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CT characteristics and clinical implications of acute type A aortic intramural hematoma
OBJECTIVES: Computed tomography (CT) has been increasingly used in the diagnosis of acute aortic syndrome, and a number of high-risk CT imaging features have been reported. We aimed to identify CT imaging findings suggesting high-risk for acute aortic syndrome by examining clinical outcomes of patie...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868134/ https://www.ncbi.nlm.nih.gov/pubmed/36698923 http://dx.doi.org/10.3389/fcvm.2022.1041796 |
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author | Yen, Hsu-Ting Wu, Chia-Chen Lee, Yi-Wei Lo, Chien-Ming Chen, Yen-Yu |
author_facet | Yen, Hsu-Ting Wu, Chia-Chen Lee, Yi-Wei Lo, Chien-Ming Chen, Yen-Yu |
author_sort | Yen, Hsu-Ting |
collection | PubMed |
description | OBJECTIVES: Computed tomography (CT) has been increasingly used in the diagnosis of acute aortic syndrome, and a number of high-risk CT imaging features have been reported. We aimed to identify CT imaging findings suggesting high-risk for acute aortic syndrome by examining clinical outcomes of patients with acute type A aortic intramural hematoma (TAIMH). METHODS: This retrospective study analyzed the relationship of clinical patient characteristics and imaging features with mortality and aortic events in 63 patients receiving initial medical treatment for TAIMH. Multivariate regression analysis was used to determine the predictors of aortic events, and the Kaplan–Meier method was used to analyze survival and aortic events. RESULTS: During a median follow-up of 4.2 years, 25 patients experienced aortic events and 40% of these occurred within 7 days of admission. In total, 12 patients experienced aortic death and 12 patients underwent open aortic surgery or endovascular stenting for aortic disease. In multivariate regression analysis, penetrating atherosclerotic ulcers (PAUs) or ulcer-like projections (ULPs) (P = 0.04) and pericardial effusion (P = 0.03) were independent predictors of aortic events. In the Cox regression model, PAUs/ULPs (P = 0.04) and pericardial effusion (P = 0.04) were independently associated with lower aortic event-free survival. CONCLUSION: Identification of high-risk CT features is important for clinical decision-making during TAIMH treatment. Early and frequent CT imaging follow-up is required in patients receiving medical treatment. PAUs/ULP and pericardial effusion were the strongest predictors of adverse aortic events. |
format | Online Article Text |
id | pubmed-9868134 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-98681342023-01-24 CT characteristics and clinical implications of acute type A aortic intramural hematoma Yen, Hsu-Ting Wu, Chia-Chen Lee, Yi-Wei Lo, Chien-Ming Chen, Yen-Yu Front Cardiovasc Med Cardiovascular Medicine OBJECTIVES: Computed tomography (CT) has been increasingly used in the diagnosis of acute aortic syndrome, and a number of high-risk CT imaging features have been reported. We aimed to identify CT imaging findings suggesting high-risk for acute aortic syndrome by examining clinical outcomes of patients with acute type A aortic intramural hematoma (TAIMH). METHODS: This retrospective study analyzed the relationship of clinical patient characteristics and imaging features with mortality and aortic events in 63 patients receiving initial medical treatment for TAIMH. Multivariate regression analysis was used to determine the predictors of aortic events, and the Kaplan–Meier method was used to analyze survival and aortic events. RESULTS: During a median follow-up of 4.2 years, 25 patients experienced aortic events and 40% of these occurred within 7 days of admission. In total, 12 patients experienced aortic death and 12 patients underwent open aortic surgery or endovascular stenting for aortic disease. In multivariate regression analysis, penetrating atherosclerotic ulcers (PAUs) or ulcer-like projections (ULPs) (P = 0.04) and pericardial effusion (P = 0.03) were independent predictors of aortic events. In the Cox regression model, PAUs/ULPs (P = 0.04) and pericardial effusion (P = 0.04) were independently associated with lower aortic event-free survival. CONCLUSION: Identification of high-risk CT features is important for clinical decision-making during TAIMH treatment. Early and frequent CT imaging follow-up is required in patients receiving medical treatment. PAUs/ULP and pericardial effusion were the strongest predictors of adverse aortic events. Frontiers Media S.A. 2023-01-09 /pmc/articles/PMC9868134/ /pubmed/36698923 http://dx.doi.org/10.3389/fcvm.2022.1041796 Text en Copyright © 2023 Yen, Wu, Lee, Lo and Chen. https://creativecommons.org/licenses/by/4.0/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) and the copyright owner(s) 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. |
spellingShingle | Cardiovascular Medicine Yen, Hsu-Ting Wu, Chia-Chen Lee, Yi-Wei Lo, Chien-Ming Chen, Yen-Yu CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title | CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title_full | CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title_fullStr | CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title_full_unstemmed | CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title_short | CT characteristics and clinical implications of acute type A aortic intramural hematoma |
title_sort | ct characteristics and clinical implications of acute type a aortic intramural hematoma |
topic | Cardiovascular Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9868134/ https://www.ncbi.nlm.nih.gov/pubmed/36698923 http://dx.doi.org/10.3389/fcvm.2022.1041796 |
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