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Relation between aortic knob width and subclinical left ventricular dysfunction in hypertensive patients

İsmail Gürbak1, İbrahim Yıldız2, Cafer Panç1

  • 1a Department of Cardiology , İstanbul Mehmet Akif Ersoy Cardiovascular and Thoracic Surgery Training and Research Hospital , İstanbul , Turkey.

Clinical and Experimental Hypertension (New York, N.Y. : 1993)
|January 30, 2018
PubMed

Insights

Aortic knob width measured on chest X-rays can help detect early signs of left ventricular dysfunction in hypertensive patients. This simple measurement may predict subclinical heart changes, aiding in cardiovascular risk assessment.

Area of Science:

  • Cardiology
  • Radiology
  • Hypertension Research

Background:

  • Left ventricular (LV) structure and function assessment is crucial for evaluating hypertensive heart disease.
  • Aortic knob width (AKW) is a radiographic measurement of the aortic arch and descending aorta.
  • Investigating the relationship between AKW and subclinical LV dysfunction in hypertensive patients is important for cardiovascular risk stratification.

Purpose of the Study:

  • To determine the association between aortic knob width (AKW) on routine chest radiography and subclinical left ventricular (LV) dysfunction in hypertensive patients.
  • To explore AKW as a potential non-invasive marker for early detection of LV dysfunction.

Main Methods:

  • 144 hypertensive patients were divided into two groups based on tissue Doppler-derived myocardial performance index (MPI): subclinical LV dysfunction (MPI ≥ 0.5) and normal LV function (MPI < 0.5).
  • Aortic knob width (AKW) was measured from routine chest radiographs.
  • Statistical analyses, including logistic regression and ROC curve analysis, were performed to assess the relationship between AKW and subclinical LV dysfunction.

Main Results:

  • Patients with subclinical LV dysfunction were older and had significantly higher left ventricular mass index (LVMI) and prevalence of LV hypertrophy.
  • Aortic knob width (AKW) was significantly higher in patients with subclinical LV dysfunction (42 ± 6 mm vs. 34 ± 5 mm, p < 0.001).
  • AKW (β = 0.617, p = 0.001) and posterior wall thickness (PWth) were independently associated with subclinical LV dysfunction. A cutoff AKW of 37 mm showed 85.9% sensitivity and 86.4% specificity for detecting subclinical LV dysfunction.

Conclusions:

  • Aortic knob width (AKW) measurement on routine chest radiography is a valuable tool for predicting subclinical left ventricular dysfunction in hypertensive patients.
  • AKW may serve as an accessible and cost-effective marker for early identification of cardiovascular risk in hypertension.
  • Further research can explore the integration of AKW into routine cardiovascular assessments for hypertensive individuals.
Abstract

Keywords:
Left ventricular dysfunctionaortic knob widthhypertensionmyocardial performance index

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