Hypertension Research Center, Department of Advanced Biomedical Science, Federico II University, Via S. Pansini 5, Naples 80131, Italy.
Department of Public Health, Federico II University, Naples, Italy.
Eur J Prev Cardiol. 2023 Nov 9;30(16):1774-1780. doi: 10.1093/eurjpc/zwad224.
In the present study, we assessed correlates and their consistency of ascending aorta (AscAo) measurement in treated hypertensive patients.
A total of 1634 patients ≥ 18 years old with available AscAo ultrasound were included. Ascending aorta was measured at end-diastole with leading edge to leading edge method, perpendicular to the long axis of the aorta in parasternal long-axis view at its maximal identifiable dimension. Correlations of AscAo and AscAo normalized for height (AscAo/HT) or body surface area (AscAo/BSA) with demographics and metabolic profile were explored. Multi-variable regression was also used to identify potential confounders influencing univariate correlations. Sensitivity analysis was performed using cardiovascular (CV) outcome. Correlations with age, estimated glomerular filtration rate, systolic blood pressure (BP), and heart rate (HR) were similar among the three aortic measures. Women exhibited smaller AscAo but larger AscAo/BSA than men with AscAo/HT offsetting the sex difference. Obesity and diabetes were associated with greater AscAo and AscAo/HT but with smaller AscAo/BSA (all P < 0.001). In multi-variable regression model, all aortic measure confirmed the sign of their relations with sex and metabolic profile independently of age, BP, and HR. In Kaplan-Mayer analysis, only dilated AscAo and AscAo/HT were significantly associated with increased risk of CV events (both P < 0.008).
Among patients with long-standing controlled systemic hypertension, magnitude of aortic remodelling is influenced by the type of the measure adopted, with physiological consistency only for AscAo and AscAo/HT, but not for AscAo/BSA.
本研究旨在评估经治疗的高血压患者升主动脉（AscAo）测量的相关因素及其一致性。
共纳入 1634 名年龄≥18 岁且有升主动脉超声检查结果的患者。升主动脉在舒张末期用前缘到前缘的方法测量，在胸骨旁长轴切面垂直于主动脉长轴，在可识别的最大维度处测量。探讨了 AscAo 和 AscAo 与身高（AscAo/HT）或体表面积（AscAo/BSA）标准化的与人口统计学和代谢特征的相关性。还使用多元回归来确定影响单变量相关性的潜在混杂因素。使用心血管（CV）结局进行敏感性分析。在三种主动脉测量方法中，AscAo 与年龄、估算肾小球滤过率、收缩压（BP）和心率（HR）的相关性相似。女性的 AscAo 较小，但 AscAo/BSA 大于男性，而 AscAo/HT 则抵消了性别差异。肥胖和糖尿病与 AscAo 和 AscAo/HT 增加有关，但与 AscAo/BSA 减少有关（均 P <0.001）。在多元回归模型中，所有主动脉测量方法均证实了其与性别和代谢特征的关系的符号，独立于年龄、BP 和 HR。在 Kaplan-Meier 分析中，只有扩张的 AscAo 和 AscAo/HT 与 CV 事件风险增加显著相关（均 P <0.008）。
在长期控制的系统性高血压患者中，主动脉重塑的程度受所采用的测量方法类型的影响，只有 AscAo 和 AscAo/HT 具有生理一致性，而 AscAo/BSA 则没有。
