title: Patient demographics and cardiovascular risk factors differentially influence geometric remodeling of the aorta compared with the peripheral arteries.
abstract: BACKGROUND
  Detailed knowledge of the dimensions and shape of the main arteries of the body and how they change with age and disease is important for understanding arterial pathophysiology and improving minimally invasive devices to treat arterial diseases. Our goal was to describe and compare geometric remodeling of the aorta and peripheral arteries in the context of patient demographics and cardiovascular risk factors.
  
  
  METHODS
  Three-dimensional reconstructions of computed tomography angiography scans were performed in 122 subjects 5-93 years of age (mean 47 ± 24 years, 64 M/58 F). Best-fit arterial diameters, lengths, and tortuosity for the principle named arteries in the chest, abdomen, pelvis, and upper thigh were measured, and multiple linear regression analysis was performed to examine how these morphologic parameters associate with patient demographics and risk factors.
  
  
  RESULTS
  Large elastic arteries increased their diameter, length, and tortuosity with age, whereas muscular arteries primarily became more tortuous. Demographics and risk factors explained >70% of the variation in diameters of the abdominal aorta, paravisceral aorta, and the aortic arch; and >75% of variation in tortuosity from the profunda femoris to the brachiocephalic artery. Male sex, larger body mass index, and hypertension contributed to larger diameters, whereas the presence of diabetes was associated with somewhat-straighter arteries. Overall, the effects of cardiovascular risk factors on geometric remodeling were small compared with those of demographics.
  
  
  CONCLUSIONS
  The geometry of the vascular tree is greatly affected by aging, demographics, and some risk factors. Elastic and muscular arteries remodel differently, possibly as the result of differences in their microstructure.
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Alexey
authors.initials: A
authors.lastname: Kamenskiy
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Miserlis
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Peter
authors.initials: P
authors.lastname: Adamson
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Micah
authors.initials: M
authors.lastname: Adamson
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Thomas
authors.initials: T
authors.lastname: Knowles
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Jamil
authors.initials: J
authors.lastname: Neme
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Koutakis
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Phillips
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Iraklis
authors.initials: I
authors.lastname: Pipinos
authors.affiliation: Department of Surgery, University of Nebraska Medical Center, Omaha, NE.
authors.forename: Jason
authors.initials: J
authors.lastname: MacTaggart
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D000792:Angiography; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D003710:Demography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000473:pathology*; D012307:Risk Factors; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D066253:Vascular Remodeling; D055815:Young Adult