Relation of Thoracic Aortic Distensibility to Left Ventricular Area (from the Multi-Ethnic Study of Atherosclerosis [MESA])

Abstract

Decreased arterial compliance is an early manifestation of adverse structural and functional changes within the vessel wall. Its correlation with left ventricular (LV) area on computed tomography (CT), a marker of LV remodeling, has not been well demonstrated. We tested the hypothesis that decreasing aortic compliance and increasing arterial stiffness is independently associated with increased LV area. The study population consisted of 3,540 (61±10 years, 46% men) from the MESA study who underwent aortic distensibility (AD) assessment on magnetic resonance imaging (MRI) and LV area measurement on CT (adjusted to body surface area). Multivariable logistic regression was performed to assess the association between body surface area (BSA) normalized LV area >75th percentile and AD after adjusting for baseline clinical, historical and imaging covariates. The mean LV area /BSA was 2,153 cm2 and mean AD was 1.84 mm Hg−1 x103. Subjects in the lowest AD quartile were older with higher prevalence of hypertension, diabetes, and hypercholesterolemia (p<0.05 for all comparisons). Using multivariate linear regression adjusting for demographics, traditional risk factors, coronary artery calcium and C-reactive protein, each standard deviation decrease was associated with 18 cm2 increase in the LV area. In addition, decreasing AD quartiles were independently associated with increased BSA LV area defined as >75th percentile. In this multi-ethnic cohort, reduced AD was associated with increased LV area. Longitudinal studies are needed to determine if decreased distensibility precedes and directly influences increased LV area.

Fabrication of Hydrogel Tubes with Vascular Mimicked Stiffness for Construction of in Vitro Vascular Models

“…The compliance of the two gel tubes was very close to the typical vascular compliances (namely, distensibility in some literature) of aortic and main pulmonary arteries in health and hypertension patients. 5,29 To our knowledge, it is the first time that hydrogels were fabricated into tubes with mimicked stiffness as native vessels.…”

“…Blood vessels show unique mechanical properties at a high elasticity , and strength, as they need to go through considerable deformations and stress fluctuations as part of the functions . An alteration of mechanical properties, especially increase of the stiffness, has long been known to relate with adverse cardiovascular outcomes such as hypertension and atherosclerosis . Mediators of these processes are usually uncoupled with other factors (e.g., hemorheological and chemical signals) in vivo, − so that in vitro vascular models are needed to mimic and study the local vascular microenvironments.…”

Peripheral Artery Disease and Aortic Disease

“…Decreased arterial compliance, estimated by aortic distensibility measured by magnetic resonance imaging in the MESA study has also been shown, even after adjustment for risk factors, CAC, and C-reactive protein to be associated with increased left ventricular area (each standard deviation decrease in aortic distensibility associated with an 18 cm 2 increase in left ventricular area) [83]. Moreover, reduced aortic distensibility was shown in another report from the MESA study to be associated with increased odds of retinal arteriolar narrowing (odds ratio 1.7) even after adjustment for risk and inflammatory factors and other measures of subclinical disease [84].…”

Non-invasive Determination of Aortic Mechanical Properties and Their Effects on Left Ventricular Function Following Endovascular Abdominal Aneurysm Repair

“…Elevated measures of arterial stiffness (central and peripheral) have been shown to negatively impact LV systolic and diastolic function, impair coronary blood flow, and have been identified as a risk factor for cardiovascular disease and mortality [1][2][3][4][5][6][7][8][9]. One possible mechanism for these findings is that increased arterial stiffness can create additional LV work while simultaneously making coronary perfusion less efficient.…”