Population-Based Risk Factors for Ascending, Arch, Descending, and Abdominal Aortic Dilations for 60-74–Year-Old Individuals

Obel, Lasse M; Diederichsen, Axel Cosmus Pyndt; Steffensen, Flemming Hald; Frost, Lars; Lambrechtsen, Jess; Busk, Martin; Urbonavičienė, Gražina; Egstrup, Kenneth; Karon, Marek; Rasmussen, Lars Melholt; Gerke, Oke; Bøvling, Anders Sarkisian; Lindholt, Jes Sanddal

doi:10.1016/j.jacc.2021.04.094

Cited by 51 publications

(33 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…14 This strategy is further substantiated by a recent study among people without HIV showing that a strong predictor of having aortic dilation at any level is the presence of dilation elsewhere. 15 …”

Section: Discussionmentioning

confidence: 99%

Association of HIV Serostatus and Inflammation With Ascending Aortic Size

Minhas

Post

Liu

et al. 2022

JAHA

View full text Add to dashboard Cite

Background The prevalence and extent of subclinical large vessel vasculopathy is not well defined among people living with HIV. We aimed to evaluate associations between aortic root and ascending aortic sizes measured by 2‐dimensional transthoracic echocardiography and HIV serostatus, and to identify risk factors for larger aortic sizes among men with HIV, including levels of circulating inflammatory markers. Methods and Results Using clinical and echocardiographic data from the MACS (Multicenter AIDS Cohort Study), adjusted multivariable linear and logistic regression was performed. Four segments of the proximal aorta were measured: aortic annulus, aortic root at the sinuses of Valsalva, sinotubular junction, and ascending aorta. HIV infection was associated with significantly larger aortic root (0.03 cm [95% CI, 0.002–0.06 cm]) and ascending aorta (0.04 cm [95% CI, 0.01–0.06 cm]) diameters. Higher standardized nadir CD4 (cluster of differentiation 4) T‐cell count was significantly associated with smaller aortic root (−0.03 cm [95% CI, −0.05 to −0.01 cm]), sinotubular junction (−0.03 cm [95% CI, −0.05 to −0.01 cm]), and ascending aorta (−0.03 cm [95% CI, −0.05 to −0.004 cm]) diameters. Higher levels of standardized TNF‐α (tumor necrosis factor‐α) were associated with larger diameters of the aortic annulus (0.02 cm [95% CI, 0.003–0.04 cm]) and sinotubular junction (0.02 cm [95% CI, 0.002–0.04 cm]). There were no other cardiovascular or HIV disease severity–related risk factors associated with the aortic dimensions. Conclusions HIV infection is an independent risk factor for greater ascending aortic sizes. Lower nadir CD4 T‐cell count and higher TNF‐α levels are associated with larger aortic sizes in men with HIV. Registration URL: https://www.clinicaltrials.gov ; Unique identifier: NCT00046280.

show abstract

Section: Discussionmentioning

confidence: 99%

Association of HIV Serostatus and Inflammation With Ascending Aortic Size

Minhas

Post

Liu

et al. 2022

JAHA

View full text Add to dashboard Cite

show abstract

“…Risk factors for aortic dilatation in general may include hypertension, male sex, family history of aortic aneurysm, and atrial fibrillation; in contrast, diabetes, smoking and coronary artery disease are more controversial risk factors for dilatation of the ascending aorta per se [ 16 ]. In our study, hypertension and aortic wall degeneration, were statistically more frequent in TAV patients than in those with BAV.…”

Section: Discussionmentioning

confidence: 99%

Ascending aortic wall degeneration in patients with bicuspid versus tricuspid aortic valve

Mennander

Kholová

Pelttari

et al. 2022

J Cardiothorac Surg

View full text Add to dashboard Cite

Background The magnitude of ascending aortic degeneration in patients with bicuspid aortic valves (BAV) is controversial. Methods The aim of this study was to investigate ascending aortic wall degeneration in patients with BAV as compared with tricuspid aortic valves (TAV). The ascending aortic wall of 67 consecutive patients was processed for histology and immunohistochemistry. The extent of surgery and wall degeneration were investigated. Unadjusted survival was evaluated by Kaplan–Meier analysis. Median follow-up for patients with BAV and TAV was 3.8 years (interquartile range [IQR] 3.5–4.1) and 3.7 years (IQR 3.4–3.9), respectively. Results There were 33 patients with BAV and 34 with TAV. Mid-ascending aorta diameter was 54 mm (IQR 50–60). Replacement of the aortic valve, together with an ascending aortic prosthesis, was more frequent in BAV vs TAV patients (24% vs. 3%, P = 0.013). However, medial fibrosis, elastic fiber thinning, incremental medial degeneration and smooth muscle cell nuclei loss were less prominent in BAV vs TAV patients (0.1 ± 0.4 vs. 0.8 ± 1.4, P = 0.016; 0.6 ± 1.4 vs. 1.6 ± 2.0, P = 0.027; 1.7 ± 0.7 vs. 2.2 ± 0.8, P = 0.045 and 2.3 ± 1.5 vs. 3.2 ± 1.3, P = 0.026, respectively). Conclusions Since degeneration of the ascending aortic wall was seldom prominent, histopathology alone may not support the need for surgery of the dilated ascending aorta in BAV patients as compared with TAV patients.

show abstract

“…Several genetic, inflammatory, anatomic (bicuspid aortic valve is an independent risk factor for TAA formation), drug-abuse, and medical-clinical conditions (e.g., hypertension) may be associated with TAA [ 102 ]. Aneurysms are largely asymptomatic prior to complications, and treatment of stable disease has better outcomes that treatment of acute presentation.…”

Section: Unstable and Impending Rupture Of Thoracic Aorta Aneurysm (Taa)mentioning

confidence: 99%

MDCT Imaging of Non-Traumatic Thoracic Aortic Emergencies and Its Impact on Diagnosis and Management—A Reappraisal

et al. 2022

View full text Add to dashboard Cite

Non-traumatic thoracic aorta emergencies are associated with significant morbidity and mortality. Diseases of the intimomedial layers (aortic dissection and variants) have been grouped under the common term of acute aortic syndrome because they are life-threatening conditions clinically indistinguishable on presentation. Patients with aortic dissection may present with a wide variety of symptoms secondary to the pattern of dissection and end organ malperfusion. Other conditions may be seen in patients with acute symptoms, including ruptured and unstable thoracic aortic aneurysm, iatrogenic or infective pseudoaneurysms, aortic fistula, acute aortic thrombus/occlusive disease, and vasculitis. Imaging plays a pivotal role in the patient’s management and care. In the emergency room, chest X-ray is the initial imaging test offering a screening evaluation for alternative common differential diagnoses and a preliminary assessment of the mediastinal dimensions. State-of-the-art multidetector computed tomography angiography (CTA) provides a widely available, rapid, replicable, noninvasive diagnostic imaging with sensitivity approaching 100%. It is an impressive tool in decision-making process with a deep impact on treatment including endovascular or open surgical or conservative treatment. Radiologists must be familiar with the spectrum of these entities to help triage patients appropriately and efficiently. Understanding the imaging findings and proper measurement techniques allow the radiologist to suggest the most appropriate next management step.

show abstract

Population-Based Risk Factors for Ascending, Arch, Descending, and Abdominal Aortic Dilations for 60-74–Year-Old Individuals

Cited by 51 publications

References 25 publications

Association of HIV Serostatus and Inflammation With Ascending Aortic Size

Association of HIV Serostatus and Inflammation With Ascending Aortic Size

Ascending aortic wall degeneration in patients with bicuspid versus tricuspid aortic valve

MDCT Imaging of Non-Traumatic Thoracic Aortic Emergencies and Its Impact on Diagnosis and Management—A Reappraisal

Contact Info

Product

Resources

About