Department of Pathology and Bioresource Center for Geriatric Research, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Itabashi, Tokyo, Japan.
J Atheroscler Thromb. 2011;18(2):157-65. doi: 10.5551/jat.6528. Epub 2010 Nov 19.
Aortic dilatation is a well-known phenomenon in the elderly. We therefore aimed to study the pathobiological determinants of aortic dilatation.
Retrospective chart review. The subjects were 833 consecutive autopsy cases (616 men and 217 women) of community deaths. The age at death ranged from 20 to 94 years, with an average of 59.2 years. We measured the internal circumference of the aortic root, arch, descending portion, abdominal portion, and bifurcation in unfixed opened aorta at the time of autopsy.
The simple correlation between age and aortic circumference was strongest for the descending portion, followed by the arch, abdominal portion, root, and bifurcation. The simple correlation coefficient reached 0.836 for the descending portion (p < 0.001). The circumference of the descending portion increased significantly as the severity of aortic atherosclerosis increased (p for trend < 0.001). Multiple regression analysis showed that age, sex, and body height were significantly correlated with the aortic circumference at all five measurement sites, while severe atherosclerosis was correlated with the aortic circumference at the root, and descending and abdominal portions. Six contributing factors (age, sex, body height, smoking history, hypertension, and severe atherosclerosis) explained 68.5% of the variance in circumference in the descending portion; age explained 57.5%; sex 8.4%; body height 1%; and severe atherosclerosis 0.8%.
The contribution of atherosclerosis to aortic dilation was very weak, representing less than one seventieth of the contribution of age. The aortic circumference, especially in the descending portion, serves as an excellent age-related marker.
主动脉扩张是老年人中一种众所周知的现象。因此，我们旨在研究主动脉扩张的病理生物学决定因素。
回顾性图表审查。研究对象为社区死亡的 833 例连续尸检病例（616 名男性和 217 名女性），死亡年龄从 20 岁到 94 岁不等，平均年龄为 59.2 岁。我们在尸检时测量了未经固定的主动脉根部、弓部、降部、腹部和分叉处的内周长。
主动脉周长与年龄的简单相关性在降部最强，其次是弓部、腹部、根部和分叉部。降部的简单相关系数达到 0.836（p<0.001）。随着主动脉粥样硬化严重程度的增加，降部的周长显著增加（趋势 p<0.001）。多元回归分析表明，年龄、性别和身高与所有五个测量部位的主动脉周长显著相关，而严重的动脉粥样硬化与根部、降部和腹部的主动脉周长相关。六个影响因素（年龄、性别、身高、吸烟史、高血压和严重动脉粥样硬化）解释了降部周长变异的 68.5%；年龄解释了 57.5%；性别 8.4%；身高 1%；严重动脉粥样硬化 0.8%。
动脉粥样硬化对主动脉扩张的贡献非常微弱，不到年龄贡献的七十分之一。主动脉周长，特别是降部，是一个很好的与年龄相关的标志物。
