Echocardiographic aortic root dilatation in hypertensive patients

Abstract

ARD is a common phenotype in hypertensive patients, with men showing a markedly higher susceptibility, but office blood pressure values do not appear to be directly associated with aortic root diameter.

Assessment of Short‐term Blood Pressure Variability in Patients With Ascending Aortic Dilatation

“…23 Similarly, in our study, we did not find a relationship between office BP values and ascending aortic dimensions. However, short-term BPV and LVMI were found to be independently correlated with aortic diameters in hypertensive patients.…”

“…22 In addition, BPV is related to microangiopathic complications at end organs, such as hypertension. 23 Hence, BPV may yield disruption of the vasa vasorum that supplies blood for fibroblasts. This situation can result in reduction of elastin and dilatation of the aorta.…”

Relationship between aortic root size and glomerular filtration rate in hypertensive patients

“…These findings allow to exclude that our results could be spuriously due to statistical redundancies, considering that GFR estimated by the CKD formula is based on factors similar to those defining aortic root dilation, such as sex and BSA or height. Even though linking dilatation of aortic root to haemodynamic factors such as high BP seems straightforward, the role of increased BP as determinant of aortic root enlargement remains controversial [1,2,[5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The ARD remodelling did not appear to be driven by clinic BP values in a recent meta-analysis of eight studies including 10 791 hypertensive patients [14].…”

“…The prevalence of LVH, a powerful predictor of cardiovascular events, increases as CKD progresses [21][22][23]. The aortic root size is positively related to LVH [5][6][7][8][9][10][11][12][14][15].…”

“…It has been recently shown that dissecting aortas are often sized well below the diameters defined by surgical guidelines [3][4]. There are some data, although not unanimous, that seem to support the concept that in hypertensive patients aortic root dilatation may represent an index of target organ damage, paralleling markers of well documented prognostic value such as left ventricular (LV) hypertrophy (LVH), carotid atherosclerosis and microalbuminuria [5][6][7][8][9][10][11][12][13][14]. Recent population-based studies showed that an enlarged ARD might predict an adverse prognosis, even in absence of aneurysmatic alterations [15][16][17][18].…”