Aortic Distensibility In Patients Research Articles

CMR 4-142 - CMR Ascending Aortic Distensibility in Patients with Degenerative Aortic Aneurysm

CMR 4-142 - CMR Ascending Aortic Distensibility in Patients with Degenerative Aortic Aneurysm

Prognostic role of aortic distensibility in patients with bicuspid aortic valve: a CMR study.

To evaluate the prognostic value of aortic distensibility measured by cardiovascular magnetic resonance (CMR) as predictors of prophylactic aortic valve or aortic surgery in patients with bicuspid aortic valve (BAV). 110 patients with BAV were included. Distensibility of middle ascending aorta (AscAo) and proximal descending aorta (DescAo) at baseline was determined using CMR. The association between aortic distensibility and primary endpoint of aortic valve and/or aortic surgery was investigated with Cox proportional hazard regression analyses. The receiver operating characteristics curves (ROC) of the area under receiver-operator (AUC) and DeLong test were used to evaluate and compare the performance of different models. During a median follow-up of 66.5months [IQR 13-75months], 42 patients experienced surgical treatments. After adjusting for traditional risk factors, aortic distensibility (P = 0.003) and severe valve dysfunction (P < 0.001) were found significantly associated with aortic valve and/or aortic surgery. The model 2 (aortic distensibility and severe valve dysfunction) is slightly better in predicting primary endpoint than the model 1 (aortic diameter and severe valve dysfunction) (AUC: 0.893 vs. 0.842, P = 0.106). In BAV patients, aortic distensibility and severe valve dysfunction are valuable predictors for final aortic valve and/or aortic surgery.

Evaluation of Aortic Distensibility in Patients with Nonalcoholic Fatty Liver Using CT.

Nonalcoholic fatty liver disease has attracted considerable attention with continuously increasing morbidity. To evaluate the aortic distensibility in patients with non-diabetic and hypertension-type Nonalcoholic Fatty Liver Disease (NAFLD) through Dual-Source Computed Tomography (DSCT). 120 patients with NAFLD (experimental group) and 30 healthy subjects (control group) were consecutively enrolled in the study. In the two groups, aortic distensibility was calculated as D = ΔA/(A0 ×Δp). Record fasting insulin, fasting blood glucose, fasting lipid status, age, heart rate, waist circumference, systolic blood pressure, and diastolic blood pressure. Calculate homeostasis model assessment of insulin resistance (HOMA-IR) and Body Mass Index (BMI). A comparative analysis between the two groups was carried out, followed by a correlation analysis between D value and risk factors. D value and liver attenuation of the patients in the NAFLD group were significantly reduced relative to those in the control group (2.24±0.63×10-3 mmHg-1 vs. 3.19±0.86×10-3 mmHg-1, P<0.001 and 41±6HU vs. 53±5HU, P<0.001, respectively) and their fasting blood glucose, fasting insulin, triglyceride, low-density lipoprotein, aspartate aminotransferase, alanine transaminase, HOMA- IR, and BMI were higher than those in the control group. Liver attenuation, HOMA-IR, age, and BMI were significantly correlated with D value in the NAFLD group. The stepwise multiple linear regression analysis indicates that liver attenuation and HOMA-IR were the significant risk factors for D value (β coefficient =0.43, P =0.001, and β coefficient =-0.33, P =0.02, respectively). Patients with NAFLD suffer from a reduction in aortic distensibility, and insulin resistance may play a significant role in the early atherosclerosis stage.

Longitudinal changes in aortic distensibility in patients with Marfan syndrome

Abstract Background Patients with Marfan syndrome (MFS) may develop aortic dissection due to progressive dilatation in the entire aorta. Increased aortic stiffness, i.e.a. decreased distensibility has been shown to often precede these dismal sequelae. Therefore, we investigated longitudinal changes in aortic distensibility throughout the entire aorta by means of Cardiac Magnetic Resonance (CMR) imaging in patients with MFS. Methods This retrospective study included all MFS patients with four CMR examinations performed between 1996 and 2012. Aortic distensibility was measured and calculated by a single analyst, in the ascending, proximal- and distal descending, and abdominal aorta. Changes in distensibility were studied using linear mixed-effects regression models. Furthermore, we investigated the association between distensibility and age, sex, blood pressure, medication use, FBN1 mutation type, and previous aortic root surgery. Results In total, 35 MFS patients (age at inclusion 28 [IQR 23–32] years, 54% male) were included. Mean aortic distensibility was low in the ascending and proximal descending aorta (resp. 3.25±1.87, 3.91±1.73x10–3 mmHg–1) at the first scan. Distensibility decreased significantly over time at level 2, 3, and 4 (resp. p=0.021, p=0.002, p=0.038) (Figure 1). The rate of distensibility loss per year (x10–3 mmHg–1/year) was respectively 0.04 and 0.06 in the proximal- and distal descending aorta. Men seemed to have a lower but more stable distensibility, whereas women showed a higher distensibility at younger age, but a faster deterioration rate over time (difference in distensibility loss per year between men and women: 0.08, p=0.038). Distensibility did not correlate significantly with medication use, FBN1 mutation type or previous aortic root surgery. Conclusion Patients with MFS have low distensibility at all levels of the aorta at young age, which keeps decreasing over time. Men had lower distensibility at younger age than women. Distensibility was stably low in men, while still deteriorating over time in women. Funding Acknowledgement Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): AMC FoundationHorstingstuit Foundation

Evaluation of carotid-femoral pulse wave velocity, aortic stiffness index, and aortic distensibility in patients with fibromyalgia.

The aim of this study was to compare the carotid-femoral pulse wave velocity (CFPWV), aortic stiffness index (ASI), and aortic distensibility values of fibromyalgia patients with those of healthy subjects. This study was conducted as a case-control study between September 2017 and March 2018. Echocardiographic evaluations were administered by the same cardiologist. ASI, aortic distensibility, CFPWV, and other echocardiographic parameters of fibromyalgia patients and healthy subjects were compared. In addition, all patients were assessed using the Fibromyalgia Impact Questionnaire (FIQ), number of tender points, and Visual Analogue Scale (VAS) pain score. The fibromyalgia group consisted of 67 female patients with a mean age of 48.54 ± 3.1years (range, 42-55years) and the control group consisted of 50 healthy subjects with a mean age of 49.76 ± 3.1years (range, 42-55years). No significant difference was observed between the groups in respect of age and body mass index (p > 0.05). CFPWV and ASI values were significantly higher in the fibromyalgia group than in the control group. Aortic distensibility values were significantly lower in the fibromyalgia group compared to the control group (p < 0.05 for all). There was a very strong, positive correlation between the CFPWV values and number of tender points (r = 0.936, p < 0.001), VAS (r = 0.927, p < 0.001), FIQ (r = 0.941, p < 0.001), and ASI (r = 0.957, p < 0.001). CFPWV and aortic stiffness seem to be increased and aortic distensibility seems to be decreased in patients with fibromyalgia. Alleviating pain and improving the disease severity may be helpful in preventing cardiovascular risk factors in patients with fibromyalgia.

TCT-299 Pulse Wave Velocity and Aortic Distensibility in Patients with Hypertensive Response Post Transcatheter Aortic Valve Replacement

TCT-299 Pulse Wave Velocity and Aortic Distensibility in Patients with Hypertensive Response Post Transcatheter Aortic Valve Replacement

Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought to investigate the effects of RDN on AD and to assess the predictive value of pre-treatment AD for BP changes. We analyzed data of 65 patients with RH included in a multicenter trial. RDN was performed in all participants. A standardized CMR protocol was utilized at baseline and at 6-month follow-up. AD was determined as the change in cross-sectional aortic area per unit change in BP. Office BP decreased significantly from 173/92 ± 24/16 mmHg at baseline to 151/85 ± 24/17 mmHg (p < 0.001) 6 months after RDN. Maximum aortic areas increased from 604.7 ± 157.7 to 621.1 ± 157.3 mm2 (p = 0.011). AD improved significantly by 33% from 1.52 ± 0.82 to 2.02 ± 0.93 × 10−3 mmHg−1 (p < 0.001). Increase of AD at follow-up was significantly more pronounced in younger patients (p = 0.005) and responders to RDN (p = 0.002). Patients with high-baseline AD were significantly younger (61.4 ± 10.1 vs. 67.1 ± 8.4 years, p = 0.022). However, there was no significant correlation of baseline AD to response to RDN. AD is improved after RDN across all age groups. Importantly, these improvements appear to be unrelated to observed BP changes, suggesting that RDN may have direct effects on the central vasculature.

Myocardial Performance Index and Aortic Distensibility in Patients with Different Left Ventricle Geometry in Newly Diagnosed Essential Hypertension

Myocardial Performance Index and Aortic Distensibility in Patients with Different Left Ventricle Geometry in Newly Diagnosed Essential Hypertension

N Terminal pro-Brain Natriuretic Peptide Level is Associated with SYNTAX Score and Aortic Distensibility in Patients with Stable Coronary Artery Disease

PP-300 The high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information in patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD) which reflects aortic stiffness and extent and complexity of CAD assessed with

Impaired Kidney Function Associated with Both Syntax Score and Aortic Distensibility in Patients with Stable Coronary Artery Disease

PP-364 The strong relationships between severe renal dysfunction with coronary artery disease (CAD) and arterial stiffness are well known. However, the associations between the kidney function with SYNTAX Score and aortic distensibility (AD) were not investigated in patients with stable CAD with

Myocardial performance index and aortic distensibility in patients with different left ventricle geometry in newly diagnosed essential hypertension

Background: Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertrophy, are associated with a greater risk of hypertensive complications. The aim of this study was to investigate the association between LV myocardial performance index (LVMPI) and aortic distensibility (AD) with different LV geometric patterns in patients with newly diagnosed hypertension (HT). Methods: We studied 181 patients with newly diagnosed HT (mean age; 51.7±5.4 years) and 39 healthy control subjects (mean age; 51.2±5.1 years). Echocardiographic examination was performed in all subjects. Four different geometric patterns were determined in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. LVMPI was calculated from the tissue Doppler derived ejection time, isovolumic contraction, and relaxation times. Results: The highest LVMPI and the lowest AD values were observed in concentric hypertrophy group compared with control, normal geometry, concentric remodelling and eccentric hypertrophy groups (p<0.05, for all). LVMPI was associated with LVMI (r=0.497, p<0.001), RWT (r=0.270, p<0.001), AD (r=-0.316, p<0.001) and E deceleration time (r=0.171, p=0.02) in bivariate analysis. In multiple linear regression analysis, LVMPI was independently related to LVMI (β=0.381, p<0.001) and AD (β=-0.263, p=0.001). View this table: Table 1. Comparisons of echocardiographic characteristics among the groups Conclusions: The LVMPI was highest and AD was lowest in patients with concentric hypertrophy. The LVMPI was independently associated with LVMI and AD in hypertensive patients.

SAT0399 Impairment in aortic elastic properties and mechanics of carotid artery system in patients with takayasu’ s arteritis

BackgroundTakayasu’s arteritis (TA) is a chronic inflammatory vasculitis of the aorta and its major branches. Increased arterial stiffness is known to be a predictor of cardiovascular mortality. Impairment of the...

Myocardial performance index and aortic distensibility in patients with different left ventricle geometry in newly diagnosed essential hypertension

Background. Abnormal left ventricular (LV) geometric patterns, particularly concentric LV hypertrophy, are associated with a greater risk of hypertensive complications. The aim of this study was to investigate the association between LV myocardial performance index (LVMPI) and aortic distensibility (AD) with different LV geometric patterns in patients with newly diagnosed hypertension (HT). Methods. We studied 181 patients with newly diagnosed HT (mean age 51.7 ± 5.4 years) and 39 healthy control subjects (mean age 51.2 ± 5.1 years). Echocardiographic examination was performed in all subjects. Four different geometric patterns were determined in hypertensive patients according to LV mass index (LVMI) and relative wall thickness (RWT). AD was calculated from the echocardiographically derived ascending aorta diameters and haemodynamic pressure measurements. LVMPI was calculated from the tissue Doppler-derived ejection time, isovolumic contraction and relaxation times. Results. The highest LVMPI and the lowest AD values were observed in concentric hypertrophy group compared with control, normal geometry, concentric remodelling and eccentric hypertrophy groups (p < 0.05, for all). LVMPI was associated with LVMI (r = 0.497, p < 0.001), RWT (r = 0.270, p < 0.001), AD (r = −0.316, p < 0.001) and E deceleration time (r = 0.171, p = 0.02) in bivariate analysis. In multiple linear regression analysis, LVMPI was independently related to LVMI (β = 0.381, p < 0.001) and AD (β = −0.263, p = 0.001). Conclusions. The LVMPI was highest and AD was lowest in patients with concentric hypertrophy. The LVMPI was independently associated with LVMI and AD in hypertensive patients.

NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD

A high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information on patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD), which reflects the aortic stiffness, and the extent and complexity of CAD, assessed with the SYNTAX score (SS), affect the secretion of NT-proBNP in stable CAD. We aimed to investigate the relationship between NT-proBNP levels and AD as well as with the extent and complexity of CAD in stable CAD patients. The study included 411 patients with stable CAD (mean age = 61.7 ± 9.9years, male/female = 247/164). The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group < 114pg/ml and NT-proBNPhigh group ≥ 114pg/ml). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. Coronary angiography was performed and SS was determined in all patients. NT-proBNP and other biochemical markers were measured in all subjects. The AD and ejection fraction values of the NT-proBNPhigh group were lower and their SS levels were higher compared with those from the NT-proBNPlow group (p < 0.05, for all). The NT-proBNP level was independently associated with AD (β = -0.378, p < 0.001), SS (β = 0.262, p < 0.001), and ejection fraction (β = - 0.295, p < 0.001) on multiple linear regression analysis. NT-proBNP was independently associated with an impaired elastic property of the aorta and with the extent and complexity of CAD as well as with left ventricular systolic dysfunction.

The Effects of Metabolic Syndrome on Aortic Distensibility in Patients with Angiographically Normal Coronary Arteries

Amac: Bu calismada, metabolik sendrom tanisi alan ve anjiyografik olarak koroner arterleri normal saptanan hastalarda metabolik sendromun invazif olarak olculmus aort sertlik parametrelerine olan etkilerini ortaya koymayi amacladik.Gerec ve Yontemler: Calismaya metabolik sendrom tanisi konan 30 hasta ve kontrol grubu olarak metabolik sendrom tanisi bulunmayan 20 hasta alindi. Hemodinamik olcumler hasta yatar pozisyonda kardiyak kateterizasyon yapimi esnasinda degerlendirildi. Aort sistolik ve diyastolik caplari olculdu ve aort sertliginin gostergeleri olan aort gerilimi ve esneyebilirligi hesaplandi.Bulgular: Metabolik sendrom grubunda, kontrol grubu ile karsilastirildiginda beklendigi uzere sistolik ve diyastolik kan basinci, nabiz basinci, bel cevresi, trigliserid duzeyi, aclik kan sekeri degerleri daha yuksek, HDL-kolesterol duzeyleri dusuk bulundu. Metabolik sendrom grubunda aort gerilimi istatistiksel olarak anlamli olmamakla birlikte daha yuksek saptandi(p=0.181). Aort esneyebilirigi ise istatistiksel olarak anlamli olarak daha dusuk idi(p

Myocardial performance and aortic elasticity are impaired in patients with ankylosing spondylitis

Objective: To measure aortic stiffness and global left ventricular (LV) function in patients with ankylosing spondylitis (AS) and no clinical evidence of heart disease.Methods: Fifty‐seven consecutive patients with AS (54 males, three females, mean age 41.78±10.02 years) without clinical evidence of cardiac involvement and 78 healthy subjects (73 males, five females, mean age 39.92±9.11 years) underwent complete echocardiographic study. Aortic stiffness was determined non‐invasively by aortic distensibility (AoD) and the global LV function was evaluated by the myocardial performance index (the Tei index).Results: AoD in patients with AS [(2.21±0.24)×10−6 cm2 dyn−1] was decreased compared to controls [(2.58±0.19) )×10−6 cm2 dyn−1, p<0.01], confirming that aortic stiffness is increased in AS. The LV Tei index was significantly increased in the patient group compared to the control group (0.392±0.031 vs. 0.370±0.034, p<0.01). The ejection fraction (EF) did not differ between the two groups (p>0.05). In multivariate linear regression analysis, AoD was significantly associated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and LV isovolumic relaxation time (IVRT) whereas the LV Tei index was associated with BASDAI and the LV mass index.Conclusions: Patients with AS and no clinical evidence of cardiac disease have increased stiffness of the aorta and decreased global myocardial performance and both of these abnormal measurements correlate with disease activity. The abnormal Tei index may reflect an early manifestation of cardiac dysfunction in these patients.

Assessment of change in aortic distensibility in patients with left ventricular hypertrophy (LVH), before and after therapy, using Cardiac Magnetic Resonance (CMR) imaging

Assessment of change in aortic distensibility in patients with left ventricular hypertrophy (LVH), before and after therapy, using Cardiac Magnetic Resonance (CMR) imaging

Relationship between myocardial performance index and aortic distensibility in patients with essential hypertension

We aimed to investigate the association between aortic distensibility (AD) and left ventricle myocardial performance index (MPI) in patients with newly diagnosed hypertension (HT). We studied 49 patients with HT and 24 healthy control subjects. AD was calculated from the echocardiographically derived ascending aorta diameters. The MPI was calculated from both conventional flow Doppler echocardiography and tissue Doppler echocardiography recordings. Conventional Doppler E/A and tissue Doppler derived Ea/Aa were determined for all the subjects. Aortic distensibility was lower, and both conventional and tissue Doppler MPI values were higher (p<0.001 for all) in patient group compared with control group. AD was correlated with systolic blood pressure (SBP) (beta=-0.436, p=0.037), Ea/Aa (beta=0.228, p=0.038) and tissue derived MPI (beta=-0.302, p=0.043) in multiple linear regression analysis. Aortic distensibility was independently related to tissue derived MPI and Ea/Aa besides SBP.

Magnetic Resonance Assessment of Aortic Pulse Wave Velocity, Aortic Distensibility, and Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus

Type 2 diabetes mellitus (DM2) may augment arterial stiffening and thereby modulates left ventricular (LV) function. Cardiovascular magnetic resonance (CMR) is well suited to assess aortic pulse wave velocity (PWV) and aortic distensibility, both markers of arterial stiffness, without the use of geometric assumptions. Furthermore, CMR is a reliable method for assessing left ventricular (LV) function. The purpose of this study was to assess LV function, PWV, and aortic distensibility in patients with DM2 using MR. Fourteen patients with well controlled, uncomplicated DM2, and 16 age and gender matched healthy subjects were included. PWV was calculated based on MR velocity mapping at two predefined aortic locations. Aortic distensibility was measured in the mid ascending aorta. LV volumes were measured by fast gradient-echo imaging to assess systolic function. Furthermore, mitral inflow was measured by MR velocity mapping to assess diastolic LV function. Mean PWV was higher in patients as compared to healthy subjects (6.83 +/- 1.60 m/s vs. 5.65 +/- 0.75 m/s, p < 0.05). This difference was independent of blood pressure. PWV correlated significantly (p < 0.05) with fasting plasma glucose and insulin levels. Aortic distensibility was lower in patients as compared to healthy subjects (4.50 x 10(- 3)+/- 2.24 x 10(- 3) mmHg(- 1) vs. 7.42 x 10(- 3)+/- 3.34 x 10(- 3) mmHg(- 1), p < 0.05). Distensibility correlated negatively with PWV and positively with LV diastolic function (p < 0.05). A combined CMR assessment of aortic PWV, aortic distensibility, and heart function reveals abnormal PWV and distensibility in patients with DM2, independent of blood pressure. Furthermore, aortic distensibility correlates with diastolic left ventricular function.

Aortic valve replacement for aortic stenosis is associated with improved aortic distensibility at long-term follow-up

Aortic valve stenosis (AS) is the most frequent form of valvular heart disease. The number of studies evaluating the effect of aortic valve replacement (AVR) for AS on aortic vascular function is limited. The aim of the present study was to examine alterations in aortic distensibility in patients with AS during a 1-year follow-up after AVR. Twelve patients with severe AS who underwent AVR were prospectively examined (mean age 65 +/- 11 years, 7 men). Systolic and diastolic ascending aortic diameters (SD and DD, respectively) were recorded in M mode 3 cm above the aortic valve from a parasternal long-axis view. The SD and DD were measured at the time of maximum anterior motion of the aorta and at the start of the QRS complex, respectively. Aortic stiffness index (beta) was defined as [ln(SBP/DBP)] x DD/deltaD, where ln is the natural logarithm, SBP and DBP are the systolic and diastolic blood pressure values, respectively, and deltaD = SD - DD. As expected, aortic stenosis severity and left ventricular mass decreased significantly after AVR. Aortic diameter changes (systolic minus diastolic dimensions) progressively increased and the aortic stiffness index progressively improved to levels comparable with those of age-, sex-, and risk factor-matched controls at the 1-year assessment. Aortic valve replacement in patients with AS is associated with a progressive improvement in aortic distensibility to 1-year values similar to those of controls.