ABSTRACT

Background: Ascending aortic aneurysms are one of the primary causes of mortality. However, not much is known about the etiologies of aortic aneurysm. Recently, in hypertensive (HT) patients, blood pressure variability (BPV) has been recommended as a remarkable risk factor for adverse cardiovascular outcomes. This study aimed to explore the association between short-term BPV and ascending aortic dilatation (AAD).

Methods: In this study, a total of 53 HT patients with AAD (aortic size index [ASI] ≥21 mm/m²) and 126 HT patients with a normal ascending aortic diameter (ASI <21 mm/m²) were included. Baseline, echocardiographic, and 24-h ambulatory blood pressure (BP) monitoring results were compared between groups. Standard deviation (SD) and coefficient of variation (CV) of BP were used to determine short-term BPV.

Results: Except for daytime SBP values, daytime, nighttime, and 24-h mean systolic (SBP) and diastolic (DBP) BP levels were similar between groups. Compared with the HT patients with normal AA, daytime SBP, daytime SD of SBP, 24-h SD of SBP, daytime CV of SBP, and 24-h CV of SBP were significantly higher in HT patients with AAD. Compared with the HT patients with normal AA, the frequency of nondipper pattern was higher and dipper pattern was lower in HT patients with AAD. In multivariate logistic regression analysis, the daytime CV of SBP, daytime SD of SBP, 24-h SD of SBP, daytime SBP, and left ventricular mass index were independently associated with AAD. In receiver operating characteristic curve analysis, the daytime CV of SBP levels of >12.95 had a sensitivity of 61% and a specificity of 59% (area under the curve, 0.659; 95% CI, 0.562–0.756; P= .01); moreover, daytime SD of SBP > 16.4 had sensitivity of 62% and specificity of 61% (AUC, 0.687; 95% CI, 0.591–0.782; P< .001).

:Conclusion Increased short-term BPV is independently associated with AAD and may be recommended as a remarkable factor risk for AAD in HT patients.

摘要

背景：升主动脉瘤是死亡的主要原因之一。但是，关于主动脉瘤的病因知之甚少。最近，在高血压（HT）患者中，血压变异性（BPV）已被推荐为心血管不良后果的重要危险因素。这项研究旨在探讨短期BPV和升主动脉扩张（AAD）之间的关联。

方法：本研究共纳入53例AAD（主动脉大小指数[ASI]≥21mm / m ²）的HT患者和126例主动脉直径正常上升（ASI <21 mm / m ²）的HT患者。比较两组之间的基线，超声心动图和24小时动态血压（BP）监测结果。BP的标准偏差（SD）和变异系数（CV）用于确定短期BPV。

结果：除白天的SBP值外，两组之间的白天，夜间和24小时平均收缩压（SBP）和舒张压（DBP）BP水平相似。与AA正常的HT患者相比，AAD HT患者的白天SBP，SBP的白天SD，SBP的24小时SD，SBP的白天CV和SBP的24小时CV显着更高。与AA正常的HT患者相比，AAD HT患者的非浸染器模式频率较高，而浸染器模式较低。在多元逻辑回归分析中，SBP的白天CV，SBP的白天SD，SBP的24小时SD，白天SBP和左心室质量指数与AAD独立相关。在接受者工作特征曲线分析中，白天的SBP CV> 12.95时，灵敏度为61％，特异性为59％（曲线下面积为0.659； 95％CI为0.562-0.756；反之亦然。P = .01）；此外，白天SBP> 16.4的SD的敏感性为62％，特异性为61％（AUC，0.687； 95％CI，0.591-0.782；P <.001）。

结论：短期BPV增加与AAD独立相关，可能被推荐为HT患者AAD的显着因素风险。