October 15, 1995Circulation164 citations
Pressure-Diameter Relation of the Human Aorta
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Key Result
Simultaneous acquisition of aortic pressure and diameter revealed significantly lower aortic distensibility in CAD patients compared to controls (1.73 vs 3.95 x 10^-6 cm2/dyne, P<0.001).
Study Design
Type
Observational (n=41)
Structured PICO
Does a newly designed intravascular catheter accurately assess the elastic properties of the aorta in conscious humans with and without CAD?
P
Population
41 conscious humans, comprising patients with coronary artery disease (CAD) (n=15), control subjects (n=10), and a third group of patients (n=16) for pulse wave velocity assessment.
I
Intervention
Simultaneous acquisition of instantaneous aortic pressure and diameter using a newly designed intravascular catheter incorporating an ultrasonic displacement meter and a catheter-tip micromanometer.
C
Comparator
Control subjects (for the CAD group comparison).
O
Outcome
Aortic distensibility and pressure-diameter loop characteristics (slope and intercept).surrogate
A novel intravascular catheter method allows for direct, accurate evaluation of aortic elastic properties in conscious humans, demonstrating reduced aortic distensibility in patients with coronary artery disease.
Main Result
Absolute Event Rate: 1.73% vs 3.95%
p-value: p=<0.001
Abstract
BACKGROUND: Pressure-diameter relation of the aorta provides important information about the elastic properties of the vessel. However, owing to methodological limitations, data regarding this relation are limited in conscious humans. In the present study, we assessed a new method for the direct estimation of the elastic properties of the aorta in conscious humans by simultaneous acquisition of instantaneous aortic pressure and diameter. METHODS AND RESULTS: With this method, instantaneous diameter of the thoracic aorta was acquired by a newly designed intravascular catheter developed in our institution that incorporates an ultrasonic displacement meter at its distal end. Instantaneous aortic pressure was acquired simultaneously at the same aortic level with a catheter-tip micromanometer. Aortic pressure-diameter loops were derived from computer analysis of data. After in vitro and animal testing, elastic properties of the aorta were investigated in coronary artery disease (CAD) patients (n = 15) and compared with those of control subjects (n = 10). Aortic distensibility was less in the CAD group than in the control group (1.73 +/- 0.33 versus 3.95 +/- 1.09 x 10(-6) x cm2 x dyne-1, P < .001). Compared with control subjects, the mean value of the slope of the pressure-diameter loops was significantly greater in the CAD group (38.89 +/- 8.75 versus 19.62 +/- 5.46 mm Hg.mm-1, P < .001), whereas the mean value of the intercept was lower in this latter group of patients (-785.60 +/- 177.55 versus -313.43 +/- 126.41 mm Hg, P < .001). An excellent correlation was found between the slope of pressure-diameter loop and age in the group of control subjects (r = .827). Ninety-three percent of the patients with CAD had values above the upper 95% confidence limits of the control subjects (P < .001). In a third group of patients (n = 16) in whom assessment of pulse wave velocity was also included in the study of the elastic properties of the aorta, pulse wave velocity had a strong inverse correlation with aortic distensibility (r = -.95) and a strong positive correlation with the slope of the pressure-diameter loop (r = .97). CONCLUSIONS: This new method of determination of pressure-diameter of the aorta enables an accurate and reliable evaluation of the elastic properties of the aorta in conscious humans and may be useful for a profound study of human aorta mechanics.
Cite This Study
Stefanadis et al. (1995) conducted an observational in Coronary artery disease (n=41). Simultaneous acquisition of instantaneous aortic pressure and diameter via intravascular catheter vs. Control subjects was evaluated on Aortic distensibility (p=<0.001). Simultaneous acquisition of aortic pressure and diameter revealed significantly lower aortic distensibility in CAD patients compared to controls (1.73 vs 3.95 x 10^-6 cm2/dyne, P<0.001).