Ki You Jeong, Kim Hack Lyoung, Oh Sohee, Jeon Won Kyeong, Rhee Tae Min, Lim Woo Hyun, Seo Jae Bin, Kim Sang Hyun, Kim Myung A, Zo Joo Hee
Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea.
Department of Biostatistics, Boramae Medical Center, Seoul, Korea.
J Cardiovasc Imaging. 2019 Jan;27(1):11-21. doi: 10.4250/jcvi.2019.27.e3.
The gender-related change in aortic morphology by arterial stiffness has not been well studied. This study was performed to investigate the association between brachial-ankle pulse wave velocity (baPWV) and aortic root size according to gender.
A total of 263 consecutive subjects (63.2 ± 10.6 years, 71.1% men) without overt cardiovascular disease who underwent both baPWV measurement and transthoracic echocardiography on the same day were retrospectively analyzed. The diameters of the aortic annulus (AN), sinus of Valsalva (SV), sinotubular junction (STJ), and ascending aorta (AA) were measured using 2-dimensional echocardiography.
The body surface area (BSA)-corrected diameters of AN, SV, STJ, and AA were significantly higher in women than in men. Univariable analyses showed that baPWV was significantly correlated with SV/BSA and STJ/BSA in men, and with SV/BSA, STJ/BSA, and AA/BSA in women (p < 0.05 for each). In men, however, these associations disappeared in multiple linear regression models after controlling for potential confounders (p > 0.05 for each). In women, the associations of baPWV with diameters of STJ/BSA (β = 0.407, p < 0.001) and AA/BSA (β = 0.391, p = 0.005) remained significant in the same multivariate models. Women-specific correlation between aortic root size and baPWV was also similarly demonstrated in age-matched analyses (n = 61 in each gender).
Among Korean adult without overt cardiovascular disease, the association between increased arterial stiffness and aortic root dilatation is stronger in women than in men.
动脉僵硬度导致的主动脉形态与性别相关的变化尚未得到充分研究。本研究旨在根据性别探讨臂踝脉搏波速度（baPWV）与主动脉根部大小之间的关联。
回顾性分析了263例连续的无明显心血管疾病的受试者（年龄63.2±10.6岁，男性占71.1%），这些受试者在同一天接受了baPWV测量和经胸超声心动图检查。使用二维超声心动图测量主动脉瓣环（AN）、主动脉窦（SV）、窦管交界（STJ）和升主动脉（AA）的直径。
女性经体表面积（BSA）校正后的AN、SV、STJ和AA直径显著高于男性。单变量分析显示，baPWV与男性的SV/BSA和STJ/BSA显著相关，与女性的SV/BSA、STJ/BSA和AA/BSA显著相关（每项p<0.05）。然而，在男性中，在控制潜在混杂因素后，这些关联在多元线性回归模型中消失（每项p>0.05）。在女性中，在相同的多变量模型中，baPWV与STJ/BSA直径（β=0.407，p<0.001）和AA/BSA直径（β=0.391，p=0.005）的关联仍然显著。在年龄匹配分析（每种性别n=61）中也类似地证明了主动脉根部大小与baPWV之间特定于女性的相关性。
在无明显心血管疾病的韩国成年人中，女性动脉僵硬度增加与主动脉根部扩张之间的关联比男性更强。
