Central aortic blood pressure and augmentation index in patients with ascending aortic aneurysms

Aim: Hypertension, besides being a risk factor for atherosclerosis, causes target organ demage to heart, eye, brain, kidney and vascular structures and carries a high mortality and morbidity. Previous studies have shown that central blood pressure and increased aortic stiffness are closely related to end organ damage due to hypertension and increased mortality. Development of aortic aneurysm is one of the target organ damages caused by hypertension. However, the development of aneurysm is observed in a small number of patients with hypertension and more pronounced increase in aortic stiffness is observed in some these patients. We aimed to compare central blood pressure, central pulse pressure and Aix, PWV parameters used for evaluating arterial stiffness with arteriograph device which is an oscillometric method between patients with and without ascending aortic aneurysm in our study. Methods: 83 patients with a diagnosis of hypertension were included in the study. Patients were divided into two groups according to whether or not they had ascending aortic aneurysm. 44 patients in the ascending aortic aneurysm group (27 males, mean age: 59 ± 11) and 39 patients in the without ascending aortic aneurysm group (20 males, mean age: 58 ± 10) were included in this study. Left ventricular end diastolic (LVEDD) and systolic (LVESD) diameters, interventricular septum (IVSd) thicknesses in diastole, left atrial (LA) and ascending aortic diameters, left ventricular ejection fraction (LVEF) and standart diastolic function parameters mitral E, A velocities, E/A ratio, isovolumetric relaxation time (IVRT) were measured by applying standart echocardiographic examination for every patient after the demographic data of the patients are obtained. The central blood pressures and aortic stiffness parameters of the patient two groups were measured non-invasively via the brachial artery using the single-point method via the Mobil-O-Graph device. PWV and Aix are used for the evaluation of arterial stiffness. Findings: There was no difference between the groups regarding age, smoking, body mass index, hyperlipidemia and duration of hypertension. LVEDD, LVESD, LA diameters were significantly higher in the aneurysm group. The E/E' ratio which is a diastolic dysfunction indicator, was significantly higher in the aneurysm group. Arterial stiffness parameters were found to be higher in aneurysm group, but did not achieve statistical significance apart from augmentation index (p=0,038). The central pulse rate was not significantly different between the two groups. The difference in peripheral and central systolic pressures was significantly lower in the aneurysm group than in the control group. There was a positive correlation between PWV and age, left atrial diameter, central pulse pressure, and there was a significantly strong negative correlation with E / A ratio in the aneurysm group. There was a significant positive correlation between PWV and age, central pulse pressure in the non-aneurysm group. Aix correlated positively with age in the aneurysm group while, showed negative correlation with E / A ratio in the same group and it was determined that showed significant negative correlation with only E/A ratio in the non-aneurysm group. Conclusion: Patients with hypertension and ascending aortic aneurysms have increased arterial stiffness, which is associated with LV diastolic dysfunction. The development of aortic aneurysm in this patient group may be related to aortic stiffness. There is a need for more extensive studies in this topic. In addition an arteriograph device that performs oscillometric measurement to determine increased aortic stiffness in this patient group can be used as a simple, inexpensive, reliable and beneficial method.