Effect of systemic hypertension on aortic dimensions. Cardiovascular magnetic resonance study

Abstract

Objectives: Longstanding systemic hypertension (HT) may cause significant dilatation of the aorta. Our objective was to quantify with cardiovascular magnetic resonance (CMR) the effect of HT on aortic dimensions. Methods: Consecutive patients who attended the CMR unit between Jan'08 and Jan'12, and did not have evidence of myocardial necrosis, cardiomyopathies other than HT, significant aortic valve disease, congenital aortic disease and secondary hypertension were included and classified according to presence (H) or absence (N) of HT. The CMR protocol included high resolution cine sequences to obtain specific planes perpendicular to the aortic long axis for each aortic segment. Aortic diameters and areas were measured in end-systole at the annulus, sinus portion, sinotubular junction, tubular portion, middle arch and descending aorta. All were indexed to body surface area. Left ventricular parameters were also recorded as well as complete clinical data. Results: 1411 patients were included, 787 H (49% males, 65±10 yrs), 624 N (63% males, 54±16yrs). ANOVA test was done (factors: group H/N, gender, BSA, age). Per-group analysis: H patients showed a significantly increased dimension at the tubular portion (H: 18,7±0,08 cm2/m2 vs N: 18,1±0,09 cm2/m2, p< 0,001), which correlated with left ventricular mass index (p<0,01). No differences were found for other segments. Per-patient analysis: group H had a higher percentage of dilatation in all segments. Lineal regression analysis showed that the presence of HT caused a mean increase of 0,6 mm/m2 in the diameter of the tubular portion. ![Figure][1] Figure 1 Conclusions: HT causes a mild but significant increase in the dimension of the ascending aorta at the level of the tubular portion, which is independent of the patients' age and correlates with left ventricular mass. [1]: pending:yes