Central pulse pressure is inversely associated with proximal aortic remodelling

Area of Science:

• Cardiology
• Vascular Biology
• Hypertension Research

Background:

• Hypertension is known to cause aortic stiffening and dilatation.
• Unexpected findings from the Framingham Heart Study indicated an inverse relationship between brachial pulse pressure and aortic diameter.
• Aortic dilatation is associated with a poorer prognosis, including cardiac events and heart failure.

Purpose of the Study:

• To investigate the relationship between invasively measured central blood pressure and proximal aortic diameter.
• To evaluate aortic remodelling in relation to invasive hemodynamic measurements.

Main Methods:

• Invasive hemodynamic study conducted on 71 consecutive patients.
• Proximal aortic diameter at the sinus of Valsalva was measured and compared to expected diameters based on age, sex, and body height (Z-score).
• Pressures were directly recorded in the proximal aorta using a catheter prior to coronary assessment.

Main Results:

• Mean invasive aortic systolic blood pressure (SBP) was 146 ± 23 mmHg and diastolic blood pressure (DBP) was 78 ± 13 mmHg, yielding a central pulse pressure (cPP inv) of 68 ± 21 mmHg.
• A significantly inverse relationship was observed between higher cPPinv and lower aortic root Z-score (P = 0.001).
• cPPinv was inversely related to Z-score (R = -0.271, P = 0.022) independently of age, mean blood pressure, and heart rate.

Conclusions:

• Aortic root Z-score is inversely associated with invasively measured central pulse pressure in patients undergoing invasive coronary assessment.
• Aortic remodelling at the sinuses of Valsalva may function as a compensatory mechanism to reduce central pulse pressure.