1
|
Hamimi AH, Ghanem AM, Hannah-Shmouni F, Elgarf RM, Matta JR, Gharib AM, Abd-Elmoniem KZ. Ascending Aorta 4D Time to Peak Distention Sexual Dimorphism and Association with Coronary Plaque Burden Severity in Women. J Cardiovasc Transl Res 2024; 17:298-307. [PMID: 37556037 DOI: 10.1007/s12265-023-10422-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 07/31/2023] [Indexed: 08/10/2023]
Abstract
Coronary artery disease (CAD) risk and plaque scores are often subjective and biased, particularly in mid-age asymptomatic women, whose CAD risk assessment has been historically underestimated. In this study, a new automatic ascending aorta time-to-peak-distention (TPD) analysis was developed for fast screening and as an independent surrogate for subclinical atherosclerosis in asymptomatic women. CCTA was obtained in 50 asymptomatic adults. Plaque burden segment involvement score (SIS) and automatic TPD were obtained from all subjects. Logistic regression analyses were performed to investigate the association between CAD risk scores and TPD with severe coronary plaque burden (SIS>5). TPD, individually, was found to be a significant predictor of SIS>5. Additionally, sex was a significant effect modifier of TPD, with a stronger statistically significant association with women. Four-dimensional aortic time-to-peak distention could supplement conventional CCTA analysis and offer a quick objective screening tool for plaque burden severity and CAD risk stratification, especially in women.
Collapse
Affiliation(s)
- Ahmed H Hamimi
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA
| | - Ahmed M Ghanem
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA
| | - Fady Hannah-Shmouni
- Internal Medicine, Endocrinology, and Genetics, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Reham M Elgarf
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA
| | - Jatin R Matta
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA
| | - Ahmed M Gharib
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA.
| | - Khaled Z Abd-Elmoniem
- Biomedical and Metabolic Imaging Branch (BMIB), National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH), 10 Center Drive, 1C334, Bethesda, MD, 20892, USA.
| |
Collapse
|
2
|
Sanchez RA, Sanchez MJ, Ramirez AJ. Renal Function, Albumin-Creatinine Ratio and Pulse Wave Velocity Predict Silent Coronary Artery Disease and Renal Outcome in Type 2 Diabetic and Prediabetic Subjects. Curr Hypertens Rev 2020; 17:131-136. [PMID: 33305706 DOI: 10.2174/1573402116999201210194817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/15/2020] [Accepted: 07/07/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Silent coronary heart disease is frequently undetected in type 2 diabetes mellitus (DM2) and pre-diabetes determined by glucose intolerance (GI). Pulse wave velocity (PWV) and albumin-creatinine ratio (ACR) have been considered markers of cardiovascular mortality, coronary heart disease and chronic renal failure. AIM To evaluate the incidence of coronary artery disease (CAD) and the relationship between urinary albumin-creatinine ratio, glomerular filtration rate (GFR) and PWV in type 2 DM with silent CAD. METHODS We analyzed 92 individuals (44 male), 49 (60±7y) type 2 DM non-insulin dependents and 43 prediabetics (43±4y), with Grade I-II hypertension and no symptoms of CAD. All type 2 DM patients were under antidiabetic treatment with A1C hemoglobin between 5.5 and 6.5%. Every patient underwent a myocardial perfusion SPECT scan. In those subjects with ischemic patterns, coronary angiography was performed. In addition, PWV, glomerular filtration rate, and ACR were evaluated. STATISTICS mean±SEM, and ANOVA among groups. RESULTS 48.59% of DM2 and 25.58% of GI patients had silent coronary artery had silent coronary artery disease and higher ACR, PWV and reduced GFR. Higher ACR and PWV and reduced GFR. DM2 and GI showed a negative relationship between GFR and ACR. Moreover, this relation was also observed in different levels of GFR (>60 ml/min and <60ml.min (p<0.05) in patients with CAD, suggesting a cardio-renal interaction in DM2. CONCLUSION Higher PWV, lower GFR and ACR predict the incidence of CAD in DM2. Dysglycemic individuals also represent a group of higher risk for coronary artery disease with similar predictors as in DM2. Diabetic and prediabetics still develop renal microalbuminuria. Thus, PWV seems to represent a reliable marker of renal impairment and coronary artery disease.
Collapse
Affiliation(s)
- Ramiro A Sanchez
- Hypertension and Metabolic Unit, Favaloro Foundation, Buenos Aires, Argentina
| | | | - Agustin J Ramirez
- Hypertension and Metabolic Unit, Favaloro Foundation, Buenos Aires, Argentina
| |
Collapse
|
3
|
Corda A, Corda F, Caivano D, Saderi L, Sotgiu G, Mollica A, Birettoni F, Porciello F, Pinna Parpaglia ML. Ultrasonographic assessment of abdominal aortic elasticity in hypertensive dogs. J Vet Intern Med 2020; 34:2337-2344. [PMID: 32949191 PMCID: PMC7694867 DOI: 10.1111/jvim.15891] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/22/2022] Open
Abstract
Background Systemic hypertension (SH) is a persistent and pathological increase in arterial blood pressure (BP). Chronic SH leads to an increase in aortic (Ao) stiffness, and measuring Ao elasticity is useful for estimating Ao stiffness in humans. Currently, no literature in veterinary medicine describes noninvasive assessment of abdominal Ao elasticity in dogs with SH. Objective Compare ultrasonographic‐derived abdominal Ao strain (AoSt) between hypertensive (HT) and normotensive (NT) dogs. Animals Fifty privately‐owned dogs with clinical signs, conditions, or both potentially associated with SH. Methods Prospective observational case‐control study. Aortic stiffness was estimated by calculating AoSt as follows: AoSt = ([AoDs − AoDd]/AoDd) × 100, where AoDs and AoDd are the Ao diameter in systole and in diastole, respectively. Aortic stiffness was calculated from 2 different Ao transverse sections, the first caudal to the left renal artery (K_AoSt), and the second cranial to the external iliac arteries (I_AoSt). Results Thirty‐two dogs were included in the HT group and 18 in the NT group. Both K_AoSt and I_AoSt in HT dogs were significantly lower (P < .05) than in NT dogs (7.4 ± SD 3.6) vs 10.3 (±3.8) and 5.7 (interquartile range [IQR], 3.9‐7.5) vs 8.1 (IQR, 7‐10.3), respectively. Only K_AoSt was significantly influenced by age. Conclusions and Clinical Importance Ultrasonographic Ao elasticity assessment was feasible to compare HT and NT dogs. Results indicated that K_AoSt and I_AoSt indices can be used to assess SH‐related Ao stiffness, especially when indirect BP measurements are inconsistent or inaccurate. Additional studies to assess the AoSt in healthy dogs of various ages are needed.
Collapse
Affiliation(s)
- Andrea Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesca Corda
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Domenico Caivano
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Laura Saderi
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Giovanni Sotgiu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandra Mollica
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Sassari, Sassari, Italy
| | - Francesco Birettoni
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | - Francesco Porciello
- Department of Veterinary Medicine, Veterinary Teaching Hospital, University of Perugia, Perugia, Italy
| | | |
Collapse
|
4
|
Ghorbani N, Muthurangu V, Khushnood A, Goubergrits L, Nordmeyer S, Fernandes JF, Lee CB, Runte K, Roth S, Schubert S, Kelle S, Berger F, Kuehne T, Kelm M. Impact of valve morphology, hypertension and age on aortic wall properties in patients with coarctation: a two-centre cross-sectional study. BMJ Open 2020; 10:e034853. [PMID: 32213521 PMCID: PMC7170596 DOI: 10.1136/bmjopen-2019-034853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE We aimed to investigate the combined effects of arterial hypertension, bicuspid aortic valve disease (BAVD) and age on the distensibility of the ascending and descending aortas in patients with aortic coarctation. DESIGN Cross-sectional study. SETTING The study was conducted at two university medical centres, located in Berlin and London. PARTICIPANTS A total of 121 patients with aortic coarctation (ages 1-71 years) underwent cardiac MRI, echocardiography and blood pressure measurements. OUTCOME MEASURES Cross-sectional diameters of the ascending and descending aortas were assessed to compute aortic area distensibility. Findings were compared with age-specific reference values. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology statement and reporting guidelines. RESULTS Impaired distensibility (below fifth percentile) was seen in 37% of all patients with coarctation in the ascending aorta and in 43% in the descending aorta. BAVD (43%) and arterial hypertension (72%) were present across all ages. In patients >10 years distensibility impairment of the ascending aorta was predominantly associated with BAVD (OR 3.1, 95% CI 1.33 to 7.22, p=0.009). Distensibility impairment of the descending aorta was predominantly associated with arterial hypertension (OR 2.8, 95% CI 1.08 to 7.2, p=0.033) and was most pronounced in patients with uncontrolled hypertension despite antihypertensive treatment. CONCLUSION From early adolescence on, both arterial hypertension and BAVD have a major impact on aortic distensibility. Their specific effects differ in strength and localisation (descending vs ascending aorta). Moreover, adequate blood pressure control is associated with improved distensibility. These findings could contribute to the understanding of cardiovascular complications and the management of patients with aortic coarctation.
Collapse
Affiliation(s)
- Niky Ghorbani
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Vivek Muthurangu
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK
| | - Abbas Khushnood
- Centre for Cardiovascular Imaging, UCL Institute of Cardiovascular Science, London, UK
| | - Leonid Goubergrits
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Sarah Nordmeyer
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
| | - Joao Filipe Fernandes
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Chong-Bin Lee
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum, Berlin, Germany
| | - Kilian Runte
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Sophie Roth
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
| | - Stephan Schubert
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Sebastian Kelle
- Department of Internal Medicine/Cardiology, Deutsches Herzzentrum, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Felix Berger
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Titus Kuehne
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany
| | - Marcus Kelm
- Charité-Universitätsmedizin, Institute for Computational and Imaging Science in Cardiovascular Medicine, Berlin, Germany
- Department of Congenital Heart Disease, Deutsches Herzzentrum Berlin, Berlin, Germany
- BIH (Berlin Institute of Health), Berlin, Germany
| |
Collapse
|
5
|
Mohammadi H, Cartier R, Mongrain R. Fiber-reinforced computational model of the aortic root incorporating thoracic aorta and coronary structures. Biomech Model Mechanobiol 2017; 17:263-283. [PMID: 28929388 DOI: 10.1007/s10237-017-0959-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 08/31/2017] [Indexed: 01/03/2023]
Abstract
Cardiovascular diseases are still the leading causes of death in the developed world. The decline in the mortality associated with circulatory system diseases is accredited to development of new diagnostic and prognostic tools. It is well known that there is an inter relationship between the aortic valve impairment and pathologies of the aorta and coronary vessels. However, due to the limitations of the current tools, the possible link is not fully elucidated. Following our previous model of the aortic root including the coronaries, in this study, we have further developed the global aspect of the model by incorporating the anatomical structure of the thoracic aorta. This model is different from all the previous studies in the sense that inclusion of the coronary structures and thoracic aorta into the natural aortic valve introduces the notion of globality into the model enabling us to explore the possible link between the regional pathologies. The developed model was first validated using the available data in the literature under physiological conditions. Then, to provide a support for the possible association between the localized cardiovascular pathologies and global variations in hemodynamic conditions, we simulated the model for two pathological conditions including moderate and severe aortic valve stenoses. The findings revealed that malformations of the aortic valve are associated with development of low wall shear stress regions and helical blood flow in thoracic aorta that are considered major contributors to aortic pathologies.
Collapse
Affiliation(s)
- Hossein Mohammadi
- Mechanical Engineering Department, McGill University, Montreal, QC, H3A 0C3, Canada
| | - Raymond Cartier
- Department of Cardiovascular Surgery, Montreal Heart Institute, Montreal, QC, H1T 1C8, Canada
| | - Rosaire Mongrain
- Mechanical Engineering Department, McGill University, Montreal, QC, H3A 0C3, Canada.
- Department of Cardiovascular Surgery, Montreal Heart Institute, Montreal, QC, H1T 1C8, Canada.
| |
Collapse
|
6
|
Mohammadi H, Cartier R, Mongrain R. The impact of the aortic valve impairment on the distant coronary arteries hemodynamics: a fluid-structure interaction study. Med Biol Eng Comput 2017; 55:1859-1872. [PMID: 28316038 DOI: 10.1007/s11517-017-1636-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 03/13/2017] [Indexed: 12/30/2022]
Abstract
Atherosclerosis is still the leading cause of death in the developed world. Although its initiation and progression is a complex multifactorial process, it is well known that blood flow-induced wall shear stress (WSS) is an important factor involved in early atherosclerotic plaque initiation. In recent clinical studies, it was established that the regional pathologies of the aortic valve can be involved in the formation of atherosclerotic plaques. However, the impact of hemodynamic effects is not yet fully elucidated for disease initiation and progression. In this study, our developed 3D global fluid-structure interaction model of the aortic root incorporating coronary arteries is used to investigate the possible interaction between coronary arteries and aortic valve pathologies. The coronary hemodynamics was examined and quantified for different degrees of aortic stenosis varying from nonexistent to severe. For the simulated healthy model, the calculated WSS varied between 0.41 and 1.34 Pa which is in the atheroprotective range. However, for moderate and severe aortic stenoses, wide regions of the coronary structures, especially the proximal sections around the first bifurcation, were exposed to lower values of WSS and therefore they were prone to atherosclerosis even in the case of healthy coronary arteries.
Collapse
Affiliation(s)
- Hossein Mohammadi
- Mechanical Engineering Department, McGill University, Montreal, QC, H3A 0C3, Canada
| | - Raymond Cartier
- Department of Cardiovascular Surgery, Montreal Heart Institute, Montreal, QC, H1T 1C8, Canada
| | - Rosaire Mongrain
- Mechanical Engineering Department, McGill University, Montreal, QC, H3A 0C3, Canada.
- Department of Cardiovascular Surgery, Montreal Heart Institute, Montreal, QC, H1T 1C8, Canada.
| |
Collapse
|
7
|
Zapolski T, Furmaga J, Jaroszyński A, Wysocka A, Rudzki S, Wysokiński AP. The reverse remodeling of the aorta in patients after renal transplantation - the value of aortic stiffness index: prospective echocardiographic study. BMC Nephrol 2017; 18:33. [PMID: 28114900 PMCID: PMC5260005 DOI: 10.1186/s12882-017-0453-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/16/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Atherosclerosis is regarded as a combination of two major separate diseases: atherosis and sclerosis. Sclerotic component depends on deterioration of elastic properties of the aortic wall and is called aortic stiffness. The most valuable, non-invasive method of aortic stiffness assessment is echocardiography, which allows to calculate the aortic stiffness index (ASI). ASI is an independent predictor of all-cause and cardiovascular mortality in different groups of patients. The main aim of study was the assessment of the aortic reverse remodeling in patients with end-stage renal disease (ESRD) after renal transplantation (RT). METHODS Study group involved 42 patients aged 43.3 ± 12.6 years, including 19 women aged 49.9 ± 10.9 years and 23 men aged 41.5 ± 12.91 years, who have undergone RT from non-related renal transplant donors, The study protocol has been consisted of 5 stages: 1 week after RT, 3 months after RT, 6 months after RT, 1 year after RT and 3 years after RT. The echocardiographic examination was performed and measurements of Aomax, Aomin were done. On the base of obtained parameters ASI, aortic distensibility (AD) and aortic strain (AS) were calculated according to adequate formulas. RESULTS The improvement of indices characterizing the elastic properties of aorta were noted. These changes attained the statistically significant level only at the end of the observation. ASI just after RT was equal - 4.65 ± 1.58, three months after RT - 4.54 ± 1.49, six months after RT - 4.59 ± 1.61, one year after RT - 4.35 ± 1.21 and three years after RT - 3.35 ± 1.29, while AD reached respectively - 6.55 ± 3.76 cm2/dyn-110-6 just after RT, - 6.38 ± 3.42 cm2/dyn-110-6 three months after RT, - 6.53 ± 3.60 cm2/dyn-110-6 six months after RT, - 6.48 ± 2.79 cm2/dyn-110-6 one year after RT and - 8.03 ± 3.95 cm2/dyn-110-6 three years after RT. Noted AS values were equal - 6.61 ± 4.05%, just after RT, - 6.40 ± 3.58% three months after RT, - 6.56 ± 3.76%, six months after RT, - 6.45 ± 2.80% one year after RT, - 8.01 ± 3.97%. and three years after RT. The exact analysis of parameters concerning aortic function showed that to achieve ASI, AD and AS improvement, long time was needed, because the most significant changes of these indices were observed only between 1 year and 3 years after RT. CONCLUSIONS There is a relationship between renal transplantation and improvement of the aortic elastic properties. The recovery of the renal function allows to initiate the reparative processes leading to at least partial restitution of the structure and features of the aorta, which is called reverse remodelling. Improvement of aortic wall elastic properties after renal transplantation is a continuous and prolonged process.
Collapse
Affiliation(s)
- Tomasz Zapolski
- Department of Cardiology, Medical University of Lublin, ul. Jaczewskiego 8, 20-950, Lublin, Poland.
| | - Jacek Furmaga
- Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Lublin, Poland
| | - Andrzej Jaroszyński
- Department of Family Medicine, Medical University of Lublin, Lublin, Poland.,Department of Nephrology, Jan Kochanowski University in Kielce, Kielce, Poland.,Department of Family Medicine and Geriatrics, Jan Kochanowski University in Kielce, Kielce, Poland
| | - Anna Wysocka
- Department of Cardiology, Medical University of Lublin, ul. Jaczewskiego 8, 20-950, Lublin, Poland.,Internal Medicine in Nursing Department, Medical University of Lublin, Lublin, Poland
| | - Sławomir Rudzki
- Department of General and Transplant Surgery and Nutritional Treatment, Medical University of Lublin, Lublin, Poland
| | - Andrzej P Wysokiński
- Department of Cardiology, Medical University of Lublin, ul. Jaczewskiego 8, 20-950, Lublin, Poland
| |
Collapse
|
8
|
Hu X, Frellesen C, Bauer RW, Kerl JM, Beeres M, Bodelle B, Lehnert T, Vogl TJ, Wichmann JL. Computed tomography of dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification. Radiol Med 2015; 120:595-602. [PMID: 25644250 DOI: 10.1007/s11547-015-0503-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE This study was done to investigate the dynamic changes of the aortic root during systole and diastole in patients with coronary artery calcification (CAC) using dual-source computed tomography (DSCT). MATERIALS AND METHODS We retrospectively analysed 77 consecutive patients who underwent calcium-scoring and angiographic cardiac DSCT. The long- and short-axis dimensions, axis areas of the aortic annulus, sinotubular junction and ascending aorta at the level of the pulmonary trunk in diastole and systole were measured. Average dimensions and relative areal changes between diastole and systole (%RA) of aortic annulus, sinotubular junction and ascending aorta were compared. RESULTS Systolic and diastolic long- and short-axis dimensions of the aortic annulus in patients with CAC (n = 44) demonstrated statistically significant differences (27.00 ± 2.84 mm vs. 28.04 ± 2.62 mm; P < 0.001; 21.78 ± 2.55 mm vs. 20.88 ± 2.31 mm; P < 0.001), while differences in average diameters and areas of the aortic annulus were nonsignificant (P > 0.586). Systolic and diastolic axial areas of the sinotubular junction in patients with CAC demonstrated significant differences (7.21 ± 1.80 cm(2) vs. 6.92 ± 1.75 cm(2); P < 0.001). The %RA of the ascending aorta in patients with severe CAC (CAC score >400; n = 15) was significantly reduced compared to patients with minimal-to-moderate CAC (CAC score <400; n = 29; 4.77 ± 2.88 vs. 7.51 ± 3.81, P = 0.014). CONCLUSIONS In comparison with patients without CAC, the long- and short-axis dimensions of the aortic annulus and areas of the sinotubular junction show significant differences during the cardiac cycle in patients with CAC. The presence of severe CAC significantly influences the flexibility of the wall of the ascending aorta.
Collapse
Affiliation(s)
- Xiaohan Hu
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | | | | | | | | | | | | | | | | |
Collapse
|
9
|
Lilly SM, Jacobs D, Bluemke DA, Duprez D, Zamani P, Chirinos J. Resistive and pulsatile arterial hemodynamics and cardiovascular events: the Multiethnic Study of Atherosclerosis. J Am Heart Assoc 2014; 3:e001223. [PMID: 25497879 PMCID: PMC4338707 DOI: 10.1161/jaha.114.001223] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Arterial blood pressure is dependent on interactions between the heart and arteries. Resistive and pulsatile components of arterial load can be assessed by systemic vascular resistance (SVR, a microvascular property) and the ratio of stroke volume to pulse pressure (a surrogate of total arterial compliance, TAC), respectively. The relationship between arterial function and cardiovascular events in populations without cardiovascular disease is unknown. Methods and Results We studied 4806 adults enrolled in the Multi‐Ethnic Study of Atherosclerosis who were free of clinical cardiovascular disease at baseline. SVR and stroke volume/pulse pressure (SV/PP) were derived by sphygmomanometry and magnetic resonance imaging. The relationship between these measures of arterial function and incident cardiovascular events was assessed using Cox regression. With a mean follow‐up of 7.5 years, cardiovascular events occurred in 358 participants (7.4%). There was no relationship between SVR and subsequent cardiovascular events. However, increased stroke volume/pulse pressure was associated with reduced event rate in unadjusted (hazard ratio=0.67, 95% CI=0.58 to 0.77, P<0.001) and analyses that adjusted for multiple confounders (HR=0.75; 95% CI=0.62 to 0.90; P<0.001). Conclusions Greater total arterial compliance, manifest by higher stroke volume/pulse pressure is associated with a reduced incidence of subsequent CVE. In contrast, SVR was not independently associated with CVE in subjects free of overt cardiovascular disease at baseline. These findings support the concept that alternations in the large conduit vessels, rather than changes in microvascular resistance, are primarily related to incident cardiovascular disease.
Collapse
Affiliation(s)
- Scott M Lilly
- Division of Cardiovascular Medicine, Ohio State University Heart and Vascular Center, Columbus, OH (S.M.L.)
| | - David Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, MN (D.J.)
| | - David A Bluemke
- Radiology and Imaging Sciences, National Institute of Health Clinical Center, Bethesda, MD (D.A.B.)
| | - Daniel Duprez
- Cardiovascular Division, University of Minnesota, MN (D.D.)
| | - Payman Zamani
- Hospital of the University of Pennsylvania, Philadelphia, PA (P.Z., J.C.)
| | - Julio Chirinos
- Hospital of the University of Pennsylvania, Philadelphia, PA (P.Z., J.C.)
| |
Collapse
|
10
|
Ede H, Erkoç MF, Okur A, Erbay AR. Impaired aortic elasticity and diastolic functions are associated with findings of coronary computed tomographic angiography. Med Sci Monit 2014; 20:2061-8. [PMID: 25348859 PMCID: PMC4214696 DOI: 10.12659/msm.892502] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is the leading cause of mortality and morbidity worldwide. Aortic elasticity and diastolic functions are helpful parameters in assessment of CAD. In this study we aimed to learn whether diastolic function and aortic elastic properties measured by echocardiography are associated with coronary calcium score (CACS), epicardial fat volume (EFV), and plaque area measured by coronary tomographic angiography. MATERIAL AND METHODS We enrolled 106 consecutive patients suspected of CAD undergoing coronary CTA and transthoracic echocardiography in this prospective study. Total CACS, plaque area, and EFV were calculated via CTA. Aortic stiffness index (ASI) and aortic distensibility (AD) were measured via echocardiography. RESULTS The patients with diastolic dysfunctions of any degree had significantly higher ASI, higher CACS, higher plaque area, and EFV. We found that as the ASI increases, the CACS and total coronary plaque area both increase, showing that there is a strong positive correlation between ASI, CACS, and total coronary plaque area. There was a significant correlation between ASI and EFV, but with a lower statistical value. CONCLUSIONS Aortic elasticity was correlated with CACS and plaque area. Diastolic dysfunction was observed more commonly among patients with higher CACS and EFV. Epicardial fat volume was not as strong as CACS in reflecting aortic elasticity.
Collapse
Affiliation(s)
- Hüseyin Ede
- Department of Cardiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Mustafa Fatih Erkoç
- Department of Radiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Aylin Okur
- Department of Radiology, Bozok University School of Medicine, Yozgat, Turkey
| | - Ali Rıza Erbay
- Department of Cardiology, Bozok University School of Medicine, Yozgat, Turkey
| |
Collapse
|
11
|
Lu Q, Liu H. Correlation of Ascending Aorta Elasticity and the Severity of Coronary Artery Stenosis in Hypertensive Patients with Coronary Heart Disease Assessed by M-Mode and Tissue Doppler Echocardiography. Cell Biochem Biophys 2014; 71:785-8. [DOI: 10.1007/s12013-014-0263-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
12
|
Liang W, Chen D, Chen W, Cheng G. The ascending aortic elasticity feature in normotensive subjects: evaluation with coronary CT angiography. Clin Imaging 2014; 38:686-92. [PMID: 25034400 DOI: 10.1016/j.clinimag.2014.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 05/27/2014] [Accepted: 06/02/2014] [Indexed: 11/17/2022]
Abstract
To evaluate the ascending aortic elasticity feature, 118 normotensive subjects who underwent coronary computed tomography angiography (CCTA) were enrolled. Two groups of parameters assessing elasticity were calculated based on the measurements of volume and area of ascending aorta. Multivariate analysis revealed that some factors including age, systolic BP, diastolic BP, heart rate, smoking status and hyperlipidemia independently related to decreased aortic elasticity. Both measuring methods are applicable for evaluation of aortic elasticity. As the prevalence of CCTA, it is meaningful that CCTA can provide not only the structural details of ascending aorta but also functional information of the vessel elasticity.
Collapse
Affiliation(s)
- Wenqian Liang
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Dandan Chen
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Weicui Chen
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China
| | - Guanxun Cheng
- Department of Imaging Center, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Ave. N., Guangzhou, Guangdong 510515, China.
| |
Collapse
|
13
|
Lee CH, Liu KS, Jhong GH, Liu SJ, Hsu MY, Wang CJ, Hung KC. Finite element analysis of helical flows in human aortic arch: a novel index. BIOMICROFLUIDICS 2014; 8:024111. [PMID: 24803960 PMCID: PMC4000403 DOI: 10.1063/1.4871037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/31/2014] [Indexed: 06/03/2023]
Abstract
This study investigates the helical secondary flows in the aortic arch using finite element analysis. The relationship between helical flow and the configuration of the aorta in patients of whose three-dimensional images constructed from computed tomography scans was examined. A finite element model of the pressurized root, arch, and supra-aortic vessels was developed to simulate the pattern of helical secondary flows. Calculations indicate that most of the helical secondary flow was formed in the ascending aorta. Angle α between the zero reference point and the aortic ostium (correlation coefficient (r) = -0.851, P = 0.001), the dispersion index of the cross section of the ascending (r = 0.683, P = 0.021) and descending aorta (r = 0.732, P = 0.010), all correlated closely with the presence of helical flow (P < 0.05). Stepwise multiple linear regression analysis confirmed angel α to be independently associated with the helical flow pattern in therein (standardized coefficients = -0.721, P = 0.023). The presence of helical fluid motion based on the atherosclerotic risks of patients, including those associated with diabetes, hypertension, hyperlipidemia, or renal insufficiency, was also evaluated. Numerical simulation of the flow patterns in aortas incorporating the atherosclerotic risks may better explain the mechanism of formation of helical flows and provide insight into causative factors that underlie them.
Collapse
Affiliation(s)
- Cheng-Hung Lee
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan ; Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan
| | - Kuo-Sheng Liu
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan ; Department of Cardiovascular Surgery, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan
| | - Guan-Heng Jhong
- Graduate Institute of Medical Mechatronics, Chang Gung University, Tao-Yuan, Taiwan
| | - Shih-Jung Liu
- Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan
| | - Ming-Yi Hsu
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan
| | - Chao-Jan Wang
- Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan
| | - Kuo-Chun Hung
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan
| |
Collapse
|
14
|
Zhao Z, Luo Y, Li G, Zhu L, Wang Y, Zhang X. Thoracic aorta vasoreactivity in rats under exhaustive exercise: effects of Lycium barbarum polysaccharides supplementation. J Int Soc Sports Nutr 2013; 10:47. [PMID: 24152940 PMCID: PMC4015534 DOI: 10.1186/1550-2783-10-47] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 10/17/2013] [Indexed: 01/31/2023] Open
Abstract
Background Reduced arterial compliance is associated with an increased rate of morbidity and mortality in cardiovascular disease. Exercise is beneficial for compromised arterial compliance. However, the beneficial effects of exercise are lost with exhaustion. Lycium barbarum L. has been used in China for centuries to maintain good health. In this regard, the primary purpose of this study was to characterize the effects of the polysaccharides from Lycium barbarum (LBPs) on arterial compliance during exhaustive exercise. Methods A four-week swimming exercise program was designed for rats, and the blood levels of malondialdehyde (MDA), super oxide dismutase (SOD), nitric oxide(NO) and heat shock protein 70(HSP70) were detected. The tension of aorta rings was measured to evaluate the response of rats on noradrenaline (NA)-induced contractions. Results The rats administered LBPs showed longer swimming time until exhaustion than the control group of rats. Exercise-induced MDA elevation was repressed by LBPs supplementation. The LBPs-supplemented rats displayed a significant increase of SOD, NO, HSP70 than the non-supplemented rats. Additionally, LBPs significantly up-regulated the expression of eNOS and improved the endothelium-dependent vasodilatation of the aorta ring. Conclusion Our study proved that LBPs administration significantly inhibited the oxidative stress, and improved the arterial compliance.
Collapse
Affiliation(s)
- Zhifang Zhao
- Department of Physiology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China
| | - Yan Luo
- Department of Physiology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China
| | - Guanghua Li
- Department of Physiology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China
| | - Lingqin Zhu
- Department of Physiology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China
| | - Yin Wang
- Department of Physiology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China
| | - Xuehong Zhang
- Department of Pediatrics, General Hospital of Ningxia Medical University, Yinchuan 750004, China
| |
Collapse
|
15
|
Kilicaslan B, Piskin GD, Susam I, Dursun H, Ozdogan O. Effect of radiotheraphy on impaired aortic elasticity and stiffness in patients with breast cancer. Angiology 2013; 65:643-8. [PMID: 23836806 DOI: 10.1177/0003319713494463] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We evaluated the effect of radiotherapy (RT) on the elastic properties of the aorta using echocardiography in patients with breast cancer (BC). A total of 105 women with left-sided epidermal growth factor receptor 2 (erb-2) BC were divided into 2 groups, group 1 with patients who did not receive RT and group 2 with patients who received RT. In all patients, echocardiographic examination and serum high-sensitivity C-reactive protein (hs-CRP) levels were determined. A significant decrease in aortic distensibility (AD) and increase in hs-CRP were seen from group 1 to group 2. The AD was inversely correlated with left ventricle diastolic diameter, systolic blood pressure (SBP), left atrial diameter, age, and RT dose. The AD was significantly related to age, SBP, and RT dose. Increased RT dose is significantly correlated with impaired elastic properties that may contribute to the relation of RT and increased rate of cardiovascular events among patients with BC who received RT.
Collapse
Affiliation(s)
- Baris Kilicaslan
- Cardiology Department, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Gonul Demir Piskin
- Radiation Oncology Department, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Ibrahim Susam
- Cardiology Department, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Huseyin Dursun
- Cardiology Department, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| | - Oner Ozdogan
- Cardiology Department, İzmir Tepecik Research and Training Hospital, Izmir, Turkey
| |
Collapse
|
16
|
Progression of arterial stiffness and coronary atherosclerosis: longitudinal evaluation by cardiac CT. AJR Am J Roentgenol 2013; 200:798-804. [PMID: 23521451 DOI: 10.2214/ajr.12.8653] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE We sought to use cardiac CT angiography (CTA) to longitudinally examine the relationship between changes in aortic stiffness and of the atherosclerotic burden over time. MATERIALS AND METHODS One hundred sixty-four patients with suspected coronary artery disease underwent two retrospectively ECG-gated cardiac CTA studies an average of 12 ± 10 months apart. Arterial stiffness was represented by the aortic distensibility index (ADI) and atherosclerosis by segment involvement score (SIS) (defined as the number of coronary artery segments per patient displaying atherosclerotic plaque). Changes in ADI and SIS between the studies were compared using linear and logistic regression accounting for differences in clinical and demographic baseline characteristics. RESULTS Age (p = 0.004), time between studies (p = 0.02), and increase in SIS (p < 0.001) were associated with a decrease in ADI on univariate analysis. Increase in SIS remained a significant independent predictor of decreased ADI on both multivariate logistic regression (with change in ADI represented categorically) and multivariate linear regression (both p < 0.001). CONCLUSION On longitudinal evaluation with cardiac CTA, the progression of aortic stiffness is associated with the progression of coronary atherosclerosis. Although outcome studies are needed, a comprehensive assessment of vascular health with cardiac CTA, including both indexes of arterial stiffness and atherosclerotic burden, may improve risk stratification and therapy monitoring.
Collapse
|
17
|
Arjmand Shabestari A, Pourghorban R, Tehrai M, Pouraliakbar H, Faghihi Langroudi T, Bakhshandeh H, Abdi S. Comparison of aortic root dimension changes during cardiac cycle between the patients with and without aortic valve calcification using ECG-gated 64-slice and dual-source 256-slice computed tomography scanners: results of a multicenter study. Int J Cardiovasc Imaging 2013; 29:1391-400. [DOI: 10.1007/s10554-013-0217-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Accepted: 04/06/2013] [Indexed: 10/27/2022]
|
18
|
Abstract
Vascular functional alterations frequently precede morphological changes and, therefore, their recognition may theoretically improve early detection of vascular injury. The aim of this review is to demonstrate recently available non-invasive clinical methods including vascular stiffness examinations, flow-mediated vasodilatation, coronary flow reserve and myocardial flow reserve measurements.
Collapse
Affiliation(s)
- Attila Nemes
- Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar II. Belgyógyászati Klinika és Kardiológiai Központ Szeged Korányi.
| | | |
Collapse
|
19
|
Elbasan Z, Şahin D, Gür M, Gözübüyük G, Akıllı RE, Koyunsever NY, Türkoğlu C, Kıvrak A, Yıldırım A, Çaylı M. Aortic distensibility and extent and complexity of coronary artery disease in patients with stable hypertensive and nonhypertensive coronary artery disease. Med Princ Pract 2013; 22:260-4. [PMID: 23327860 PMCID: PMC5586749 DOI: 10.1159/000345842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 11/13/2012] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the relationship between aortic distensibility (AD) and the extent and complexity of atherosclerotic lesions assessed with SYNTAX score (SS) in patients with stable coronary artery disease. SUBJECTS AND METHODS Three hundred and seventy-six consecutive patients (230 males and 146 females; mean age: 61.6 ± 9.9 years) with angiographically proven coronary artery disease were included in the study. The SS was calculated using the SS algorithm on the baseline diagnostic angiogram in the 376 patients. AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements in all patients. Frequencies of risk factors, biochemical and hematological data were recorded. The patients were divided into two groups according to the median AD value as AD(low) and AD(high) groups. RESULTS The SS was higher in the AD(low) group compared with the AD(high) group (18.5 ± 10.2 vs. 8.3 ± 5.9, p < 0.001). The AD was independently related to age (β = -0.104, p = 0.019), hypertension (β = -0.202, p < 0.001) and SS (β = -0.457, p < 0.001) and was more strongly associated with SS in hypertensive patients compared to nonhypertensive patients (r = -0.524 vs. r = -0.414, p < 0.001 for all). CONCLUSION The findings showed that impaired AD might be an independent predictor for the severity of coronary atherosclerosis, particularly in patients with hypertension.
Collapse
Affiliation(s)
| | - DurmuşYıldıray Şahin
- *Durmuş Yıldıray Şahin, Department of Cardiology, Adana Numune Education and Research Hospital, TR-01170 Adana (Turkey), E-Mail
| | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Elbasan Z, Sahin DY, Gür M, Kalkan GY, Yıldız A, Kaya Z, Kıvrak A, Gözübüyük G, Özdoğru I, Çaylı M. Aortic distensibility and aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Echocardiography 2012; 30:407-13. [PMID: 23227955 DOI: 10.1111/echo.12066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND There is growing evidence that aortic distensibility (AD) is a subclinical marker of early atherosclerosis. Aortic intima-media thickness (IMT) was an earlier marker than carotid IMT of preclinical atherosclerosis. In this study, we aimed to assess the relationship between thoracic aortic IMT and AD. METHODS We studied 192 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Four different grades were determined according to IMT of thoracic aorta (Grade 1 < 1 mm; 1 mm ≤ Grade 2 < 3 mm; 3 mm ≤ Grade 3 < 5 mm; 5 mm ≤ Grade 4). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements in all patients. High sensitive C-reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer. RESULTS TEE evaluation characterized thoracic aortic intimal morphology as grade 1 in 71 patients (37%), grade 2 in 57 patients (29.7%), grade 3 in 34 patients (17.7%), and grade 4 in 30 (15.6%) patients. The lowest AD level was observed in grade 4 group compared with grade 1 and grade 2 groups (P < 0.001, P = 0.009, respectively). AD level of grade 3 group was lower than grade 1 and grade 2 group (P < 0.001, P = 0.021, respectively). In multiple linear regression analysis, AD was independently associated with age (β = -0.138, P = 0.029), hsCRP (β = -0.209, P = 0.001), and aortic IMT (β = -0.432, P < 0.001). CONCLUSION AD is independently associated with age, thoracic aortic IMT, and hsCRP. Impaired elasticity index of the aorta might be an independent predictor for the severity of thoracic atherosclerosis.
Collapse
Affiliation(s)
- Zafer Elbasan
- Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Santana DB, Zocalo YA, Ventura IF, Arrosa JFT, Florio L, Lluberas R, Armentano RL. Health Informatics Design for Assisted Diagnosis of Subclinical Atherosclerosis, Structural, and Functional Arterial Age Calculus and Patient-Specific Cardiovascular Risk Evaluation. ACTA ACUST UNITED AC 2012; 16:943-51. [DOI: 10.1109/titb.2012.2190990] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|