Systolic stretching of the ascending aorta

Abstract

Introduction: Longitudinal stretching of the aorta due to systolic heart motion contributes to the stress in the wall of the ascending aorta. The objective of this study was to assess longitudinal systolic stretching of the aorta and its correlation with the diameters of the ascending aorta and the aortic root. Material and methods: Aortographies of 122 patients were analyzed. The longitudinal systolic stretching of the aorta caused by the contraction of the heart during systole and the maximum dimensions of the aortic root and ascending aorta were measured in all patients. Results: The maximum dimension of the aortic root was on average 34.9 ±4.5 mm and the mean diameter of the ascending aorta was 33.9 ±5.4 mm. The systolic aortic stretching negatively correlated with age (r =-0.49, p < 0.001) and the diameter of the tubular ascending aorta (r =-0.44, p < 0.001). There was no significant correlation between the stretching and the dimension of the aortic root (r =-0.11, p = 0.239). There was a statistically significant (p < 0.001) difference in the longitudinal aortic stretching values between patients with a normal aortic valve (10.6 ±3.1 mm) and an aortic valve pathology (8.0 ±3.2 mm in all patients with an aortic valve pathology; 7.5 ±4.3 mm in isolated aortic stenosis, 8.5 ±2.9 mm in the case of isolated insufficiency, 8.2 ±2.8 mm for valves that were both stenotic and insufficient). Conclusions: Systolic aortic stretching negatively correlates with the diameter of the tubular ascending aorta and the age of the patients, and does not correlate with the diameter of the aortic root. It is lower in patients with an aortic valve pathology.

Four-dimensional analysis of aortic root motion in normal population using retrospective multiphase computed tomography

“… 3 , 17 Other had reported 7.1 ± 2.5 mm and 9.6 ± 3.4 mm by use of invasive aortography. 4 , 18 The feature of STJ in-plane motion of 7.37 ± 1.96 mm with an annulus rotation of 11.8 ± 4.60° has never been identified before and is reported for the first time. Thus, a relatively simple and pragmatic ECG-gated dynamic CT aortogram may offer a new view to the aortic root and provide reliable information aortic root motion in three dimensions.…”

“…In the future, non-invasive aortic root movement measures may identify patients at higher risk for progressive aortic enlargement and adverse clinical outcomes, potentially allowing for closer monitoring and more appropriate therapy in patients with cardiovascular diseases. 4 , 5 , 18 , 38 This could be important in populations with high risk of developing aortic dissection or aneurysmatic formation, including patients with bicuspid aortic valve and connective tissue disorders, especially Marfan’s syndrome.…”

Systematic adjustment of root dimensions to cusp size in aortic valve repair: a computer simulation

“…Within the range tested, stenosis did not occur with annular reduction. Thus, it should be considered that STJ dimensions could be correlated with the longitudinal stretching stress of the ascending aorta [ 28 ].…”

Inversion of Left Ventricular Axial Shortening: In Silico Proof of Concept for Treatment of HFpEF

“…Since LV longitudinal shortening is the major contributor to heart's stroke volume [2] any alterations in AA elasticity and the subsequently increase in mechanical load on the LV may play an relevant role in heart failure, particularly for heart failure with preserved ejection fraction (HFpEF). During systolic longitudinal shortening of the heart the atrio-ventricular plane, which includes the aortic annulus, is displaced towards the apex of the heart by 16mm (range 14 to 19mm) [2][3][4]. As a result, the ascending aorta (AA) is stretched by 11.6±2.9mm, while the aortic arch at the level of the brachiocephalic artery and the apex are only displaced by 2.9±0.4mm (range 0 to 6mm) [5] and 1.9±0.5mm (range -0.1 to 5.1mm) respectively [2,6].…”