Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine, Chuo-ku, Sapporo, Japan.
Eur J Cardiothorac Surg. 2017 Dec 1;52(6):1118-1124. doi: 10.1093/ejcts/ezx191.
This study aimed to re-examine the conventional predictive factors for dissected aortic enlargement, such as the aortic and false lumen diameter and to consider whether the morphological elements of the dissected aorta could be predictors by quantifying the 'shape' of the true lumen based on elliptic Fourier analysis.
A total of 80 patients with uncomplicated type B aortic dissection were included. The patients were divided into 'Enlargement group' and 'No Change group.' Between the 2 groups, the mean systolic blood pressure during follow-up, aortic and false lumen maximum diameters, and analysed morphological data were compared using each statistical method.
The maximum aortic and false lumen diameters were significantly larger in the Enlargement group than in the No Change group (39.3 vs 35.9 mm; P = 0.0058) (23.5 vs 18.2 mm; P = 0.000095). The principal component 1, which is the data calculated by elliptic Fourier analysis, was significantly lower in the Enlargement group than in the No Change group (0.020 vs - 0.072; P = 0.000049). The mean systolic blood pressure ≥130 mmHg, aortic diameter, false lumen diameter and principal component 1 were included in the Cox proportional hazard model as covariates to determine the significant predictive variable. Principal component 1 demonstrated the only significance with aortic enlargement on multivariate analysis (odds ratio = 0.32; P = 0.048).
The analysed and calculated morphological data of the shape of the true lumen can be more effective predictive factors of aortic enlargement of type B dissection than the conventional factors.
本研究旨在重新检查传统的主动脉夹层扩大预测因素,如主动脉和假腔直径,并通过基于椭圆傅里叶分析量化真腔的“形状”,考虑主动脉夹层的形态学要素是否可以作为预测因子。
共纳入 80 例单纯性 B 型主动脉夹层患者。将患者分为“扩大组”和“无变化组”。通过比较各组之间的随访期间平均收缩压、主动脉和假腔最大直径以及分析的形态学数据,采用每种统计学方法进行比较。
扩大组的最大主动脉和假腔直径明显大于无变化组(39.3 与 35.9mm;P=0.0058)(23.5 与 18.2mm;P=0.000095)。在扩大组中,第一主成分(通过椭圆傅里叶分析计算的数据)明显低于无变化组(0.020 与-0.072;P=0.000049)。将平均收缩压≥130mmHg、主动脉直径、假腔直径和第一主成分作为协变量纳入 Cox 比例风险模型,以确定显著的预测变量。在多变量分析中,只有第一主成分与主动脉扩大具有显著相关性(比值比=0.32;P=0.048)。
与传统因素相比,分析和计算真腔形状的形态学数据可以成为 B 型主动脉夹层扩大的更有效预测因素。