ABSTRACT
PURPOSE: : The association between aortic root diameters and aortic regurgitation in hypertension (HT) is disputed with lack of understanding of the underline mehanisms lT. We investigate the relationship between aortic root diameters and aortic regurgitation in newly diagnosed and never treated hypertensive patients and in a group healthy subjects. METHOD: Participants were 175 hypertensives (42 F and 133 M) and 305 normotensives (134 F, 168 M) age matched (mean age 52.4±13 vs 52.6 ±15.2 years). Antropometric, office blood pressure (BP) measurements, a comprehensive echocardiography and local carotid stiffness study were performed. Aortic measures for annulus, sinuses of Valsalva, sinotubular junction and ascending aorta were taken in late diastole according to the leading edge method. The sinotubular junction/annulus ratio was calculated. RESULTS: Hypertensive patients had significantly higher body surface area (BSA), systolic (SBP) and diastolic pressure (DBP), mean arterial pressure (MAP) and pulse?pressure (PP) (p<0.0001) than normotensives. Annulus and sinotubular junction diameters, indexed by BSA and after adjustment for gender, MAP, heart rate?(HR), were significantly higher in normotensives than hypertensives. Considering subjects with aortic regurgitation (trivial or mild) we found a higher prevalence in?hypertensives (25.7 % vs 10.2%, p<0.0001). Moreover in hypertensives we found no difference in aortic diameters between patients with or without aortic regurgitation?but ascending aorta /BSA (p=0.002) whereas in healthy subjects aortic regurgitation was associated with larger aortic root diameters included sinotubular junction/annulus ratio (table 1). In the logistic regression analysis, aortic regurgitation was associated with age, gender, BP parameters, one point carotid stiffness parameters. CONCLUSIONS: Hypertensive patients had smaller indexed aortic root dimensions than normal subjects but they had heigher prevalence of trivial-mild aortic regurgitation in contrast to normotensives who had aortic regurgitation combined with larger aortic diameters.
