ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Atherosclerosis and Vascular Medicine
CTA Evaluation of Ascending and Descending Aortic Elasticity in Adults with Ascending Aortic Dilation
Jingdong Zhang
Tingting Zhang
Yuan Yuan
Department of Radiology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China, Beijing, China
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Abstract
Background: Ascending aortic dilation is a common cardiovascular condition linked to complications such as dissection and rupture. Aortic elasticity is critical for hemodynamic regulation, yet the extent of stiffness beyond the ascending aorta remains unclear. Objective: To evaluate ascending and descending aortic elasticity in adults with ascending aortic dilation using computed tomography angiography (CTA) and to explore determinants of regional and systemic vascular remodeling. Methods: We included 240 patients undergoing CTA between January and December 2023, categorized into an ascending aortic dilation group (n = 122) and a control group with normal ascending aorta (n = 118). Aortic compliance (AC), distensibility (AD), and stiffness index (β) were measured at multiple aortic landmarks. Statistical analyses included t-tests, chi-square tests, Pearson correlation, and multivariable linear regression adjusted for age, sex, hypertension, pulse pressure, heart rate, and BMI was performed to identify independent determinants of aortic elasticity. Results: The dilation group showed significantly lower AC (ascending: 1.63 vs 2.08 mm²/mmHg; descending: 0.57 vs 0.95 mm²/mmHg) and AD (ascending: 1.52 vs 3.03×10⁻³ mmHg⁻¹; descending: 1.35 vs 2.07×10⁻³ mmHg⁻¹) and higher β (ascending: 6.41 vs 3.97; descending: 6.33 vs 4.43) in both ascending and descending aorta compared with controls, indicating stiffness extends beyond the ascending segment. In controls, systolic blood pressure, pulse pressure, and age were independently associated with aortic elasticity, whereas in the dilation group, only pulse pressure and age remained significant. Measurements demonstrated excellent intra-and inter-observer reproducibility. Conclusion: Ascending aortic dilation is associated with systemic arterial stiffening affecting both ascending and descending aorta. CTA-based assessment of aortic elasticity provides a reliable non-invasive tool for detecting widespread vascular remodeling and may inform risk stratification and clinical management. Further prospective studies are warranted to validate these findings and investigate prognostic implications.
Summary
Keywords
Aortic elasticity, computed tomography angiography, ascending aortic dilation, Aortic distensibility, Cardiovascular Risk Assessment
Received
05 August 2025
Accepted
05 December 2025
Copyright
© 2025 Zhang, Zhang and Yuan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yuan Yuan
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