Independent determinants of ascending aortic dilatation in hypertensive patients: smoking, endothelial dysfunction, and increased epicardial adipose tissue.

Background: Ascending aortic aneurysm is an uncommon condition with lethal consequences. Lately, epicardial adipose tissue (EAT) is acknowledged as an organ with important effects on the vascular system. In this study, we aimed to investigate whether EAT, cardiovascular risk factors, and vascular structure and functions are independently related to ascending aortic dilatation.
Methods and Results: Vascular structure and functions were determined by carotid intima-media thickness, pulse wave velocity, and brachial artery flow-mediated dilation. Study parameters were compared between 46 patients with a dilated ascending aorta (diameter ≥ 37 mm) and 58 individuals with a normal aortic diameter of <37 mm. Ascending aortic diameter significantly correlated with age (r=0.420, P<0.001), waist circumference (r=0.235, P=0.032), EAT (r=0.507, P<0.001), mean carotid intima-media thickness (r=0.354, P<0.001), flow-mediated dilation (r=-0.513, P<0.001), and diastolic blood pressure (r=0.365, P<0.001). Although C-reactive protein was related to BMI (r=0.485, P<0.001), waist circumference (r=0.368, P=0.001), and EAT (r=0.315, P=0.003), it was not correlated with ascending aortic diameter (r=0.092, P=0.403). Linear regression analysis revealed EAT thickness (β: 0.483, P<0.001), smoking (β: 0.366, P=0.002), and flow-mediated dilation (β: -0.332, P=0.007) as the determinants of ascending aortic dilatation.
Conclusion: On the basis of our findings, smoking, endothelial dysfunction, and increased EAT may be suggested as risk factors for ascending aortic dilation due to local or systemic effects in hypertensive patients.
(© 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.)