Weak Relationship of Intraperitoneal Fat Volume With Ascending Aortic Wall Thickness

Abstract OBJECTIVES The goal of therapy of proximal aortic aneurysms is to prevent an aortic catastrophe, e.g. acute dissection or rupture. The decision to intervene is currently based on maximum aortic diameter complemented by known risk factors like bicuspid aortic valve, positive family history or rapid growth rate. When applying Laplace’s law, wall tension is determined by pressure × radius divided by aortic wall thickness. Because current imaging modalities lack precision, wall thickness is currently neglected. The purpose of our study was therefore to correlate maximum aortic diameter with aortic wall thickness and known indices for adverse aortic events. METHODS Aortic samples from 292 patients were collected during cardiac surgery, of whom 158 presented with a bicuspid aortic valve and 134, with a tricuspid aortic valve. Aortic specimens were obtained during the operation and stored in 4% formaldehyde. Histological staining and analysis were performed to determine the thickness of the aortic wall. RESULTS Patients were 62 ± 13 years old at the time of the operation; 77% were men. The mean aortic dimensions were 44 mm, 41 mm and 51 mm at the aortic root, sinotubular junction and ascending aorta, respectively. Aortic valve stenosis was the most frequent (49%) valvular dysfunction, followed by aortic valve regurgitation (33%) and combined dysfunction (10%). The maximum aortic diameter at the ascending level did not correlate with the thickness of the media (R = 0.07) or the intima (R = 0.28) at the convex sample site. There was also no correlation of the ascending aortic diameter with age (R = −0.18) or body surface area (R = 0.07). The thickness of the intima (r = 0.31) and the media (R = 0.035) did not correlate with the Svensson index of aortic risk. Similarly, there was a low (R = 0.29) or absent (R = −0.04) correlation between the aortic size index and the intima or media thickness, respectively. There was a similar relationship of median thickness of the intima in the 4 aortic height index risk categories (P < 0.001). CONCLUSIONS Aortic diameter and conventional indices of aortic risk do not correlate with aortic wall thickness. Other indices may be required in order to identify patients at high risk for aortic complications.

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AB0967 Determinants of Aortic Wall Thickness in Patients without Aortitis: A Computed Tomography-Based Study: Table 1

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2014-eular.1116 ◽

2014 ◽

Vol 73 (Suppl 2) ◽

pp. 1119.3-1120

Author(s):

A. Nakhleh ◽

D. Rimar ◽

I. Rukhkyan ◽

V. Wolfson ◽

I. Rosner ◽

...

Keyword(s):

Computed Tomography ◽

Wall Thickness ◽

Aortic Wall ◽

Aortic Wall Thickness

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Validation of semiautomated and locally resolved aortic wall thickness measurements from computed tomography

Journal of Vascular Surgery ◽

10.1016/j.jvs.2013.11.065 ◽

2015 ◽

Vol 61 (4) ◽

pp. 1034-1040 ◽

Cited By ~ 14

Author(s):

Eric K. Shang ◽

Eric Lai ◽

Alison M. Pouch ◽

Robin Hinmon ◽

Robert C. Gorman ◽

...

Keyword(s):

Computed Tomography ◽

Wall Thickness ◽

Aortic Wall ◽

Aortic Wall Thickness ◽

Thickness Measurements

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Maternal undernutrition reduces aortic wall thickness and elastin content in offspring rats without altering endothelial function

Clinical Science ◽

10.1042/cs20060036 ◽

2006 ◽

Vol 111 (4) ◽

pp. 281-287 ◽

Cited By ~ 28

Author(s):

Michael R. Skilton ◽

Alison K. Gosby ◽

Ben J. Wu ◽

Lisa M. L. Ho ◽

Roland Stocker ◽

...

Keyword(s):

Wall Thickness ◽

Aortic Wall ◽

Infant Nutrition ◽

Protein Diet ◽

Low Protein Diet ◽

Organ Bath ◽

High Fat ◽

Maternal Undernutrition ◽

Low Protein ◽

Aortic Wall Thickness

Epidemiological studies suggest a link between fetal/early infant nutrition and adult coronary artery disease. In the present study, we examined the effects of altering nutrition during gestation, lactation and juvenile life on aortic structure and function in rats. Wistar rat dams were fed either a control or low-protein diet throughout pregnancy, or a low-protein diet for the final 7 days of gestation only. At 21 days post-partum, male pups were weaned on to a control, low-protein or high-fat diet. At 12 weeks, the offspring rats were killed. In 46 rats, aortic sections were mounted and stained to assess media thickness and elastin content. In a further 38 rats, aortic rings were suspended in an organ bath and vascular reactivity was tested with dose–response curves to the endothelium-dependent dilator acetylcholine and the endothelium-independent dilator sodium nitroprusside. Rats exposed to maternal protein restriction while in utero had a significantly decreased aortic wall thickness compared with control rats (P=0.005). Total elastin content of the aorta was also decreased by both maternal low-protein (P=0.02) and early postnatal low-protein (P=0.01) diets. Neither maternal nor postnatal low-protein or high-fat diets, however, resulted in any significant changes in arterial dilator function. In conclusion, fetal undernutrition in rats, induced via a maternal low-protein diet, causes a decrease in aortic wall thickness and elastin content without altering aortic dilator function. These changes in vascular structure may amplify aging-related changes to the vasculature and contribute to the pathophysiology of the putative link between impaired fetal growth and adult cardiovascular disease.

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IMPROVEMENT IN CHOLESTEROL EFFLUX CAPACITY IS ASSOCIATED WITH A REDUCTION IN AORTIC WALL THICKNESS BY MRI INDEPENDENT OF TRADITIONAL CV RISK FACTORS

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(17)34866-0 ◽

2017 ◽

Vol 69 (11) ◽

pp. 1477

Author(s):

Mohammad Tarek Kabbany ◽

Amit Dey ◽

Parag Shukla ◽

Abhishek Chaturvedi ◽

Anshuma Rana ◽

...

Keyword(s):

Risk Factors ◽

Wall Thickness ◽

Cholesterol Efflux ◽

Aortic Wall ◽

Cholesterol Efflux Capacity ◽

Aortic Wall Thickness

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Abstract P363: Visceral, but Not Subcutaneous Adiposity by Computed Tomography is Associated With Increased Aortic Wall Thickness in Psoriasis Patients

Circulation ◽

10.1161/circ.137.suppl_1.p363 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Jacob W Groenendyk ◽

Parag Shukla ◽

Youssef A Elnabawi ◽

Joshua P Rivers ◽

Aditya Goyal ◽

...

Keyword(s):

Cardiovascular Risk ◽

Wall Thickness ◽

Aortic Wall ◽

Subclinical Atherosclerosis ◽

Visceral Adiposity ◽

Framingham Risk ◽

High Prevalence ◽

Multivariable Regression ◽

Aortic Wall Thickness ◽

Subcutaneous Adiposity

Introduction: Patients with psoriasis (PSO), an inflammatory skin disease, experience increased cardiovascular disease and obesity. Traditional measures of obesity, such as BMI and waist-to-hip ratio (WHR), do not fully capture the increased cardiovascular risk. Assessment of adipose tissue distribution via CT scan enables characterization of visceral adiposity (VAT) versus subcutaneous adiposity (SAT), which is clinically useful as excess VAT is known to be associated with cardiovascular events. Aortic Wall Thickness (AWT) is a validated measure of subclinical atherosclerosis. However, the relationship between adiposity distribution and AWT is unknown. Hypothesis: We hypothesized that VAT, but not SAT, BMI, or WHR, would be associated with increased AWT in PSO patients. Methods: Consecutive PSO patients (n=164) underwent quantification of VAT and SAT via CT, and AWT via MRI of the descending aorta. Interrelationships were analyzed via multivariable regression. Results: Patients were middle-aged (mean 50.4), predominantly male (56%), and were at low cardiovascular risk (median Framingham risk 3), despite high prevalence of hyperlipidemia (47%). VAT was significantly associated with AWT (β=0.18, p=0.04), SAT, BMI, or WHR did not demonstrate similar association. This association persisted beyond adjustment for SAT, Framingham score, insulin resistance, and systolic BP (β=0.30, p=0.03). Conclusions: Visceral adiposity demonstrated an association with AWT, a marker of early atherosclerosis, whereas subcutaneous adiposity, BMI, and WHR did not. These findings add to a growing body of literature that visceral fat and its assessment may provide incremental data for risk of subclinical CVD.

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Aortic stiffness is associated with vascular calcification and remodeling in a chronic kidney disease rat model

AJP Renal Physiology ◽

10.1152/ajprenal.00079.2011 ◽

2011 ◽

Vol 300 (6) ◽

pp. F1431-F1436 ◽

Cited By ~ 45

Author(s):

Keith Ng ◽

Cara M. Hildreth ◽

Jacqueline K. Phillips ◽

Alberto P. Avolio

Keyword(s):

Chronic Kidney Disease ◽

Smooth Muscle ◽

Kidney Disease ◽

Wall Thickness ◽

Vascular Remodeling ◽

Aortic Stiffness ◽

Aortic Wall ◽

Strong Predictor ◽

Aortic Calcification ◽

Aortic Wall Thickness

Increased aortic pulse-wave velocity (PWV) reflects increased arterial stiffness and is a strong predictor of cardiovascular risk in chronic kidney disease (CKD). We examined functional and structural correlations among PWV, aortic calcification, and vascular remodeling in a rodent model of CKD, the Lewis polycystic kidney (LPK) rat. Hemodynamic parameters and beat-to-beat aortic PWV were recorded in urethane-anesthetized animals [12-wk-old hypertensive female LPK rats ( n = 5)] before the onset of end-stage renal disease and their age- and sex-matched normotensive controls (Lewis, n = 6). Animals were euthanized, and the aorta was collected to measure calcium content by atomic absorption spectrophotometry. A separate cohort of animals ( n = 5/group) were anesthetized with pentobarbitone sodium and pressure perfused with formalin, and the aorta was collected for histomorphometry, which allowed calculation of aortic wall thickness, medial cross-sectional area (MCSA), elastic modulus (EM), and wall stress (WS), size and density of smooth muscle nuclei, and relative content of lamellae, interlamellae elastin, and collagen. Mean arterial pressure (MAP) and PWV were significantly greater in the LPK compared with Lewis (72 and 33%, respectively) animals. The LPK group had 6.8-fold greater aortic calcification, 38% greater aortic MCSA, 56% greater EM/WS, 13% greater aortic wall thickness, 21% smaller smooth muscle cell area, and 20% less elastin density with no difference in collagen fiber density. These findings demonstrate vascular remodeling and increased calcification with a functional increase in PWV and therefore aortic stiffness in hypertensive LPK rats.

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Measurement of aortic-wall thickness in living dogs

Medical & Biological Engineering ◽

10.1007/bf02477294 ◽

1973 ◽

Vol 11 (1) ◽

pp. 39-42 ◽

Cited By ~ 2

Author(s):

A. E. Marble ◽

W. Hilliard ◽

A. S. MacDonald ◽

C. H. Miller ◽

J. G. Holland ◽

...

Keyword(s):

Wall Thickness ◽

Aortic Wall ◽

Aortic Wall Thickness

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P3447Multimodal assessment and phenomapping of early atherosclerosis in children with chronic disease

European Heart Journal ◽

10.1093/eurheartj/ehz745.0320 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

F A Ververs ◽

A L M Eikendal ◽

J J M Westenberg ◽

R J Van Der Geest ◽

R Nuboer ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Chronic Disease ◽

Wall Thickness ◽

Aortic Wall ◽

Pulse Wave ◽

Research Fund ◽

Risk Profiles ◽

Aortic Wall Thickness ◽

Early Atherosclerosis

Abstract Background Childhood survival of chronic disease steadily increased over the last decades. However, accumulating evidence suggests that survivors are at risk for early atherosclerosis. The “Cardiovascular Disease in Children with chronic disease” (CDC) study has two aims. First, multimodal assessment of early atherosclerosis was performed in adolescents with chronic inflammatory- and metabolic disorders in order to develop new diagnostic approaches. As fatty streak formation starts in the abdominal aorta, aortic wall thickness (AWT) and pulse wave velocity (PWV) were measured using cardiovascular magnetic resonance imaging (MRI), and compared with traditional carotid intima-media thickness (cIMT) and echocardiography. Second, comprehensive risk profiling was performed, including phenomapping of early risk factors, in order to establish cardiovascular risk profiles in childhood. Methods 113 adolescents aged 12–19 years old were enrolled*. The study population includes adolescents with juvenile idiopathic arthritis (JIA, n=19), cystic fibrosis (CF, n=24), obesity (n=20), corrected coarctation of the aorta (CoA, n=25), and corrected atrial septal defect as control group (ASD, n=25). The aorta was imaged on a 3.0 Tesla MR system using the 3D-T1-BB-VISTA sequence. Aortic PWV was assessed using velocity-encoded MRI. cIMT was measured in three directions for both the right- and left carotid artery using echography. Unbiased hierarchical clustering was performed on phenotypic data (phenomapping), including anthropomorphic-, metabolic-, and inflammatory parameters. Results* Aortic pulse wave velocity on MRI was highest in the obese group compared to controls (p=0.002), yet JIA patients (p=0.015), CoA patients (p=0.029), and CF patients (p=0.044) also showed increased PWV compared to controls. Aortic wall thickness was highest in obese adolescents (p=0.020) and in CF patients (p=0.043). cIMT was only increased in CoA patients (p=0.000). While PWV and AWT showed correlation with inflammatory- and metabolic parameters such as lymphocyte count (PWV, p=0.043), monocyte count (PWV, p=0.002; AWT, p=0.036), CRP (AWT, p=0.032), and QUICKI (PWV, p=0.026), cIMT correlated with systolic blood pressure (p=0.017). Phenomapping of risk factors will further define distinct cardiovascular risk profiles*. Conclusion Multimodal assessment of early atherosclerosis in children with chronic disease reveals differential vascular changes. While traditional cIMT is associated with increased systolic blood pressure in young CoA patients, aortic PWV and aortic wall thickness reflect early systemic inflammatory- and metabolic derangement. Phenomapping traditional risk factors alongside inflammatory- and metabolic parameters bears promise to establish early cardiovascular risk profiles in childhood chronic disease*. *Patient inclusion finishes May 2019, followed by phenomapping of patient characteristics. At the ESC, final data will be presented. Acknowledgement/Funding Wilhelmina Children's Hospital Research Fund, Dutch Topsector Life Sciences and Health TKI fund, Nutricia Research fund. HS was supported by VENI-NWO.

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