Relationship of aortic cross-sectional area to height ratio and the risk of aortic dissection in patients with bicuspid aortic valves

Background: While increased carotid intima-media thickness (IMT) is considered an independent risk factor for cardiovascular disease (CVD), little is known about the relationship of aortic thickness (AWT) and aortic distensibility (AD) with CVD risk factors. We studied the association of these aortic parameters with other measures of subclinical CVD. Methods: The Multi-Ethnic Study of Atherosclerosis (MESA) includes 6,814 participants, aged 45– 85 years; white, African-American, Hispanic, and Chinese. AD and AWT were measured by MRI. Average and maximum AWT of the proximal descending thoracic aorta were used as two measures of AWT. AD was calculated as the difference in aortic cross-sectional area indexed by diastolic cross-sectional area and average pulse pressure. IMT of the common and internal carotid arteries were determined by high-resolution B-mode ultrasonography and LV mass was determined by MRI. Phantom-adjusted Agatston calcium score from CT images was used to define coronary artery calcification (CAC). Results: In univariable analyses, higher carotid IMT, ankle-brachial index (ABI) <0.9, CAC score, LV mass, and presence of coronary calcium were associated with lower AD and higher AWT (table ). However, in multivariable analyses, the only measures of subclinical CVD that had significant associations with both AD and AWT were LV mass and carotid IMT, while ABI was associated with only AWT. After adding age to the models, CAC score was no longer associated with either AD or AWT. The relationship between CAC score and AD varied by ethnicity; higher CAC score was associated with higher AD only in African Americans. Conclusions: AD and AWT are related to carotid IMT and LV mass, even after controlling for traditional risk factors. The associations of AD and AWT with CAC appears to be mainly due to their relationship with conventional risk factors, particularly age. Overall, AWT and AD may have closer relationship with LV mass than with subclinical atherosclerosis.

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Aortic Cross-Sectional Area/Height Ratio and Outcomes in Patients With a Trileaflet Aortic Valve and a Dilated Aorta

Circulation ◽

10.1161/circulationaha.116.022995 ◽

2016 ◽

Vol 134 (22) ◽

pp. 1724-1737 ◽

Cited By ~ 20

Author(s):

Ahmad Masri ◽

Vidyasagar Kalahasti ◽

Lars G. Svensson ◽

Eric E. Roselli ◽

Douglas Johnston ◽

...

Keyword(s):

Aortic Valve ◽

Cross Sectional Area ◽

Sectional Area ◽

Height Ratio ◽

Cross Sectional

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Effect of passive myocardium on the compliance of porcine coronary arteries

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00090.2003 ◽

2003 ◽

Vol 285 (2) ◽

pp. H653-H660 ◽

Cited By ~ 31

Author(s):

Leila H. Hamza ◽

Quang Dang ◽

Xiao Lu ◽

Ayesha Mian ◽

Sabee Molloi ◽

...

Keyword(s):

Coronary Arteries ◽

Cross Sectional Area ◽

Sectional Area ◽

Arterial Tree ◽

Cross Sectional ◽

Video Densitometry ◽

Relationship Of ◽

Intravascular Pressure

The objective of this study was to determine the effect of passive myocardium on the coronary arteries under distension and compression. To simulate distension and compression, we placed a diastolic-arrested heart in a Lucite box, where both the intravascular pressure and external (box) pressure were varied independently and expressed as a pressure difference (ΔP = intravascular pressure – box pressure). The ΔP-cross-sectional area relationship of the first several generations of porcine coronary arteries and the ΔP-volume relationship of the coronary arterial tree (vessels >0.5 mm in diameter) were determined using a video densitometric technique in the range of +150 to –150 mmHg. The vasodilated left anterior descending (LAD) coronary artery of six KCl-arrested hearts were perfused with iodine and 3% Cab-O-Sil. The intravascular pressure was varied in a triangular pattern, whereas the absolute cross-sectional area of each vessel and the total arterial volume were calculated using video densitometry under different box pressures (0, 50, 100, and 150 mmHg). In the range of positive ΔP, we found that the compliance of the proximal LAD artery in situ (4.85 ± 3.8 × 10–3 mm2/mmHg) is smaller than that of the same artery in vitro (16.5 ± 6 × 10–3 mm2/mmHg; P = 0.009). Hence, the myocardium restricts the compliance of the epicardial artery under distension. In the negative ΔP range, the LAD artery does not collapse, whereas the same vessel readily collapses when tested in vitro. Hence, we conclude that myocardial tethering prevents collapse of large blood vessel under compression.

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