Assessment of Impaired Aortic Distensibility in Hypertensive Patients Undergoing Cardiac Computed Tomography

Background: Arterial elasticity is an essential feature of vessels that plays a role in hypertension, which is considered a major modifiable risk factor for developing cardiovascular diseases. Multi-slice cardiac computed tomography angiography (CTA) has evolved as a noninvasive technique for the evaluation of aortic distensibility and localized stiffness, as well as atherosclerotic coronary artery diseases (CAD). Aim: To evaluate aortic distensibility impairment and aortic stiffness measured by cardiac CTA and their relation with hypertension and the development of atherosclerotic CAD. Patients and methods: 100 hypertensive patients and 100 normotensive patients were included in our case-control study. All these patients underwent brief history taking, clinical examination, standard electrocardiogram (ECG), routine laboratory investigations, and multi-slice cardiac CTA. Aortic distensibility index (ADI) and pulsed wave velocity (PWV) were estimated by measuring maximum (systolic and diastolic) cross-sectional area (CSA) of the ascending aorta (AAo) and blood pressure (systolic and diastolic) measurements using previously published equations. Coronary calcium scoring and coronary plaque burden assessment were done. Results: The hypertensive patients had lower ADI and higher PWV than normotensive patients, with negatively correlated ADI and positively correlated PWV with elevated systolic blood pressure. Multivariable analysis revealed that ADI was associated more significantly with age and hypertension. ADI and PWV were significantly correlated with the severity of CAD. Conclusion: Aortic distensibility impairment and aortic stiffness are well associated with hypertension and with the severity of atherosclerotic CAD. Multi-slice CTA provides a good measure for ADI and PWV, which can be useful in predicting hypertension and atherosclerotic CAD.