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Reduced shear stress and associated aortic deformation in the thoracic aorta of patients with chronic obstructive pulmonary disease.

Abstract：

OBJECTIVE:Central aortic stiffness and chronic obstructive pulmonary disease (COPD) are associated with increased incidence of devastating aortopathies. However, the exact mechanism leading to elevated aortic stiffness in patients with COPD is unknown. The purpose of this study was to quantify flow and shear hemodynamic indices, known markers of vascular remodeling, in the thoracic aorta of patients with mild to moderate COPD (n = 16) and to compare these results with an age-matched control group (n = 10). METHODS:Four-dimensional flow magnetic resonance imaging has been applied to measure hemodynamic wall shear stress (WSS) at four specific planes along the ascending aorta, aortic arch, and proximal descending aorta for all subjects. Peak systolic WSS and time-averaged WSS, which respectively reflect magnitude and temporal shear variability, were calculated at standardized planes. Aortic deformation was measured by means of relative area change (RAC) at the midlevel of the ascending and descending aorta. RESULTS:Compared with controls, patients with COPD had significantly reduced RAC in the mid ascending aorta (9% vs 18%; P < .0001) and descending aorta (15% vs 19%; P = .0206). Peak systolic WSS in COPD patients was significantly reduced in all considered planes, with the most dramatic difference occurring in the descending aorta (0.46 vs 0.86 N/m2; P < .0001). Peak systolic WSS and time-averaged WSS were both significantly correlated with aortic RAC at each evaluated plane. CONCLUSIONS:Reduced flow shear metrics assessed at specific aortic regions correlated with RAC, a marker of aortic stiffness. Reduced hemodynamic WSS may then contribute to central aortic stiffening and perpetuate the risk for development of severe aortopathy.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Schäfer M,Kheyfets VO,Barker AJ,Stenmark K,Hunter KS,McClatchey PM,Buckner JK,Reece TB,Jazaeri O,Fenster BE

doi

10.1016/j.jvs.2017.06.110

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

246-253

issue

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(17)31921-3

journal_volume

pub_type

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Reduced shear stress and associated aortic deformation in the thoracic aorta of patients with chronic obstructive pulmonary disease.