Pulse Wave Velocity Involving Proximal Portions of the Aorta Correlates with the Degree of Aortic Dilatation at the Sinuses of Valsalva in Ascending Thoracic Aortic Aneurysms

Abstract

Objective: To determine the relationship between arterial stiffness measured in different aortic segments and the presence and extent of ascending thoracic aortic aneurysm (ATAA). Methods: Patients at a Thoracic Aortic Diseases clinic at a University teaching hospital were compared to patients attending a Cardiology outpatient Clinic at the same institution. A non-invasive measure of vascular stiffness was performed using pulse wave velocity (PWV) measurement of several vascular segments-carotidfemoral pulse wave velocity (cfPWV), heart-femoral pulse wave velocity (hfPWV) and brachial-ankle pulse wave velocity (baPWV). Aortic dimensions were measured on echocardiogram. Results: Patients with ATAA (N = 32) were 66 years and the same age as those without ATAA (N = 46). There was no significant difference between those with or without aortic aneurysm with respect to cfPWV, hfPWV or baPWV. In ATAA, there was a significant (p <0.05) inverse correlation between aortic diameter at the sinuses of Valsalva and cfPWV, as well as hfPWV, but not with baPWV. This relationship was not evident in persons without ATAA. Conclusion: Reduced aortic stiffness (increased compliance), assessed by cfPWV or hfPWV, correlates with larger aortic size of ATAA at the level of the sinuses of Valsalva but not at the ascending aorta, suggesting cfPWV may be a useful method to assess the size of ATAA at the level of the sinuses of Valsalva. Overall aortic stiffness assessed by PWV did not differentiate persons with or without an ATAA, in individuals who do not have a genetic or inheritable cause of their ATAA.

Aortic Root Dimensions and Pulse Wave Velocity in Young Competitive Athletes

“…Although no correlations were found between aortic root diameters and the stiffness parameters, PWV, and central systolic blood pressure, in this study, it can be speculated that the pulse wave is already altered in its development because the pulse wave arises precisely at the aortic root. At least there is evidence that pulse wave is altered when aortic size is larger at the level of the sinuses of Valsalva [26]. Vriz and co-workers [27] also found that the increment in aortic diameter with age was less when adjusted for aortic stiffness and therefore also recommend taking aortic stiffness measures into account when the increase of aortic diameter is considered.…”

Accentuating and Opposing Factors Leading to Development of Thoracic Aortic Aneurysms Not Due to Genetic or Inherited Conditions

“…The loss of elastin may increase blood pressure leading to a further increase in circumferential stress, which creates a further impetus for aortic aneurysm expansion. The relative amounts of changes in arterial wall components – collagen, elastin, glycosaminoglycans, fibrulins, fibronectin, and vascular smooth muscle cells – in the aortic segments that experience these changes, may influence aortic compliance in TAA ( 81 ).…”