Age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis

Background. Ischemic heart disease (CHD) holds a leading position in the structure of causes of general mortality and in the structure of mortality from cardiovascular diseases. We extended the standard echocardiography with assessment of thoracic aorta elasticity to identify markers of the thoracic aorta elasticity worsen associated with coronary atherosclerosis. When analyzing the data, we identified different clinical characteristics of study participants as one of the main reasons for the difficulty in comparing the data with the results of previous studies, which made it necessary to highlight age and gender characteristics of indicators.

Aim. To analyze age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis.

Material and methods. An observational analytical cross- sectional clinical trial was conducted from 2016 to 2019. Our study included 109 patients aged 39 to 82 years (mean age 65 ± 9 years, median 66 years), who were divided into 2 groups according to the results of invasive coronarography: 64 patients with coronary atherosclerosis and 45 patients without angiographic signs of coronary atherosclerosis. In the group with coronary atherosclerosis average age was 66 ± 8 years (median 66 years). In the group without coronary atherosclerosis average age was 64 ± 9 years (median 66 years). During transthoracic echocardiography, the following were obtained: coefficient of distensibility, compliance coefficient, elasticity (stiffness) module of Peterson, stiffness index of the ascending thoracic aorta; systolic velocity S, early diastolic velocity E, late diastolic velocity A of the near wall of the ascending aorta, flow velocity propagation (FVP) of the descending thoracic. Analysis of age and gender characteristics of thoracic aorta elasticity indices in patients with coronary atherosclerosis was done.

Results. An increase in the stiffness index of the ascending thoracic aorta associated with coronary atherosclerosis occurs in the age group 39–66 years, a decrease in the coefficients of extensibility and compliance, an increase in Peterson’s modulus of elasticity (stiffness) of the as cending thoracic aorta — in the age group 67–82 years. A decrease in the E velocity of the near wall of the ascending thoracic aorta and FVP, associated with coronary atherosclerosis, occurs regardless of belonging to the age group, a decrease in the S velocity — in the age group 39–66 years. A decrease in the compliance coefficient of the ascending thoracic aorta, velocity S of the near wall of the ascending thoracic aorta, associated with coronary atherosclerosis, occurs only in men, an increase in the stiffness index — only in women. A decrease in the extensibility coefficient, an increase in the Peterson’s modulus of elasticity (stiffness), a decrease in the E velocity, and a decrease in CRP associated with coronary atherosclerosis occur regardless of gender.

Conclusion. Worsening of the thoracic aorta elasticity in patients with coronary atherosclerosis, assessed using echocardiographic technologies, depends on gender and age.

1. Демографический ежегодник России. 2017: Стат. сб. / Росстат. — M., 2017. — 265 c.

2. Knuuti J. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes // European heart journal. — 2019.

3. Güngör B., Yılmaz H., Ekmekçi A., Özcan K.S., Tijani M., Osmonov D. Aortic stiffness is increased in patients with premature coronary artery disease: a tissue Doppler imaging study.2014; Journal of cardiology. 63(3):223–229.

4. Fukuda D., Yoshiyama M., Shimada K., Yamashita H., Ehara S., Nakamura Y. & Yoshikawa J. Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease. 2006; Heart, 92(6):759–762.

5. Chung C.M., Tseng Y.H., Lin Y.S., Hsu J.T., Wang P.C. Association of brachial-ankle pulse wave velocity with atherosclerosis and presence of coronary artery disease in older patients//ClinIntervAging. — 2015. — N. 10. — P. 1369-1375.

6. Mushkambarov IN, Beresten NF, Tkachenko SB, Romanov SN, Kolesnikov VN. Modern Opportunities of echocardiography in the examination of patients with coronary heart disease. Modern problems of science and education. 2020.2 [Internet]. Available from https://scienceeducation.ru/ru/article/view?id=29600. Russian.

7. Otto C. Practice of Clinical Echocardiography. 5th edition. Elsevier; 2017. 1024 p.

8. O’Rourke M.F., Staessen J.A., Vlachopoulos C, Duprez D. Clinical applications of arterial stiffness; definitions and reference values. American journal of hypertension. 2002. 15(5):426–44.

9. Stefanadis C. et al. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease //European Heart Journal. — 1990. — V. 11. — N. 11. — P. 990–996.

10. Gatzka C.D. et al. Relation between coronary artery disease, aortic stiffness, and left ventricular structure in a population sample //Hypertension. — 1998. — V. 32. — N. 3. — P. 575–578.

11. Eryol N.K. et al. Color Doppler tissue imaging in assessing the elastic properties of the aorta and in predicting coronary artery disease. JpnHeart J. 2002 May; 43(3): 219–230.

12. Güngör B., Yılmaz H., Ekmekçi A., Özcan K.S., Tijani M., Osmonov D. Aortic stiffness is increased in patients with premature coronary artery disease: a tissue Doppler imaging study.2014; Journal of cardiology, 63(3): 223–229.

13. Lee JG, Joo SJ. Arterial stiffness and cardiovascular risk. Korean J Intern Med. 2019;34(3):504–506. doi:10.3904/kjim.2019.110

14. Knuuti J. et al. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes //European heart journal. — 2019.

15. Güngör B, Yılmaz H, Ekmekçi A, Özcan KS, Tijani M, Osmonov D. Aortic stiffness is increased in patients with premature coronary artery disease: a tissue Doppler imaging study.2014; Journal of cardiology. 63(3): 223-229.

16. Fukuda D, Yoshiyama M, Shimada K, Yamashita H, Ehara S, Nakamura Y. & Yoshikawa, J. Relation between aortic stiffness and coronary flow reserve in patients with coronary artery disease. 2006; Heart, 92(6): 759-762.

17. Chung CM, Tseng YH, Lin YS, Hsu JT, Wang PC. Association of brachial-ankle pulse wave velocity with atherosclerosis and presence of coronary artery disease in older patients//ClinIntervAging. — 2015. — N. 10. — P. 1369-1375.

18. Mushkambarov IN, Beresten NF, Tkachenko SB, Romanov SN, Kolesnikov VN. Modern Opportunities of echocardiography in the examination of patients with coronary heart disease. Modern problems of science and education. 2020.2 [Internet]. Available from https://science-education.ru/ru/article/view?id=29600. Russian.

19. Otto C. Practice of Clinical Echocardiography. 5th edition. Elsevier; 2017. 1024 p.

20. O’Rourke MF, Staessen JA, Vlachopoulos C, Duprez D. Clinical applications of arterial stiffness; definitions and reference values. American journal of hypertension. 2002. 15(5):426-44.

21. Stefanadis C. et al. Distensibility of the ascending aorta: comparison of invasive and non-invasive techniques in healthy men and in men with coronary artery disease //European Heart Journal. — 1990. — V. 11. — N. 11. — P. 990-996.

22. Gatzka CD. et al. Relation between coronary artery disease, aortic stiffness, and left ventricular structure in a population sample //Hypertension. — 1998. — V. 32. — N. 3. — P. 575-578.

23. Eryol NK. et al. Color Doppler tissue imaging in assessing the elastic properties of the aorta and in predicting coronary artery disease. JpnHeart J. 2002 May; 43(3): 219–230.

24. Güngör B, Yılmaz H, Ekmekçi A, Özcan KS, Tijani M, Osmonov D. Aortic stiffness is increased in patients with premature coronary artery disease: a tissue Doppler imaging study.2014; Journal of cardiology, 63(3): 223-229.