Department of Clinical Radiology, Kuopio University Hospital, Clinical Imaging Center, Finland.
Department of Cardiothoracic Surgery, Heart Center, Kuopio University Hospital, Kuopio, Finland.
Eur J Radiol. 2022 May;150:110234. doi: 10.1016/j.ejrad.2022.110234. Epub 2022 Mar 11.
To explore the risk factors, growth rate and outcomes of ascending aortic (AA) dilatation in patients scheduled for imaging follow-up.
This retrospective study included 143 patients who were followed-up with thoracic aortic CT-angiography. AA diameters were measured from aortic root (sinus Valsalva) and mid-AA at the baseline and after long-term follow-up. Risk factors and clinical outcomes were collected from medical records. The standard error of measurement (SEM) method was used to assess the statistical significance of the growth rate of AA dilatation.
The patients' mean age was 64.0 ± 10.0 years (males n = 115, 80.4%). The mean imaging follow-up time was 3.4 ± 1.6 years and 5.7 ± 1.7 years in the clinical follow-up. According to the SEM method, 37.8% of the patients (n = 54) experienced significant AA growth; 18.9% (n = 27) in the aortic root (0.5 ± 0.7 mm/year), and 24.5% (n = 35) in the mid-AA (0.4 ± 0.5 mm/year). None of the patients experienced aortic rupture or dissection or died due to aortic reasons during the follow-up. Eighteen patients (12.6%) underwent elective surgical AA reconstruction and 10 patients (7.0%) died due to some other reason. Male gender was the only factor to associate with significant accelerated growth (p = 0.047). However, antihypertensive medication did seem to be a protective factor (p = 0.01).
Less than half of the patients followed due to AA dilatation displayed significant AA growth during the long-term follow-up. In addition, the growth rate per year was small. None of the patients experienced any aortic catastrophes indicating that the prognosis of patients participating in regular imaging follow-up is good.
探讨接受影像学随访的患者升主动脉（AA）扩张的危险因素、生长速度和结局。
本回顾性研究纳入了 143 名接受胸主动脉 CT 血管造影随访的患者。从主动脉根部（瓦尔萨尔瓦窦）和 AA 中段在基线和长期随访时测量 AA 直径。从病历中收集危险因素和临床结局。采用标准误差（SEM）法评估 AA 扩张生长速度的统计学意义。
患者的平均年龄为 64.0±10.0 岁（男性 n=115，80.4%）。影像学随访时间平均为 3.4±1.6 年，临床随访时间平均为 5.7±1.7 年。根据 SEM 法，37.8%（n=54）的患者出现明显的 AA 生长；主动脉根部（0.5±0.7mm/年）和 AA 中段（0.4±0.5mm/年）分别为 18.9%（n=27）和 24.5%（n=35）。随访期间无患者发生主动脉破裂或夹层，也无患者因主动脉原因死亡。18 名患者（12.6%）接受了择期 AA 重建手术，10 名患者（7.0%）因其他原因死亡。男性是与明显加速生长相关的唯一因素（p=0.047）。然而，降压药物似乎是一个保护因素（p=0.01）。
不到一半的因 AA 扩张而接受随访的患者在长期随访中显示出明显的 AA 生长。此外，每年的生长速度较小。没有患者发生任何主动脉灾难，这表明定期接受影像学随访的患者预后良好。
