication

Central aortic pressure may flag progression risk despite controlled brachial BP; leaves open prospective validation before guiding AA/AD management.

Abstract

BACKGROUND: Some aortic aneurysm (AA) or aortic dissection (AD) patients can be observed to detect disease progression if optimal blood pressure is achieved. However, in another group of patients, disease progression occurs despite well-controlled blood pressure. The aim of this study was to determine the prognostic value of central aortic pressure in AA and AD. METHODS: Fifty-six newly diagnosed AA or AD patients (37 men, age: 60.3 +/- 12.9 years) who did not need urgent surgery or interventional treatment were enrolled. All patients achieved brachial SBP < or = 120 mm Hg with beta-blocker-based treatment within 1 month. Then, central aortic pressure parameters were noninvasively checked with radial tonometry (SphygmoCor Px Pulse Wave Analysis System, AtCor Medical, Sydney, Australia). All patients were monitored for at least 6 months and for up to 5 years. RESULTS: Thirty-three patients did well without disease progression. However, disease progression was noted despite well-controlled brachial blood pressure in 23 patients. In intergroup comparisons, central aortic systolic pressure (112.7 +/- 3.5 mm Hg vs. 104.3 +/- 7.5 mm Hg) and aortic augmentation index (AI: 33.4 +/- 13.5% vs. 23.4 +/- 8.7%) were significantly high in the disease progression group (P < 0.05). CONCLUSION: In some AA or AD patients, central aortic pressure and AI can be considered as surrogate prognostic markers.

Discussion

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Cite This Study

Moon et al. (2010) conducted a cohort in Aortic aneurysm or aortic dissection (n=56). Central aortic systolic pressure and aortic augmentation index vs. Patients without disease progression was evaluated on Central aortic systolic pressure in patients with vs. without disease progression (p=< 0.05). Central aortic systolic pressure (112.7 vs. 104.3 mm Hg, P<0.05) and augmentation index (33.4% vs. 23.4%, P<0.05) were significantly higher in AA/AD patients with disease progression.

synapsesocial.com/papers/6ae0c99c44fddc8a2eeda840 https://doi.org/10.2143/ac.65.3.2050346

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Central aortic pressure in aortic aneurysm and aortic dissection: a novel prognostic marker

Key Points

Study Design

PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

Central aortic pressure in aortic aneurysm and aortic dissection: a novel prognostic marker

Key Points

Study Design

PICO

Main Result

Implication

Abstract

Discussion

Cite This Study

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