Abstract 11152: Hemodynamic Correlates of Aortic Root Dimensions in an Adult Population: The Strong Heart Study
BACKGROUND: Whether an association exists between hypertension and aortic root (AR) dilatation is uncertain, due to complex interaction among demographic and hemodynamic factors.
METHODS: AR dimension (ARD), was measured (sinuses of Valsalva, end-diastole) in 3185 participants in the 4th Strong Heart Study exam (61% women, 18-to-93 yr-old), free of prevalent coronary heart disease. ARD was compared with the value predicted by age, sex and height, using an equation previously generated in 1207 normal subjects, to predict ideal sex-specific ARD. A sex-specific Z-score was therefore calculated (ARD-z). Positive ARD-z identify greater ARD, whereas negative values indicate ARD smaller than ideal.
RESULTS: Hypertension was present in 40% of men and 32% of women, obesity in 54% and 62% (both p<0.0001), and diabetes in 22% and 25%, respectively. In a multivariable linear regression we entered 4 variables (table), based on pathophysiologic considerations (steady stress, distending force, left ventricular performance). ARD-z was related positively to stroke volume, diastolic blood pressure (BP) and heart rate and negatively to systolic BP (Table). Residuals of ARD-z were positively correlated with BMI, waist circumference, body fat (by BIA, all p<0.0001) and indices of inflammation, including C-reactive protein, fibrinogen and PAI-1, white blood cell count, and neutrophil count (p<0.05 to <0.0001). In extended regression model, neutrophil count remained independently related to ARD-z (p<0.001) together with indicators of body fatness (all p<0.0001), without changes in β-coefficients and variance inflation shown in table.
CONCLUSIONS: After controlling for age, sex and body size, larger ARD is associated with higher stroke volume, diastolic BP and heart rate and is influenced by body fatness and inflammation. Higher ARD is independently related to lower systolic BP, suggesting an association of greater aortic volume compliance with lower pulse pressure.
Author Disclosures: G. de Simone: None. M.J. Roman: None. M. De Marco: None. R. Izzo: None. E.T. Lee: None. R.B. Devereux: None.
- © 2014 by American Heart Association, Inc.