Ascending Aortic Length and Its Association With Type A Aortic Dissection

BACKGROUND: The aim of this study was to determine the role of ascending aortic length and diameter in type A aortic dissection. METHODS AND RESULTS: Computed tomography scans from patients with acute type A dissections (n=51), patients with proximal thoracic aortic aneurysms (n=121), and controls w...

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Autores principales: Eliathamby, Daniella, Gutierrez, Mariana, Liu, Aileen, Ouzounian, Maral, Forbes, Thomas L., Tan, Kong Teng, Chung, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403277/
https://www.ncbi.nlm.nih.gov/pubmed/34121418
http://dx.doi.org/10.1161/JAHA.120.020140
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author Eliathamby, Daniella
Gutierrez, Mariana
Liu, Aileen
Ouzounian, Maral
Forbes, Thomas L.
Tan, Kong Teng
Chung, Jennifer
author_facet Eliathamby, Daniella
Gutierrez, Mariana
Liu, Aileen
Ouzounian, Maral
Forbes, Thomas L.
Tan, Kong Teng
Chung, Jennifer
author_sort Eliathamby, Daniella
collection PubMed
description BACKGROUND: The aim of this study was to determine the role of ascending aortic length and diameter in type A aortic dissection. METHODS AND RESULTS: Computed tomography scans from patients with acute type A dissections (n=51), patients with proximal thoracic aortic aneurysms (n=121), and controls with normal aortas (n=200) were analyzed from aortic annulus to the innominate artery using multiplanar reconstruction. In the control group, ascending aortic length correlated with diameter (r (2)=0.35, P<0.001), age (r (2)=0.17, P<0.001), and sex (P<0.001). As a result of immediate changes in aortic morphology at the time of acute dissection, predissection lengths and diameters were estimated based on models from published literature. Ascending aortic length was longer in patients immediately following acute dissection (median, 109.7 mm; interquartile range [IQR], 101.0–115.1 mm), patients in the estimated predissection group (median, 104.2 mm; IQR, 96.0–109.3 mm), and patients in the aneurysm group (median, 107.0 mm; IQR, 99.6–118.7 mm) in comparison to controls (median, 83.2 mm; IQR, 74.5–90.7 mm) (P<0.001 all comparisons). The diameter of the ascending aorta was largest in the aneurysm group (median, 52.0 mm; IQR, 45.9–58.0 mm), followed by the dissection group (median, 50.3 mm; IQR, 46.6–57.5 mm), and not significantly different between controls and the estimated predissection group (median, 33.4 mm [IQR, 30.7–36.7 mm] versus 35.2 mm [IQR, 32.6–40.3 mm], P=0.09). After adjustment for diameter, age, and sex, the estimated predissection aortic lengths were 16 mm longer than those in the controls and 12 mm longer than in patients with nondissected thoracic aneurysms. CONCLUSIONS: The length of the ascending aorta, after adjustment for age, sex, and aortic diameter, may be useful in discriminating patients with type A dissection from normal controls and patients with nondissected thoracic aneurysms.
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spelling pubmed-84032772021-09-03 Ascending Aortic Length and Its Association With Type A Aortic Dissection Eliathamby, Daniella Gutierrez, Mariana Liu, Aileen Ouzounian, Maral Forbes, Thomas L. Tan, Kong Teng Chung, Jennifer J Am Heart Assoc Original Research BACKGROUND: The aim of this study was to determine the role of ascending aortic length and diameter in type A aortic dissection. METHODS AND RESULTS: Computed tomography scans from patients with acute type A dissections (n=51), patients with proximal thoracic aortic aneurysms (n=121), and controls with normal aortas (n=200) were analyzed from aortic annulus to the innominate artery using multiplanar reconstruction. In the control group, ascending aortic length correlated with diameter (r (2)=0.35, P<0.001), age (r (2)=0.17, P<0.001), and sex (P<0.001). As a result of immediate changes in aortic morphology at the time of acute dissection, predissection lengths and diameters were estimated based on models from published literature. Ascending aortic length was longer in patients immediately following acute dissection (median, 109.7 mm; interquartile range [IQR], 101.0–115.1 mm), patients in the estimated predissection group (median, 104.2 mm; IQR, 96.0–109.3 mm), and patients in the aneurysm group (median, 107.0 mm; IQR, 99.6–118.7 mm) in comparison to controls (median, 83.2 mm; IQR, 74.5–90.7 mm) (P<0.001 all comparisons). The diameter of the ascending aorta was largest in the aneurysm group (median, 52.0 mm; IQR, 45.9–58.0 mm), followed by the dissection group (median, 50.3 mm; IQR, 46.6–57.5 mm), and not significantly different between controls and the estimated predissection group (median, 33.4 mm [IQR, 30.7–36.7 mm] versus 35.2 mm [IQR, 32.6–40.3 mm], P=0.09). After adjustment for diameter, age, and sex, the estimated predissection aortic lengths were 16 mm longer than those in the controls and 12 mm longer than in patients with nondissected thoracic aneurysms. CONCLUSIONS: The length of the ascending aorta, after adjustment for age, sex, and aortic diameter, may be useful in discriminating patients with type A dissection from normal controls and patients with nondissected thoracic aneurysms. John Wiley and Sons Inc. 2021-06-14 /pmc/articles/PMC8403277/ /pubmed/34121418 http://dx.doi.org/10.1161/JAHA.120.020140 Text en © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Eliathamby, Daniella
Gutierrez, Mariana
Liu, Aileen
Ouzounian, Maral
Forbes, Thomas L.
Tan, Kong Teng
Chung, Jennifer
Ascending Aortic Length and Its Association With Type A Aortic Dissection
title Ascending Aortic Length and Its Association With Type A Aortic Dissection
title_full Ascending Aortic Length and Its Association With Type A Aortic Dissection
title_fullStr Ascending Aortic Length and Its Association With Type A Aortic Dissection
title_full_unstemmed Ascending Aortic Length and Its Association With Type A Aortic Dissection
title_short Ascending Aortic Length and Its Association With Type A Aortic Dissection
title_sort ascending aortic length and its association with type a aortic dissection
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8403277/
https://www.ncbi.nlm.nih.gov/pubmed/34121418
http://dx.doi.org/10.1161/JAHA.120.020140
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