Central Pulse Pressure Inversely Correlated with Proximal Aortic Modeling, Study Reveals

A study revealed that an inverse correlation is found between an aortic root z-score and invasively measured central pulse pressure in patients undergoing invasive coronary assessment.

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According to researchers that hypertension leads to aortic stiffening and dilatation but unexpected data from the Framingham Heart Study showed an inverse relationship between brachial pulse pressure and aortic diameter. The aortic diameter would not only lead to lower pulse pressure but also to a worse prognosis such as cardiac events or heart failure.

The relationship between invasively measured central blood pressure and proximal aortic diameter was evaluated in 71 consecutive patients referred to invasive hemodynamic study. Experts assessed proximal aortic remodeling in terms of z-score, comparing diameters measured at the sinus of Valsalva to the diameter expected according to patients’ age, gender, and body weight. They then recorded pressures directly in the proximal aorta using a catheter before coronary assessment.

Average invasive aortic systolic and diastolic BP were 146 and 78 mm/Hg, respectively, giving a central pulse pressure of 68 mm/Hg. Proximal aortic diameter was 34.9mm, while the z-score was -0.3.

For patients with higher cPP inv showed a markedly lower z-score (-0.789 vs. 0.155). Notably, cPP inv showed an inverse correlation with z-score, independently from age, average BP, and heart rate.

Researchers said that remodeling at the sinuses of Valsalva may be a compensatory mechanism to limit pulse pressure.

 

Source: J Hypertension 2021

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