Jia Chong-Fu, Wang Zhao-Qian, Sun Xi-Xia, Yang Zhi-Qiang, Zou Yu-Jie, Jiang Yi-Nong
Department of Cardiovascular Radiology, The First Affiliated Hospital of Dalian Medical University, 222#, Zhong Shan Road, Dalian, 116011, Liaoning, China.
Department of Cardiology, The First Affiliated Hospital of Dalian Medical University, 222#, Zhong Shan Road, Dalian, 116011, Liaoning, China.
Int J Cardiovasc Imaging. 2017 Aug;33(8):1245-1251. doi: 10.1007/s10554-017-1099-x. Epub 2017 Mar 16.
To investigate the relationship between ascending aortic distensibility (AAD) and hypertensive target organ damage (TOD) and its potential value in prediction. One hundred and sixty seven primary hypertension inpatients who underwent coronary CTA examination were enrolled into our study. Retrospective ECG-triggering scanning mode were applied and the images were reconstructed every 5% phase in the entire R-R interval. Maximum and minimum ascending aortic areas as well as the AAD value were calculated on the interested slice. AAD (P < 0.001) and brachial-ankle pulse wave velocity (baPWV, P < 0.05) were changed significantly as the deterioration of TOD. Multivariate logistic regression analysis between TOD and its possible influence factors indicated that AAD was the only independent risk factor for the presence and severity of TOD. One standard deviation decrease on AAD would increase the risk of TOD significantly: TOD1 (odds ratio 0.45, P < 0.05), TOD2 (odds ratio 0.23, P < 0.05), and TOD3 (odds ratio 0.01, P < 0.05). The odds ratio of TOD in the third tertile group was found 5.47 times higher than that in the second tertile group, and the second tertile group TOD odds ratio was 6.4 times higher than that in the first tertile group. Decline of AAD can be taken as the independent predict factor for TOD in primary hypertension patients, superior to baPWV method and other conventional predictors. Without additional contrast media consumption and radiation dose, AAD derived from coronary CTA may provide early detection for hypertensive TOD.
探讨升主动脉扩张性（AAD）与高血压靶器官损害（TOD）之间的关系及其预测的潜在价值。选取167例接受冠状动脉CTA检查的原发性高血压住院患者纳入本研究。采用回顾性心电触发扫描模式，在整个R-R间期以5%相位间隔重建图像。在感兴趣层面计算升主动脉最大和最小面积以及AAD值。随着TOD的恶化，AAD（P＜0.001）和臂踝脉搏波速度（baPWV，P＜0.05）有显著变化。TOD与其可能影响因素的多因素logistic回归分析表明，AAD是TOD存在和严重程度的唯一独立危险因素。AAD每降低一个标准差，TOD风险显著增加：TOD1（比值比0.45，P＜0.05），TOD2（比值比0.23，P＜0.05），TOD3（比值比0.01，P＜0.05）。第三三分位数组的TOD比值比是第二三分位数组的5.47倍，第二三分位数组的TOD比值比是第一三分位数组的6.4倍。AAD下降可作为原发性高血压患者TOD的独立预测因素，优于baPWV方法及其他传统预测指标。无需额外使用对比剂和辐射剂量，冠状动脉CTA得出的AAD可为高血压TOD提供早期检测。
