Increased arterial stiffness in males with abdominal aortic aneurysm

Abstract

Background Abdominal aortic aneurysm (AAA), a localized dilatation of the abdominal aorta, has a prevalence of about 1.5%–3% among 65‐ to 70‐year‐old males in Europe. AAA confers an increased risk of developing major cardiovascular events in addition to the risk of aneurysm rupture. The aim of this study was to evaluate whether the arterial wall distensibility is altered in subjects with AAA. Methods Two hundred and eighty‐four male subjects (182 with AAA and 102 controls) were enrolled in the study. Arterial wall distensibility was evaluated using non‐invasive applanation tonometry to measure regional pulse wave velocity between the carotid and femoral arteries and the carotid and radial arteries. In addition, blood pressure was measured, and the pulse pressure waveform was analysed. Results Higher aortic augmentation index (25.1% versus 20.6%; p < .001) and higher aortic pulse wave velocity (12.3 m/s versus 10.9 m/s; p < .001) were demonstrated in the AAA cohort. The slightly higher arm pulse wave velocity in the AAA group (9.4 m/s versus 9.1 m/s; p < .05) was abolished after adjusting for mean arterial blood pressure. Conclusions Males with AAA have decreased aortic wall distensibility and enhanced reflection waves in central aorta during systole. These results imply that increased arterial wall stiffness may be a contributing factor to the overall higher cardiovascular risk seen in patients with AAA.

Wall shear stress and relative residence time as potential risk factors for abdominal aortic aneurysms in males: a 4D flow cardiovascular magnetic resonance case–control study

“…It is widely recognized that AAA disease is associated with cardiovascular events not directly related to the aneurysm, but the extent to which AAA is associated with general aortic disease is less clear [ 6 ]. Åström Malm et al [ 11 ] recently reported increased aortic stiffness in males with AAA compared to matched controls based on the carotid-to-femoral pulse wave velocity (PWV) method. Further studies with 4D Flow CMR-based regional PWV estimation may establish whether increased stiffness in AAA patients occurs uniformly throughout the aorta or mainly in the infrarenal abdominal aorta.…”

“…For example, the co-prevalence of AAA and thoracic aortic aneurysm is 10–30% [ 7 – 9 ]. Further, recent studies associated AAA with increased left-ventricular workload and faster ageing of the central arteries [ 10 , 11 ].…”

Males with abdominal aortic aneurysm have reduced left ventricular systolic and diastolic function

“…AAA <55 mm is classified as a small AAA. The controls had an absolute infrarenal aortic diameter within the reference range (<30 mm), and no sign of ectasia, at their screening examinations during the past 5 years (Åström Malm et al, 2020).…”

“…Increased arterial stiffness as well as generalized arteriomegaly have been demonstrated in AAA patients (Åström Malm et al, 2020;Johnsen et al, 2009). This indicates that AAA may be a systemic disease rather than a local disease, and moreover that its pathological process is not confined to the abdominal aorta.…”

“…However, even without rupture, AAA increases the risk of other major cardiovascular events, including chronic heart failure, but the mechanisms underlying this are unclear (Bath et al, 2015). Males with AAA may have decreased aortic wall distensibility and enhanced systolic wave reflection (Åström Malm et al, 2020). Moreover, Yoshida et al (2020 demonstrated an association between increased arterial stiffness and subclinical left ventricular dysfunction in a healthy population.…”