Division of Vascular Medicine, Department of Aortic Surgery, Kawasaki Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
Department of Aortic Surgery, Kawasaki Aortic Center, Kawasaki Saiwai Hospital, Kawasaki, Kanagawa, Japan.
Ann Thorac Cardiovasc Surg. 2021 Apr 20;27(2):119-125. doi: 10.5761/atcs.oa.20-00137. Epub 2020 Nov 3.
Several factors determining differences between types A and B aortic dissection (AD) have been reported; however, little data exist examining their differences in left ventricular hypertrophy (LVH). We compared the prevalence of LVH in patients with types A and B AD.
We retrospectively analyzed 334 patients with acute AD (227 type A; 107 type B). Concentric hypertrophy (CH; increased left ventricular mass index [LVMI] and relative wall thickness [RWT]) is one of four types of left ventricular (LV) geometry thought to be most associated with hypertension. We compared LVMI and the prevalence of CH in patients with types A or B AD. Multivariate logistic regression analyses of variables associated with type B AD were performed.
Comparing type A and B AD, LVMI (95 ± 26 vs.107 ± 28, p <0.001) and prevalence of CH (26% vs. 44%, p = 0.001) were higher in type B AD. In multivariate analysis, CH was an independent factor associated with type B AD (odds ratio: 2.62, confidence interval: 1.54-4.47, p <0.001).
Our data suggested LVH was more prevalent in type B than in type A AD. Considering LVH usually results from hypertension, patients with type B AD may be more affected by hypertension than those with type A.
已有报道指出，多种因素可导致 A 型和 B 型主动脉夹层（AD）之间存在差异；然而，关于其左心室肥厚（LVH）差异的数据较少。我们比较了 A 型和 B 型 AD 患者 LVH 的患病率。
我们回顾性分析了 334 例急性 AD 患者（227 例 A 型；107 例 B 型）。同心性肥厚（CH；左心室质量指数[LVMI]和相对室壁厚度[RWT]增加）是与高血压关系最密切的四种左心室（LV）几何形状之一。我们比较了 A 型或 B 型 AD 患者的 LVMI 和 CH 的患病率。对与 B 型 AD 相关的变量进行多变量逻辑回归分析。
与 A 型 AD 相比，B 型 AD 的 LVMI（95±26 比 107±28，p<0.001）和 CH 患病率（26%比 44%，p=0.001）更高。多变量分析显示，CH 是与 B 型 AD 相关的独立因素（比值比：2.62，95%置信区间：1.54-4.47，p<0.001）。
我们的数据表明，B 型 AD 患者的 LVH 比 A 型 AD 患者更常见。鉴于 LVH 通常由高血压引起，B 型 AD 患者可能比 A 型 AD 患者受高血压的影响更大。
