Relationship of aortic knob width with cardio-ankle vascular stiffness index and its value in diagnosis of subclinical atherosclerosis in hypertensive patients: a study on diagnostic accuracy

Korkmaz L., Erkan H., Korkmaz A. A., Acar Z., Agac M. T., Bektas H., ...More

ANATOLIAN JOURNAL OF CARDIOLOGY, vol.12, no.2, pp.102-106, 2012 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 12 Issue: 2
  • Publication Date: 2012
  • Doi Number: 10.5152/akd.2012.034
  • Journal Name: ANATOLIAN JOURNAL OF CARDIOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.102-106
  • Karadeniz Technical University Affiliated: No

Abstract

Objective: The aim of our study was to determine the usefulness of the aortic knob width (AKW) in the assessment of subclinical atherosclerosis in hypertensive patients. Methods: In this study on diagnostic accuracy, 374 consecutive hypertensive patients with at least one cardiovascular risk factor were enrolled. AKW was measured on chest X-ray. Cardio-ankle vascular index (CAVI) was measured by VaSera-1000 CAVI instrument. The diagnostic value of AKW was assessed using ROC analysis. Results: There was a significant correlation between aortic knob width and CAVI (r=0.45, p<0.001), age (0.39, p<0.001), systolic (r=0.17, p<0.001), diastolic (r=0.23, p<0.001) and mean (r=0.2, p<0.001) blood pressures. In linear regression analysis CAVI (beta=0.3, 95% CI 0.33-0.98, p<0.001), age (beta=0.3, 95% CI 0.09 - 0.21, p<0.001) and diastolic blood pressure beta=0.2, 95% CI 0.08-1.9, p<0.001) were independently associated with AKW. It was significantly higher in patients with subclinical atherosclerosis (CAVI >= 9) than borderline (8 <= CAVI <9) (41.4 +/- 5.5 versus 36.7 +/- 5.3 mm, p<0.001) and healthy (CAVI <8) subjects (41.4 +/- 5.5 versus 35.5 +/- 4.3 mm, p<0.001). Analysis using the ROC curve has demonstrated that aortic knob of 41 mm constitutes the cut-off value for the presence of subclinical atherosclerosis with 71% sensitivity and 77% specificity (AUC-0.67, 95% CI 0.51-0.82). Conclusion: Observation of aortic knob on chest X-ray in hypertensive patients may provide important predictive information of subclinical atherosclerosis. (Anadolu Kardiyol Derg 2012; 12: 102-6)