title: 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.
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics, Ghent University Hospital, De Pintelaan 185, 3K12D, Administratie pediatrie, B-9000, Ghent, Belgium. katya.degroote@uzgent.be.
authors.forename: Katya
authors.initials: K
authors.lastname: De Groote
authors.affiliation: Cardiovascular Magnetic Resonance, Department of Radiology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Daniël
authors.initials: D
authors.lastname: Devos
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Van Herck
authors.affiliation: Department of Cardiology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Laurent
authors.initials: L
authors.lastname: Demulier
authors.affiliation: Department of Paediatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: Wesley
authors.initials: W
authors.lastname: Buysse
authors.affiliation: Division of Paediatric Endocrinology, Department of Paediatrics, Ghent University Hospital, Ghent, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: De Schepper
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics, Ghent University Hospital, De Pintelaan 185, 3K12D, Administratie pediatrie, B-9000, Ghent, Belgium.
authors.forename: Daniël
authors.initials: D
authors.lastname: De Wolf
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000002:abnormalities*; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014424:Turner Syndrome / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D054079:Vascular Malformations / Q000150:complications* / Q000175:diagnosis
keywords: Aortic arch; Ascending aorta; Hypertension; Risk stratification; Turner syndrome