Abnormal aortic arch morphology in Turner syndrome patients is a risk factor for hypertension
Abstract
Hypertension in Turner syndrome (TS) is a multifactorial, highly prevalent and significant problem that warrants timely diagnosis and rigorous treatment. The objective of this study was to investigate the association between abnormal aortic arch morphology and hypertension in adult TS patients. This was a single centre retrospective study in 74 adult TS patients (age 29.41 ± 8.91 years) who underwent a routine cardiac MRI. Patients were assigned to the hypertensive group (N = 31) if blood pressure exceeded 140/90 mmHg and/or if they were treated with antihypertensive medication. Aortic arch morphology was evaluated on MRI images and initially assigned as normal (N = 54) or abnormal (N = 20), based on the curve of the transverse arch and the distance between the left common carotid-left subclavian artery. We additionally used a new more objective method to describe aortic arch abnormality in TS by determination of the relative position of the highest point of the transverse arch (AoHP). Logistic regression analysis showed that hypertension is significantly and independently associated with age, BMI and abnormal arch morphology, with a larger effect size for the new AoHP method than for the classical method. TS patients with hypertension and abnormal arch morphology more often had dilatation of the ascending aorta. There is a significant association between abnormal arch morphology and hypertension in TS patients, independent of age and BMI, and not related to other structural heart disease. We suggest that aortic arch morphology should be included in the risk stratification for hypertension in TS and propose a new quantitative method to express aortic arch morphology.
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CMR is superior to TTE for the diagnosis of BAV, aortic dilation and aortic arch anomalies while also providing important data on shunt fractions and ventricular volumes.
“CMR is also superior to TTE for the diagnosis of BAV, aortic dilation and aortic arch anomalies395,429-433 while also providing important data on shunt fractions and ventricular volumes that may inform clinical management.388”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [433]
The intrinsic shape of the aorta in individuals with TS who do not have coarctation may contribute to the etiology of hypertension and can become more accentuated over time as the aorta elongates.
“The intrinsic shape of the aorta in individuals with TS who do not have coarctation may also contribute to the etiology of hypertension and can become more accentuated over time as the aorta elongates.433”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [433]
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- Authors
- De Groote, K., Devos, D., Van Herck, K., Demulier, L., Buysse, W., De Schepper, J., & De Wolf, D.
- Affiliations
- Ghent University Hospital (BE)
- ORCID
- Demulier, Laurent
- Venue
- Heart and Vessels
- Published
- 2014-06-17
- Volume
- 30
- Issue
- 5
- Pages
- 618-625
- ISSN
- 0910-8327 (ISSN-L)
- 1615-2573
- OpenAlex
- W2170804248
- Cited by
- 30
- References
- 28
- Citations by year
- 2024: 3 · 2023: 4 · 2022: 2 · 2021: 2 · 2020: 2 · 2019: 5 · 2018: 6 · 2017: 1 · 2016: 4 · 2015: 1
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Heart and Vessels (publishedVersion)
- PubMed (publishedVersion)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Clinical Aspects of Sex Determination and Chromosomal Abnormalities
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Aortic Disease and Treatment Approaches
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Keywords
- Turner syndrome, hypertension, aortic arch morphology, hypertension risk factors, ascending aortic dilatation, cardiac MRI, risk stratification
- MeSH terms
- Adult, Aorta, Thoracic, Blood Pressure, Female, Humans, Hypertension, Male, Retrospective Studies, Risk Factors, Turner Syndrome, Magnetic Resonance Imaging, Cine, Vascular Malformations
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