Abstract 16329: Small Aortic Root Dimension: A Contributor to Increased Arterial Stiffness in Hypertension (The Campania Salute Network Registry)
Background: In preliminary analysis in a population-based study larger aortic root dimension (ARD) was associated with higher stroke volume, diastolic blood pressure (BP) and heart rate, but lower systolic BP. Thus we assessed whether ARD influences a 2-element windkessel model of arterial stiffness in the setting of arterial hypertension.
Methods: Ultrasound carotid intima-media thickness (IMT), echocardiographic ARD and pulse pressure (brachial) / stroke index ratio (PP/SVi) were measured in 12392 hypertensive patients (age 53±12 years, 43% women) free of prevalent cardiovascular (CV) disease and with ejection fraction ≥ 50% from the Campania Salute Network Registry. 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 thereafter calculated (ARD-z). PP/SVi was categorized in normal (lowest and middle tertiles) and high (highest tertile).
Results: High PP/SVi was slightly more common in women than in men (37% vs. 30%, p<0.01). Patients with high PP/SVi were older (55±13 vs. 52±12 years), more likely to be diabetic (12% vs. 7%) and less likely to be smokers (16% vs. 20%, all p<0.01). They had higher IMT and cholesterol level and lower BMI and GFR (all p < 0.01). ARD-z was significantly lower in the high than in the normal PP/SVi group (p<0.01). In multivariable logistic regression analysis, increased PP/SVi was associated with lower ARD-z and higher IMT (both p<0.0001), independent of significant associations with older age, female gender, low BMI, diabetes and smoking habit (Table). GFR and cholesterol levels were not independent covariates of PP/SVi.
Conclusion: Small ARD together with atherosclerotic modifications of conduit arteries are associated with increased 2-element windkessel model of arterial stiffness in hypertension, independently of significant effect of female gender and arteriosclerosis.
Author Disclosures: M. Lønnebakken: None. R. Izzo: None. M. De Marco: None. G. Esposito: None. E. Stabile: None. N. De Luca: None. E. Gerdts: None. B. Trimarco: None. G. de Simone: None.
- © 2014 by American Heart Association, Inc.