Severe aortic stenosis and its association with hypertension: Analysis of clinical and echocardiographic parameters
Abstrakt
Background/aims. Aortic stenosis (AS) and hypertension are associated with cardiac hypertrophy and aortic dilatation.
The effect of their coincidence on the ascending aortic dimensions has not yet been evaluated, and therefore was the aim of our study. Methods.
We performed cross-sectional analysis of history, clinical, angiographic and echocardiographic data of consecutive patients evaluated before surgery for non-rheumatic AS. Results.
The study sample included 225 patients (age 68 +/- 9 years, 60% males), with mean transaortic gradient of 55 +/- 17 mmHg. Hypertension was present in 153 (68%) patients.
The hypertensives had more severe dyspnea (NYHA class 2.2 +/- 0.9 vs 1.9 +/- 0.9, p=0.05) and higher prevalence of coronary artery disease (57% vs 33%, p < 0.001), but did not differ from the normotensives in the ascending aortic dimensions, the left ventricular mass, ejection fraction and remodeling patterns. Wider ascending aortic dimensions were independently associated with bicuspid aortic valve (p < 0.001), and with maximal gradient in those with tricuspid aortic valve.
Vasodilators were used in 84 (54%) hypertensives. Conclusion.
We found hypertension in 68% of patients with severe AS. Bicuspid aortic valve and stenosis severity were independent predictors of ascending aortic dimensions, but not the history of hypertension and blood pressure.