Transesophageal echocardiographic assessment of the effects of age, gender, and hypertension on thoracic aortic wall size, thickness, and stiffness

Abstract

Aging is associated with progressive arterial stiffening and widening of the pulse pressure, resulting in a high prevalence of systolic hypertension. The contribution of increased aortic thickness to this process and to essential hypertension has been poorly characterized. With transesophageal echocardiography, aortic thickness and diameter can be measured. Thus, the influence of aging, gender, and hypertension on the geometry and stiffness of the descending thoracic aorta in humans can be determined in vivo. In 83 patients undergoing transesophageal echocardiography for clinical indications, recordings of the descending thoracic aorta were made. There were 53 normotensive subjects (33 men and 20 women, mean age 46 years, range 14 to 79 years) and 25 hypertensive subjects (8 men and 17 women, mean age 67 years, range 50 to 80 years). Measurements of diastolic and systolic aortic thickness and aortic diameter were made, and three measures of the elastic properties of the aorta were calculated: (1) Peterson's elastic modulus, (2) Young's modulus, and (3) the stiffness index (beta). Aortic thickness averaged 1.1 +/- 0.1 mm in both normotensive men and women. Normotensive women had a significantly greater thickness/diameter ratio than men (0.06 +/- 0.01 vs 0.05 +/- 0.01, p < 0.01), but there were no differences in stiffness between men and women. Age was highly positively correlated with thickness (r = 0.74, p < 0.001), diameter (r = 0.67, p < 0.001), beta (r = 0.79, p < 0.001), Peterson's modulus (r = 0.78, p < 0.001), and Young's modulus (r = 0.81, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)