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Hemodynamic Predictors of Atherosclerosis in the Thoracic Aorta
Mikhail R. Sukernik1, Oscar D. West, Babu Chittivelu
1Division of Cardiology, Room 15101, Harlem Hospital Center, 506 Lenox Avenue, New York, NY 10037.
Insights
Low shear rate (SR) is linked to aortic atherosclerosis. This study found that reduced maximal SR and older age independently predict the presence of atherosclerotic plaques in the descending aorta.
Area of Science:
- Cardiovascular Medicine
- Biomedical Engineering
- Medical Imaging
Background:
- Atherosclerosis in the descending aorta (DA) is a significant cardiovascular risk factor.
- Understanding the hemodynamic factors associated with DA atherosclerosis is crucial for risk stratification.
Purpose of the Study:
- To investigate the relationship between flow parameters and atherosclerotic plaque presence in the DA.
- To identify independent predictors of DA atherosclerosis.
Main Methods:
- Transesophageal echocardiography was used to assess 83 patients (≥40 years).
- Flow parameters, including maximal velocity and shear rate (SR), were measured in the DA.
- Atherosclerotic plaques and spontaneous echo contrast were identified in the DA.
Main Results:
- Patients with DA atherosclerosis were older and had higher rates of spontaneous echo contrast.
- Lower maximal velocity and lower maximal shear rate (SR) were observed in patients with DA atherosclerosis.
- Age and maximal SR were independent predictors of DA atherosclerosis in multivariate analysis.
Conclusions:
- Low shear rate (SR) is associated with the presence of aortic atherosclerosis.
- Maximal SR and age are key independent predictors of DA atherosclerosis.
Abstract:
We sought to identify atherosclerotic plaques and measured flow parameters in the descending aorta (DA) of 83 consecutive patients (40 years and older) studied with transesophageal echocardiography. Patients with atherosclerotic plaques in the DA were older (68 +/- 10 vs 58 +/- 12 years [P = 0.0001]), had a higher proportion of spontaneous echo contrast in the DA (15/46 [33%] vs 3 of 37 [8%] P = 0.02), had larger aortic diameters (2.52 +/- 0.35 vs 2.37 +/- 0.36 cm [P = 0.06]), had a lower maximal velocity in the DA (54.2 +/- 21.5 vs 73.8 +/- 33.0 cm/sec [P = 0.02]), and had a lower calculated maximal shear rate (SR) (88.0 +/- 37.6 vs 129.0 +/- 67.0 sec(-1) [P = 0.002]). There was no significant difference between groups with respect to sex, hypertension, diabetes, total cholesterol, and smoking. In multivariate analysis only age (P = 0.002) and maximal SR (P = 0.03) were identified as independent predictors of atherosclerosis in the DA. We conclude that low SR is associated with aortic atherosclerosis.