International Journal of Cardiology: Heart & Vasculature (Dec 2024)
Impact of renin-angiotensin system targeted therapy on aortic elastic properties assessed by computed tomography
Abstract
Background: Aortic stiffening is a well-known cardiovascular risk factor. Computed tomography (CT) has proven to be a valuable tool in the assessment of aortic elastic properties. Drugs that inhibit the renin-angiotensin system (RAS) play a central role in cardioprotective therapy. We aimed to evaluate the relationship between aortic elastic properties and RAS-targeted therapy in hypertensive patients. Methods: This is an observational prospective study of hypertensive patients with nonobstructive coronary artery disease who underwent coronary CT angiography (CCTA). Aortic compliance and distensibility were calculated from the ECG-gated CCTA image. Patients were divided into two groups − those with RAS-targeted therapy − RAS(+) and those with non-RAS-targeted therapy − RAS(−). The elastic properties of the aorta were compared between the two groups. Results: A total of 142 patients were included in the final analysis. 53.5 % of the population were in the RAS(+) group and 46.5 % in the RAS(−) group. Elastic properties of ascending and descending aorta were significantly higher in the RAS(+) group compared to the RAS(−) group: AA compliance 1.42 ± 0.75 mm2/mmHg in the RAS(+) vs 1.03 ± 0.91 mm2/mmHg in the RAS(−), p = 0.024; AA distensibility 2.86 ± 1.11 x10-3mm3 in the RAS(+) vs 1.82 ± 0.97 x10-3mm3 in RAS(−), p < 0.001; DA compliance 1.45 ± 1.10 mm2/mmHg in the RAS(+) vs 1.11 ± 0.91 mm2/mmHg in the RAS(−), p 0.031; DA distensibility 2.35 ± 0.84 x10-3mm3 in the RAS(+) vs 1.73 ± 1.21 x10-3mm3 in RAS(−), p < 0.001. There was an excellent correlation between RAS therapy and ascending aorta compliance and distensibility (r = 0.901, p < 0.001 and r = 0.875, p < 0.001, respectively). Conclusion: Patients receiving RAS-blocking treatment revealed significantly higher compliance and distensibility of ascending and descending aorta. In addition, aortic elastic properties were significantly correlated with the RAS-targeted therapy.
