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经胸超声心动图在腹部主动脉瘤机会性筛查中的评价。

Appraisal of transthoracic echocardiography for opportunistic screening of abdominal aortic aneurysm.

机构信息

Department of Cardiology, University of Health Sciences, Ankara City Hospital.

Department of Cardiology, TOBB Economics and Technology University Medical School, Ankara, Turkey.

出版信息

Medicine (Baltimore). 2021 Jun 4;100(22):e26171. doi: 10.1097/MD.0000000000026171.

Abstract

Abdominal aortic aneurysm is a life threatening disease. Most of the patients diagnosed incidentally because of the asymptomatic nature of this disease. This study aimed to determine the frequency of abdominal aortic aneurysm and evaluate the value of opportunistic screening during transthoracic echocardiography.A total of 5138 patients referred for echocardiographic evaluation for any reason were screened for abdominal aortic aneurysm between November 2014 to July 2019. The aneurysm was defined as an abdominal aorta with a diameter greater than 30 mm, or segmental dilatation of more than 50% of its size in non-dilated parts.The overall frequency of abdominal aortic aneurysm was 2.2% (n = 109) in the study population. Male sex (P < .001), older age (P < .001), presence of diastolic dysfunction (P = .036), hypertension (P < .001), coronary artery disease (P < .001), and hyperlipidemia (P < .001) were associated with abdominal aortic aneurysm. Patients with aneurysm had significantly increased diameters of the aortic trunk (P < .001) and ascending aorta (P < .001), significantly thicker interventricular septum (P < .001) and posterior wall (P < .001), significantly increased end-diastolic diameter (P < .001) and enlarged left atrium (P < .001), and significantly decreased ejection fraction (P < .001). The mostly met criteria for screening abdominal aortic aneurysm in international guidelines was the age of the patients.Based on the results of this study, screening patients over 60 years of age who undergo a transthoracic echocardiography for any reason would be beneficial to detect an asymptomatic abdominal aortic aneurysm in Turkish population.

摘要

腹主动脉瘤是一种危及生命的疾病。大多数患者因该疾病无症状而偶然诊断。本研究旨在确定腹主动脉瘤的频率,并评估经胸超声心动图检查中机会性筛查的价值。

2014 年 11 月至 2019 年 7 月,共有 5138 例因任何原因接受超声心动图评估的患者被筛查出腹主动脉瘤。定义为腹主动脉直径大于 30mm,或非扩张部分直径扩张超过 50%。

在研究人群中,腹主动脉瘤的总体频率为 2.2%(n=109)。男性(P<0.001)、年龄较大(P<0.001)、存在舒张功能障碍(P=0.036)、高血压(P<0.001)、冠心病(P<0.001)和高脂血症(P<0.001)与腹主动脉瘤相关。有动脉瘤的患者主动脉干(P<0.001)和升主动脉(P<0.001)直径明显增大,室间隔(P<0.001)和后壁(P<0.001)明显增厚,舒张末期直径明显增大(P<0.001),左心房明显增大(P<0.001),射血分数明显降低(P<0.001)。国际指南中筛查腹主动脉瘤的最主要标准是患者的年龄。

基于本研究结果,对任何原因接受经胸超声心动图检查的 60 岁以上患者进行筛查,将有利于在土耳其人群中发现无症状的腹主动脉瘤。

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