Abstract 12941: Gender Differences in Age-Related Aortic Elongation and Dilatation: Longitudinal Results From the Multiethnic Study of Atherosclerosis

Abstract

Background: Major aortic remodeling processes ensue with aging. Information on the patterns of the longitudinal changes in aortic geometry is essential to understand the dramatic hemodynamic changes observed with aging. Methods: Data from 1396 MESA participants who had aortic magnetic resonance imaging in 2000-02 and 2010-12 were analyzed. Ascending aorta diastolic diameter (Add), strain (Astr), arch length (Alen) and their rates of change (Δ) were determined using the validated automated software (ARTFUN, INSERM LIB). Multivariate analysis was performed to examine the correlates of the changes of these parameters. Least square means of Add and Alen adjusted for body surface area were plotted against age for those not on anti-HTN drugs on either visit (n=590). Results: The main correlates of increased ΔAdd, and ΔAlen were male gender, smaller baseline Add, and Alen, lower PP, greater MAP and ΔMAP. Increased ΔAdd was also associated with greater baseline Astr and with not being on anti-HTN drugs, while greater ΔAlen, was associated with smaller ΔPP in women only (P<0.05 for all). Figures.1 shows cross sectional Add, and Alen (upper panels) and their longitudinal changes (lower panels). In men, Add, and Alen increased with aging; ΔAlen was steady but ΔAdd increased significantly after the 7th decade. In women, although Add and Alen increased with aging, ΔAdd decreased linearly with advancing aging while ΔAlen increased after the 7th decade. Conclusion: Gender, baseline blood pressure parameters and baseline aortic geometry and elasticity are the main determinants of aortic remodeling. Aortic elongation and dilatation follow different trajectories and vary by gender. In contrast to men, aortic dilation in women was minimal beyond the 7th decade and aortic elongation was the main remodeling process and was inversely associated with changes in PP. Gender differences in aortic remodeling might explain the increased pulsatility observed in women with advancing aging.