Aortic Stiffness, Central Blood Pressure, and Pulsatile Arterial Load Predict Future Thoracic Aortic Aneurysm Expansion
Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future a...
Gespeichert in:
| Veröffentlicht in: | Hypertension (Dallas, Tex. 1979) Jg. 77; H. 1; S. 126 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
| Veröffentlicht: |
01.01.2021
|
| ISSN: | 1524-4563, 1524-4563 |
| Online-Zugang: | Weitere Angaben |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| Abstract | Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future aneurysm expansion. One hundred five consecutive, unoperated subjects with thoracic aortic aneurysm were recruited and prospectively followed. By combining arterial tonometry with echocardiography, we estimated measures of aortic stiffness, central blood pressure, steady, and pulsatile arterial load at baseline. Aneurysm size was measured at baseline and follow-up with imaging; growth was calculated in mm/y. Stepwise multivariable linear regression assessed associations of arterial stiffness and load measures with aneurysm growth after adjusting for potential confounders. Mean±SD age, baseline aneurysm size, and follow-up time were 62.6±11.4 years, 46.24±3.84 mm, and 2.92±1.01 years, respectively. Aneurysm growth rate was 0.43±0.37 mm/y. After correcting for multiple comparisons, higher central systolic (β±SE: 0.026±0.009, P=0.007), and pulse pressures (β±SE: 0.032±0.009, P=0.0002), carotid-femoral pulse wave velocity (β±SE: 0.032±0.011, P=0.005), amplitudes of the forward (β±SE: 0.044±0.012, P=0.0003) and reflected (β±SE: 0.060±0.020, P=0.003) pressure waves, and lower total arterial compliance (β±SE: -0.086±0.032, P=0.009) were independently associated with future aneurysm growth. Measures of aortic stiffness and pulsatile hemodynamics are independently associated with future thoracic aortic aneurysm growth and provide novel insights into disease activity. Our findings highlight the role of central hemodynamic assessment to tailor novel risk assessment and therapeutic strategies to patients with thoracic aortic aneurysm.Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future aneurysm expansion. One hundred five consecutive, unoperated subjects with thoracic aortic aneurysm were recruited and prospectively followed. By combining arterial tonometry with echocardiography, we estimated measures of aortic stiffness, central blood pressure, steady, and pulsatile arterial load at baseline. Aneurysm size was measured at baseline and follow-up with imaging; growth was calculated in mm/y. Stepwise multivariable linear regression assessed associations of arterial stiffness and load measures with aneurysm growth after adjusting for potential confounders. Mean±SD age, baseline aneurysm size, and follow-up time were 62.6±11.4 years, 46.24±3.84 mm, and 2.92±1.01 years, respectively. Aneurysm growth rate was 0.43±0.37 mm/y. After correcting for multiple comparisons, higher central systolic (β±SE: 0.026±0.009, P=0.007), and pulse pressures (β±SE: 0.032±0.009, P=0.0002), carotid-femoral pulse wave velocity (β±SE: 0.032±0.011, P=0.005), amplitudes of the forward (β±SE: 0.044±0.012, P=0.0003) and reflected (β±SE: 0.060±0.020, P=0.003) pressure waves, and lower total arterial compliance (β±SE: -0.086±0.032, P=0.009) were independently associated with future aneurysm growth. Measures of aortic stiffness and pulsatile hemodynamics are independently associated with future thoracic aortic aneurysm growth and provide novel insights into disease activity. Our findings highlight the role of central hemodynamic assessment to tailor novel risk assessment and therapeutic strategies to patients with thoracic aortic aneurysm. |
|---|---|
| AbstractList | Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future aneurysm expansion. One hundred five consecutive, unoperated subjects with thoracic aortic aneurysm were recruited and prospectively followed. By combining arterial tonometry with echocardiography, we estimated measures of aortic stiffness, central blood pressure, steady, and pulsatile arterial load at baseline. Aneurysm size was measured at baseline and follow-up with imaging; growth was calculated in mm/y. Stepwise multivariable linear regression assessed associations of arterial stiffness and load measures with aneurysm growth after adjusting for potential confounders. Mean±SD age, baseline aneurysm size, and follow-up time were 62.6±11.4 years, 46.24±3.84 mm, and 2.92±1.01 years, respectively. Aneurysm growth rate was 0.43±0.37 mm/y. After correcting for multiple comparisons, higher central systolic (β±SE: 0.026±0.009, P=0.007), and pulse pressures (β±SE: 0.032±0.009, P=0.0002), carotid-femoral pulse wave velocity (β±SE: 0.032±0.011, P=0.005), amplitudes of the forward (β±SE: 0.044±0.012, P=0.0003) and reflected (β±SE: 0.060±0.020, P=0.003) pressure waves, and lower total arterial compliance (β±SE: -0.086±0.032, P=0.009) were independently associated with future aneurysm growth. Measures of aortic stiffness and pulsatile hemodynamics are independently associated with future thoracic aortic aneurysm growth and provide novel insights into disease activity. Our findings highlight the role of central hemodynamic assessment to tailor novel risk assessment and therapeutic strategies to patients with thoracic aortic aneurysm.Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic aneurysm are critically needed. To address this need, we sought to determine the role of aortic stiffness and pulsatile arterial load on future aneurysm expansion. One hundred five consecutive, unoperated subjects with thoracic aortic aneurysm were recruited and prospectively followed. By combining arterial tonometry with echocardiography, we estimated measures of aortic stiffness, central blood pressure, steady, and pulsatile arterial load at baseline. Aneurysm size was measured at baseline and follow-up with imaging; growth was calculated in mm/y. Stepwise multivariable linear regression assessed associations of arterial stiffness and load measures with aneurysm growth after adjusting for potential confounders. Mean±SD age, baseline aneurysm size, and follow-up time were 62.6±11.4 years, 46.24±3.84 mm, and 2.92±1.01 years, respectively. Aneurysm growth rate was 0.43±0.37 mm/y. After correcting for multiple comparisons, higher central systolic (β±SE: 0.026±0.009, P=0.007), and pulse pressures (β±SE: 0.032±0.009, P=0.0002), carotid-femoral pulse wave velocity (β±SE: 0.032±0.011, P=0.005), amplitudes of the forward (β±SE: 0.044±0.012, P=0.0003) and reflected (β±SE: 0.060±0.020, P=0.003) pressure waves, and lower total arterial compliance (β±SE: -0.086±0.032, P=0.009) were independently associated with future aneurysm growth. Measures of aortic stiffness and pulsatile hemodynamics are independently associated with future thoracic aortic aneurysm growth and provide novel insights into disease activity. Our findings highlight the role of central hemodynamic assessment to tailor novel risk assessment and therapeutic strategies to patients with thoracic aortic aneurysm. |
| Author | Wells, George A Dennie, Carole Chan, Kwan Leung Boodhwani, Munir Boczar, Kevin E Beauchesne, Luc Coutinho, Thais |
| Author_xml | – sequence: 1 givenname: Kevin E surname: Boczar fullname: Boczar, Kevin E – sequence: 2 givenname: Munir surname: Boodhwani fullname: Boodhwani, Munir – sequence: 3 givenname: Luc surname: Beauchesne fullname: Beauchesne, Luc – sequence: 4 givenname: Carole surname: Dennie fullname: Dennie, Carole – sequence: 5 givenname: Kwan Leung surname: Chan fullname: Chan, Kwan Leung – sequence: 6 givenname: George A surname: Wells fullname: Wells, George A – sequence: 7 givenname: Thais surname: Coutinho fullname: Coutinho, Thais |
| BookMark | eNpNkE1PAjEQhhuDiYj-h3rzwGK_sceVgJAQIIIHT6R2p3HN0mLbjfrv3SgHT_O-M0-ew1ying8eELqhZESponfzl830aTddbRfrVTkvR5R1B8WEPkN9KpkohFS89y9foMuU3gmhQohxH32WIeba4m2unfOQ0hBPwOdoGvzQhFDhTeyWbYQhNr5rbZNMrhvAZcwQ6w5bBvNLVbXNeNbmjsW7txCN7bQne-mhjd_pgKdfR-NTHfwVOnemSXB9mgP0PJvuJvNiuX5cTMplYSUlurDMaS5fqeKVAC35GAy1FeWWaEO4cLpSVDnGNXf3glZWCM0sEMFAaU6MYwN0--c9xvDRQsr7Q50sNI3xENq0Z0LJseSy-88PuRBlQw |
| CitedBy_id | crossref_primary_10_1161_JAHA_122_028116 crossref_primary_10_1016_j_rec_2024_10_009 crossref_primary_10_1159_000540987 crossref_primary_10_1016_j_avsg_2024_11_018 crossref_primary_10_1161_HYPERTENSIONAHA_124_23795 crossref_primary_10_14814_phy2_15410 crossref_primary_10_15829_1560_4071_2024_6051 crossref_primary_10_1016_S0140_6736_22_01970_5 crossref_primary_10_3390_ijms22105057 crossref_primary_10_1016_j_yjmcc_2024_04_015 crossref_primary_10_1093_ejcts_ezaf128 crossref_primary_10_1016_j_amjcard_2023_07_031 crossref_primary_10_1016_j_jtcvs_2022_03_032 crossref_primary_10_3389_fcvm_2022_936142 crossref_primary_10_3390_jcdd10010006 crossref_primary_10_1183_13993003_04440_2020 crossref_primary_10_1161_JAHA_122_029466 crossref_primary_10_1016_j_cjca_2022_07_013 crossref_primary_10_1097_HCO_0000000000001012 crossref_primary_10_1016_j_cjca_2022_08_006 crossref_primary_10_3390_ijms23042111 crossref_primary_10_1161_ATVBAHA_123_320235 crossref_primary_10_3390_bioengineering11030204 crossref_primary_10_1093_ejcts_ezab533 crossref_primary_10_1016_j_recesp_2024_10_012 crossref_primary_10_3390_jimaging8100280 crossref_primary_10_1016_j_jacc_2023_05_067 crossref_primary_10_1093_ehjimp_qyae133 crossref_primary_10_1097_RLI_0000000000000768 |
| ContentType | Journal Article |
| DBID | 7X8 |
| DOI | 10.1161/HYPERTENSIONAHA.120.16249 |
| DatabaseName | MEDLINE - Academic |
| DatabaseTitle | MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | no_fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1524-4563 |
| GroupedDBID | --- .-D .XZ .Z2 01R 0R~ 18M 1J1 2WC 40H 4Q1 4Q2 4Q3 53G 5GY 5RE 5VS 71W 77Y 7O~ 7X8 AAAAV AAAXR AAFWJ AAGIX AAHPQ AAIQE AAJCS AAMOA AAMTA AAQKA AARTV AASCR AASOK AAXQO AAYEP ABASU ABBUW ABDIG ABJNI ABOCM ABPXF ABQRW ABVCZ ABXVJ ABXYN ABZAD ABZZY ACDDN ACEWG ACGFO ACGFS ACILI ACLDA ACWDW ACWRI ACXJB ACXNZ ACZKN ADBBV ADGGA ADHPY ADKSD ADSXY AE3 AE6 AEBDS AENEX AFBFQ AFDTB AFEXH AFNMH AFUWQ AGINI AHMBA AHOMT AHQNM AHQVU AHVBC AIJEX AINUH AJCLO AJIOK AJNWD AJZMW AKCTQ AKULP ALKUP ALMA_UNASSIGNED_HOLDINGS ALMTX AMJPA AMKUR AMNEI AOHHW AOQMC BAWUL BCGUY BOYCO BQLVK C45 CS3 DIK DIWNM E.X E3Z EBS EEVPB EJD ERAAH EX3 F2K F2L F2M F2N F5P FCALG FL- GNXGY GQDEL GX1 H0~ HLJTE HZ~ IKREB IKYAY IN~ IPNFZ JK3 K-A K-F K8S KD2 KMI KQ8 L-C L7B N9A N~7 N~B O9- OAG OAH OB3 ODMTH OGROG OHYEH OK1 OL1 OLG OLH OLU OLV OLY OLZ OPUJH OVD OVDNE OVIDH OVLEI OWBYB OWV OWW OWY OWZ OXXIT OZ- P2P PQQKQ RAH RIG RLZ S4R S4S TEORI TR2 TSPGW V2I VVN W3M W8F WH7 WOQ WOW X3V X3W XYM YFH YOC YYM ZFV |
| ID | FETCH-LOGICAL-c5109-c2f935b163d4e9537ea1cd13c09a034f9d616f2393f841dc4492ce042e6930af2 |
| IEDL.DBID | 7X8 |
| ISICitedReferencesCount | 34 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=00004268-202101000-00016&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1524-4563 |
| IngestDate | Mon Sep 08 08:50:57 EDT 2025 |
| IsDoiOpenAccess | false |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Language | English |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c5109-c2f935b163d4e9537ea1cd13c09a034f9d616f2393f841dc4492ce042e6930af2 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| OpenAccessLink | https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA.120.16249 |
| PQID | 2465753515 |
| PQPubID | 23479 |
| ParticipantIDs | proquest_miscellaneous_2465753515 |
| PublicationCentury | 2000 |
| PublicationDate | 2021-January |
| PublicationDateYYYYMMDD | 2021-01-01 |
| PublicationDate_xml | – month: 01 year: 2021 text: 2021-January |
| PublicationDecade | 2020 |
| PublicationTitle | Hypertension (Dallas, Tex. 1979) |
| PublicationYear | 2021 |
| SSID | ssj0014447 |
| Score | 2.498111 |
| Snippet | Thoracic aortic aneurysm is a disease associated with high morbidity and mortality. Clinically useful strategies for medical management of thoracic aortic... |
| SourceID | proquest |
| SourceType | Aggregation Database |
| StartPage | 126 |
| Title | Aortic Stiffness, Central Blood Pressure, and Pulsatile Arterial Load Predict Future Thoracic Aortic Aneurysm Expansion |
| URI | https://www.proquest.com/docview/2465753515 |
| Volume | 77 |
| WOSCitedRecordID | wos00004268-202101000-00016&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1LSwMxEA6-EC--xTcpeOzS3U02uzlJlZYetBSsUE8lmwcW6q669fXvnYlbevAieFwShhC-fDN8MztDyIUDr89SLQLNJA-4MSzIszwMQsvy2AmRsET5YRNpv5-NRnJQC25VXVY550RP1KbUqJG3Yo4pAgbu9_L5JcCpUZhdrUdoLJNVBqEMojodLbIInPsBY-Ci4BiJYOuk4UlCRK3ew6ADAWMfGavdQ0kQFkTM5S9O9o6mu_XfI26TzTrEpO0fTOyQJVvskvXbOom-Rz7aJS7Ru9nEOWS6Jq01XnqFZez055fBV9ukqoCvtylW_EwtWvR4pTel8rvA4ox2fVcSOnwEMGkwW1tvY6fMr-qJdj6BcFCT2yf33c7wuhfU8xcCDS9VBjp2kiU5RGyGW5mw1KpIm4jpUKqQcSeNiITDHmou45HRnMtYW2ABi_MVlYsPyEpRFvaQ0CxkJk6Vy4SUXKg8FxnTLLHSSq5Ta45IY36lY8A3Ji1UYcu3ary41OM_7DkhGzEWnXiN5JSsOnjD9oys6ffZpHo99_D4BlsExBw |
| linkProvider | ProQuest |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Aortic+Stiffness%2C+Central+Blood+Pressure%2C+and+Pulsatile+Arterial+Load+Predict+Future+Thoracic+Aortic+Aneurysm+Expansion&rft.jtitle=Hypertension+%28Dallas%2C+Tex.+1979%29&rft.au=Boczar%2C+Kevin+E&rft.au=Boodhwani%2C+Munir&rft.au=Beauchesne%2C+Luc&rft.au=Dennie%2C+Carole&rft.date=2021-01-01&rft.issn=1524-4563&rft.eissn=1524-4563&rft.volume=77&rft.issue=1&rft.spage=126&rft_id=info:doi/10.1161%2FHYPERTENSIONAHA.120.16249&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1524-4563&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1524-4563&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1524-4563&client=summon |