The positive correlation between brachial‐ankle pulse wave velocity and aortic diameter in Chinese patients with diabetes

Abstract

Aortic dilation is associated with an increased risk of cardiovascular diseases.Increased brachial-ankle pulse wave velocity (baPWV) is a hallmark of vascular aging and arterial stiffness, as well as an important risk factor for vascular disease. This study aimed to retrospectively analyze the correlation between baPWV and aortic diameter (AoD) of inpatients with diabetes. A total of 1294 diabetic patients with the detailed medical records were investigated. Arterial stiffness was assessed using baPWV and AoD using echocardiography. The results showed that baPWV and AoD increase with age (p <0.05). Based on multiple linear regression analysis, age, systolic and diastolic blood pressure, left atrial diameter, right ventricle diameter, pulmonary artery diameter, peak velocity of early transmitral blood flow/peak velocity of late transmitral blood flow, and baPWV independently correlated with AoD in patients with diabetes. Additionally, an increased risk of aortic dilation occurred in the highest baPWV quartile compared with the lowest quartile (p <0.001). In conclusion, baPWV is independently and positively associated with AoD. Hence, prospective cohorts or randomized clinical trials will be the next step to further determine whether interventions designed to improve arterial stiffness in patients with diabetes will reduce the risk of aortic dilation. K E Y W O R D Saortic diameter, arterial stiffness, brachial-ankle pulse wave velocity, diabetes BACKGROUNDCardiovascular disease is a leading cause of mortality and a threat to human health worldwide. Several studies have reported that a larger aortic diameter (AoD) is prospectively associated with cardiovascular morbidity, 1,2 and has been described as an important marker of hypertension-related organ damage. 3 Moreover, excessive dilation of the aorta was linked to aneurysm formation and dissection, both of which are potentially fatal diseases. 4 To date, however, few proven therapeutic strategies are available to alleviate or reverse this progression. Thus, the study of risk factors related to aortic dilation mayThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Proximal aorta dilatation in hypertension

“…PWV is now the gold standard for noninvasive assessment of this process [95]. Several cross-sectional studies have proved a positive correlation between PWV and proximal aortic dilatation in hypertensive patients ( r = 0.247 for carotid–femoral PWV and ascending aorta diameter [89], r = 0.578 for brachial-ankle PWV and aortic root size [11], both P < 0.05). The dilatation of aorta and the increase of PWV may be the different manifestations of the same pathological process in vascular aging and remodeling.…”

“…Additionally, proximal aortic dilatation has been regarded as a morphological manifestation of vascular remodeling and is closely associated with traditional cardiovascular risk factors like left ventricular hypertrophy (LVH) and arteriosclerosis [1,[9][10][11][12]. However, the long-term prognostic value of proximal aortic dilatation has not been confirmed in hypertensive patients, which maybe one of the reasons why this indicator was not included as a risk stratification factor in current guidelines for hypertension [13,14].…”

Association between invasively measured central aortic pulse pressure and diameter of ascending aorta

“…Several studies have investigated the association between arterial stiffness and aortic root size, with mixed results. While most studies have found a positive correlation between arterial stiffness and aortic root size [10][11][12][13][14][15], some studies have also reported negative correlations between the two indicators [16]. Notably, all these studies have used non-invasive measures of arterial stiffness, which may have limited accuracy.…”

Association between invasively measured central aortic pulse pressure and diameter of ascending aorta

“…Research exploring the link between arterial pulsatile hemodynamics and aortic root size has yielded varying results. While the majority of studies indicate a positive correlation between these factors [11][12][13][14][15][16] , there are also reports of negative correlations 17,18 . It is important to note that most of these studies relied on non-invasive methods to gauge arterial pulsatile hemodynamics, which might not be as precise.…”