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(Circulation. 2000;101:1819.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Assessment of Aortic Line of Elasticity Using Polynomial Regression Analysis

Christodoulos Stefanadis, MD, FESC; John Dernellis, MD; Eleftherios Tsiamis, MD; Leonidas Diamantopoulos, MD; Andreas Michaelides, MD, FESC; Pavlos Toutouzas, MD, FESC

From Hippokration Hospital, Department of Cardiology, University of Athens, Greece.

Correspondence to Christodoulos Stefanadis, MD, FESC, 9 Tepeleniou St, 15452 Athens, Greece. E-mail cstefan{at}cc.uoa.gr

Background—The aim of this study was to assess the sigmoid line of elasticity in the human aorta.

Methods and Results—The pressure-diameter relation was measured in the descending aorta in 120 subjects. In an additional group of 6 subjects, transient vena caval occlusion produced 5 sets of pressure-diameter data. We found that the best fit curve of the pooled pressure-diameter data was a third-order polynomial. A polynomial equation was used to calculate the sigmoid line of elasticity in the entire population and after the administration of diltiazem (15 patients) or enalaprilat (10 patients). The sigmoid line of elasticity was significantly different with respect to age (P<0.001), history of hypertension (P<0.004), and hypercholesterolemia (P<0.02). The difference between the transition point and the peak systolic pressure was increased in normal subjects compared with patients (P<0.0001). The sigmoid line shifted leftward and upward with diltiazem, but it remained unchanged with enalaprilat. During an average of 3 years of follow-up, 19 of 88 patients developed stroke (n=4), unstable angina (n=8), acute myocardial infarction (n=4), or acute pulmonary edema (n=3).

Conclusions—This approach provides a quantitative evaluation of the aortic line of elasticity, which can differentiate the intrinsic from the extrinsic aortic elastic properties. Furthermore, it is a powerful and independent risk factor for cardiovascular events.

Key Words: aorta • elasticity • nonlinear dynamics

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