Centre de Médecine Préventive Cardiovasculaire, Hôpital Européen Georges Pompidou, APHP, Paris, France.
J Hum Hypertens. 2013 Aug;27(8):504-9. doi: 10.1038/jhh.2012.69. Epub 2013 Jan 24.
Aging produces a simultaneous thoracic aorta (TA) enlargement and unfolding. We sought to analyze the impact of hypertension on these geometric changes. Non-contrast computed tomography images were obtained from coronary artery calcium scans, including the entire aortic arch, in 200 normotensive and 200 hypertensive asymptomatic men. An automated algorithm reconstructed the vessel in three-dimensions, estimating orthogonal aortic sections along the whole TA pathway, and calculated several geometric descriptors to assess TA morphology. Hypertensive patients were older with respect to normotensive (P<0.001). Diameter and volume of TA ascending, arch and descending segments were higher in hypertensive patients with respect to normotensive (P<0.001) and differences persisted after adjustment for age. Hypertension produced an accelerated unfolding effect on TA shape. We found increments in aortic arch width (P<0.001), radius of curvature (P<0.001) and area under the arch curve (P<0.01) with a concomitant tortuosity decrease (P<0.05) and no significant change in aortic arch height. Overall, hypertension produced an equivalent effect of 2-7-years of aging. In multivariate analysis adjusted for age and hypertension treatment, diastolic pressure was more associated to TA size and shape changes than systolic pressure. These data suggest that hypertension accelerates TA enlargement and unfolding deformation with respect to the aging effect.
衰老是导致胸主动脉（TA）同时扩张和展开的原因。我们旨在分析高血压对这些几何变化的影响。在 200 名血压正常的男性和 200 名无症状高血压男性的冠状动脉钙扫描中获得了非对比计算机断层扫描图像，包括整个主动脉弓。自动算法在三维重建血管，估计整个 TA 路径的正交主动脉截面，并计算几个几何描述符来评估 TA 形态。与血压正常者相比，高血压患者年龄更大（P<0.001）。与血压正常者相比，高血压患者的 TA 升主动脉、弓部和降主动脉的直径和体积更高（P<0.001），且在调整年龄后差异仍然存在。高血压对 TA 形状产生了加速展开的影响。我们发现主动脉弓宽度增加（P<0.001）、曲率半径增加（P<0.001）和弓下曲线面积增加（P<0.01），同时伴有迂曲度降低（P<0.05），而主动脉弓高度没有明显变化。总的来说，高血压对 TA 扩张和展开变形的影响相当于 2-7 年的衰老。在调整年龄和高血压治疗的多变量分析中，舒张压与 TA 大小和形状变化的相关性大于收缩压。这些数据表明，高血压加速了 TA 相对于衰老效应的扩大和展开变形。
