Central aortic pressure in aortic aneurysm and aortic dissection: A novel prognostic marker

Background - Some aortic aneurysm (AA) or aortic dissection (AD) patients can be observed to detect disease progression if optimal blood pressure is achieved. However, in another group of patients, disease progression occurs despite well-controlled blood pressure. The aim of this study was to determine the prognostic value of central aortic pressure in AA and AD. Methods - Fifty-six newly diagnosed AA or AD patients (37 men, age: 60.3 ± 12.9 years) who did not need urgent surgery or interventional treatment were enrolled. All patients achieved brachial SBP < 120 mm Hg with beta-blocker-based treatment within 1 month. Then, central aortic pressure parameters were noninvasively checked with radial tonometry (SphygmoCor® Px Pulse Wave Analysis System, AtCor Medical, Sydney, Australia). All patients were monitored for at least 6 months and for up to 5 years. Results - Thirty-three patients did well without disease progression. However, disease progression was noted despite well-controlled brachial blood pressure in 23 patients. In intergroup comparisons, central aortic systolic pressure (112.7 ± 3.5 mm Hg vs. 104.3 ± 7.5 mm Hg) and aortic augmentation index (AI: 33.4 ± 13.5% vs. 23.4 ± 8.7%) were significantly high in the disease progression group (P < 0.05). Conclusion - In some AA or AD patients, central aortic pressure and AI can be considered as surrogate prognostic markers.