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Three-dimensional evaluation of thoracic aorta enlargement and unfolding in hypertensive men using non-contrast

D Craiem1, G Chironi, M E Casciaro

  • 1Centre de Médecine Préventive Cardiovasculaire, Hôpital Européen Georges Pompidou, APHP, Paris, France. dcraiem@favaloro.edu.ar

Journal of Human Hypertension
|January 25, 2013
PubMed

Insights

Hypertension accelerates thoracic aorta (TA) enlargement and unfolding, similar to 2-7 years of aging. Diastolic pressure significantly impacts TA size and shape changes more than systolic pressure.

Area of Science:

  • Cardiovascular Imaging
  • Aortic Mechanics
  • Hypertension Research

Background:

  • Aging is associated with thoracic aorta (TA) enlargement and unfolding.
  • Hypertension is a major cardiovascular risk factor with potential effects on aortic geometry.

Purpose of the Study:

  • To investigate the impact of hypertension on thoracic aorta (TA) geometric changes.
  • To compare the effects of hypertension and aging on TA morphology.

Main Methods:

  • Utilized non-contrast computed tomography (CT) scans from coronary artery calcium studies.
  • Employed an automated algorithm for 3D reconstruction and geometric analysis of the TA in 200 hypertensive and 200 normotensive men.
  • Calculated TA diameter, volume, width, radius of curvature, area, tortuosity, and height.

Main Results:

  • Hypertensive patients exhibited larger TA diameter and volume across all segments compared to normotensive individuals, even after age adjustment.
  • Hypertension accelerated TA unfolding, indicated by increased arch width, radius of curvature, and area under the arch, with decreased tortuosity.
  • The geometric changes in hypertensive individuals were equivalent to 2-7 years of aging, with diastolic pressure showing a stronger association with TA alterations than systolic pressure.

Conclusions:

  • Hypertension significantly accelerates thoracic aorta (TA) enlargement and unfolding, mimicking aspects of the natural aging process.
  • Diastolic blood pressure is a key determinant of TA size and shape modifications in hypertensive individuals.
  • These findings highlight the detrimental geometric impact of hypertension on the thoracic aorta, emphasizing the need for blood pressure management.

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