Vasculopathy in Turner Syndrome: Arterial Dilatation and Intimal Thickening without Endothelial Dysfunction

Context: Women with Turner syndrome (TS) have an increased cardiovascular mortality rate from both structural and ischemic heart disease, especially aortic dissection. Objective: We hypothesized that TS women have a fundamental arterial wall defect that may be due to genetic factors or estrogen deficiency. Design, Setting, and Patients: TS women (n = 93) were compared with normal controls (n = 25) and women with 46,XX primary amenorrhea (PA) (n = 11) with a similar history of estrogen deficiency. Clinical parameters, aortic root diameter, extraaortic arterial structure [common carotid (CD), brachial artery diameter, and carotid intima-media thickness (IMT)], arterial stiffness (pulse-wave velocity, augmentation index), and endothelial function (flow-mediated dilatation) were assessed. Main Outcome Measures: These included arterial diameters and vascular physiology parameters. Results: Differences in arterial structure were observed among TS, normal controls, and 46,XX PA women: IMT (0.61 ± 0.07 vs. 0.55 ±...