P27 Invasive Central Pulse Pressure is Related to Aortic Root Dilatation

Abstract

Background

Aortic root dilation is an established risk factor for aortic dissection. Despite the relations between aortic root remodeling, carotid-femoral pulse wave velocity (cfPWV) and aortic blood pressure have been advocated by several clinical studies and is supported by physical law, invasive data are lacking. We aimed to investigate the relationship between aortic root remodeling, invasively-measured central blood pressure and cfPWV in patients referred for invasive hemodynamic evaluation for suspected coronary disease.

Methods

In 71 patients aortic pulse pressure (aoPP) was measured in the proximal aorta with a calibrated fluid-filled pressure catheter. Before entering the hemodynamic room all patients underwent 2D echocardio-graphic quantification of aortic root diameter and measurement of cfPWV. Aortic root diameter was then expressed into z-score following age, sex and height adjusted reference values (1).

Results

Mean age was 67 ± 10 years and 76.1% of patients were men. Invasive aortic systolic pressure was 146 ± 23 mmHg, diastolic pressure was 78 ± 13 mmHg, and aoPP was 68 ± 21 mmHg. Aortic Z-score was −0.32 ± 1.7, while CfPWV was 9.8±3 m/s. While Log10cfPWV and aoPP showed a positive relation (r = 0.426, p<0.01) while aoPP and aortic Z-score were inversely associated (r = −0.271, p = 0.02). In a multivariable linear regression analysis, Z-score and Log₁₀cfPWV were statistically-significant independent predictors of aoPP (p = 0.01 and p < 0.01, respectively) after adjustment for age, sex, BSA, heart rate, invasive MBP, and stroke volume. Conclusions: In a population referred to invasive coronary hemodynamic evaluation for suspected coronary disease, aortic root remodeling and aortic stiffness were independently associated with a lower aoPP.