Related Experiment Video
Updated: Jul 17, 2026
Mesenteric Artery Contraction and Relaxation Studies Using Automated Wire Myography
Published on: September 22, 2011
Central pulse pressure is a major determinant of ascending aorta dilation in Marfan syndrome
G Jondeau1, P Boutouyrie, P Lacolley
1Service de Cardiologie and Consultation Marfan, Ambroise Paré, Boulogne, France.
Background:
In patients with Marfan syndrome (MFS), brachial pulse pressure (PP) has been recognized as a risk factor for aortic dilatation, leading to aortic dissection, the main cause of premature death. However, the relationships between aortic PP, aortic stiffness, and aortic root dilation have not been investigated. Our main objective was to determine whether central PP, which takes into account wave reflections and aortic stiffness, is a better determinant of ascending aorta diameter than brachial PP in MFS patients.
Methods And Results:
Twenty patients with confirmed MFS and 20 age- and sex-matched control subjects were included in this cross-sectional, noninvasive study. Elastic properties of the abdominal aorta and common carotid, common femoral, and radial arteries were calculated from the pulsatile changes in arterial diameter and pressure. The ascending aorta diameter, measured with conventional echocardiography, was 37% larger in MFS than in control subjects (P<0.001). Arterial distensibility was 38% lower in MFS than in control subjects at the site of the abdominal aorta (P<0.01) but not at other sites (common carotid, common femoral, and radial arteries). Independently of age and body surface area, ascending aorta diameter was positively correlated with carotid PP in MFS (P<0. 01) and negatively in control subjects (P<0.01) but was not correlated with brachial PP and mean blood pressure.
Conclusions:
In patients with MFS, local PP, estimated from carotid PP, was a major determinant of ascending aorta diameter, whereas brachial PP was not. Increased arterial stiffness was confined to the aorta.
Insights
In Marfan syndrome (MFS), carotid pulse pressure, not brachial, predicts aortic root dilation. Arterial stiffness is primarily in the aorta, highlighting the need for central pressure monitoring in MFS patients.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Medical Physiology
Background:
- Marfan syndrome (MFS) is associated with aortic dilatation and dissection, a leading cause of premature death.
- Brachial pulse pressure (PP) is a known risk factor, but its relationship with aortic stiffness and root dilation in MFS remains unclear.
- Investigating central PP as a determinant of ascending aorta diameter is crucial for risk stratification in MFS.
Purpose of the Study:
- To compare central pulse pressure (PP) with brachial PP in determining ascending aorta diameter in Marfan syndrome (MFS) patients.
- To assess arterial stiffness and its correlation with aortic dimensions in MFS.
- To identify the most effective PP measurement for predicting aortic root dilation in MFS.
Main Methods:
- A cross-sectional, noninvasive study involving 20 MFS patients and 20 controls.
- Measurement of elastic properties in abdominal aorta, carotid, femoral, and radial arteries.
- Ascending aorta diameter assessed by echocardiography; PP and arterial distensibility calculated.
Main Results:
- Ascending aorta diameter was significantly larger in MFS patients (37% increase, P<0.001).
- Arterial distensibility was reduced in the abdominal aorta of MFS patients (38% decrease, P<0.01), but not other arteries.
- Ascending aorta diameter correlated positively with carotid PP in MFS (P<0.01) but not brachial PP.
Conclusions:
- Carotid pulse pressure, reflecting central pressure, is a key determinant of ascending aorta diameter in Marfan syndrome.
- Brachial pulse pressure is not correlated with aortic diameter in MFS patients.
- Increased arterial stiffness in MFS is localized to the aorta, suggesting targeted therapeutic approaches.
Related Concept Videos
01:30Blood Pressure
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
01:21Sites for measuring blood pressure
The Brachial Artery: Primary Site for Blood Pressure Measurement
01:18Hypertension and Regulation of Blood Pressure
01:27Regulation of Stroke Volume
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
01:24Blood Pressure
01:18Neural Regulation of Blood Pressure
Baroreceptor Reflex
Baroreceptors, located in the carotid sinuses and aortic arch, detect changes in blood pressure. When blood pressure rises, these stretch-sensitive receptors...