The relationship between abdominal aortic aneurysm wall compliance, maximum diameter and growth rate

Aim: Aortic compliance as measured by the pressure-strain elastic modulus (Ep) and stiffness (beta) may allow a more precise estimate of rupture risk The aim of this study was to determine the relationships between compliance, maximal aneurysm diameter and growth rate. Methods: Sixty abdominal aortic aneurysm patients of median age 73 years, were studied. Growth rate was derived from repeat ultrasound scans obtained over a median period of 21 months (range 6-48), At the end of follow-up, patients underwent measurement of maximum aortic diameter, Ep and beta using the Diamove echo-tracking system. Results: Growth rate correlated positively (r = 0.6, P < 0.01) with maximum diameter on entry to the study There was a positive correlation between mean arterial pressure and Ep (r = 0.3, P = 0.03), but not between mean arterial pressure and beta (r = 0.8, P = 0.61). A positive correlation was found between final maximum diameter and Ep (r = 0.22, P = 0.04) but not beta (r = 0.16, P = 0.11). There was no significant relationship between growth rate and Ep or beta. Conclusion: Large aneurysms tended to be less compliant. Within a population of abdominal aortic aneurysm of similar maximum diameter there was a 10-fold variation in Ep and beta. Compliance and growth rate were not related. If aortic compliance is related to risk of rupture then this predictive information is likely to be largely independent of that currently obtained from size and growth rate. (C) 1999 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.