Thijssen Carlijn G E, Mutluer Ferit O, van der Toorn Janine E, Bons Lidia R, Gökalp Arjen L, Takkenberg Johanna Jm, Mokhles Mostafa M, van Kimmenade Roland R J, Vernooij Meike W, van der Lugt Aad, Budde Ricardo P J, Roos-Hesselink Jolien W, Kavousi Maryam, Bos Daniel
Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
Cardiology, Radboudumc, Nijmegen, The Netherlands.
Heart. 2022 Apr 28. doi: 10.1136/heartjnl-2021-320574.
Longitudinal data on age-related changes in the diameters of the thoracic aorta are scarce. To better understand normal variation and to identify factors influencing this process, we aimed to report male-female-specific and age-specific aortic growth rate in the ageing general population and identify factors associated with growth rate.
From the prospective population-based Rotterdam Study, 943 participants (52.0% females, median age at baseline 65 years (62-68)) underwent serial non-enhanced cardiac CT. We measured the diameters of the ascending (AA) and descending aorta (DA) at two time points and expressed absolute and relative differences. Linear mixed effects analysis was performed to identify determinants associated with change in aortic diameters.
Mean AA diameter at baseline was 37.3±3.6 mm in male population and 34.7±3.2 mm in female population, mean DA diameter was 29.6±2.3 in male population and 26.9±2.2 mm in female population. The median absolute change in diameters during follow-up (mean scan interval 14.1±0.3 years) was 1 mm (0-2) for both the AA and DA. Absolute change per decade in AA diameter was significantly larger in males than in females (0.72 mm/decade (0.00-1.43) vs 0.70 mm/decade (0.00-1.41), p=0.006), as well as absolute change in AD diameter (0.71 mm/decade (0.00-1.42) vs 0.69 mm/decade (0.00-1.36), p=0.008). There was no significant difference between male and female population in relative change of their aortic diameters during follow-up. Age, male sex, higher body mass index (BMI) and higher diastolic blood pressure (DBP) showed a statistically significant independent association with increase in AA and DA diameters over time.
Some degree of increase in thoracic aortic diameters is typical in both men and women of an aging population. Factors associated with this change in thoracic aortic diameters were sex, age, BMI and DBP.
关于胸主动脉直径随年龄变化的纵向数据稀缺。为了更好地理解正常变异并确定影响这一过程的因素，我们旨在报告老年普通人群中男性和女性特定以及年龄特定的主动脉生长率，并确定与生长率相关的因素。
从基于人群的前瞻性鹿特丹研究中，943名参与者（52.0%为女性，基线时年龄中位数为65岁（62 - 68岁））接受了系列非增强心脏CT检查。我们在两个时间点测量了升主动脉（AA）和降主动脉（DA）的直径，并表示了绝对和相对差异。进行线性混合效应分析以确定与主动脉直径变化相关的决定因素。
男性人群基线时AA平均直径为37.3±3.6毫米，女性人群为34.7±3.2毫米；男性人群DA平均直径为29.6±2.3毫米，女性人群为26.9±2.2毫米。随访期间（平均扫描间隔14.1±0.3年）直径的中位数绝对变化，AA和DA均为1毫米（0 - 2）。AA直径每十年的绝对变化男性显著大于女性（0.72毫米/十年（0.00 - 1.43）对0.70毫米/十年（0.00 - 1.41），p = 0.006），DA直径的绝对变化也是如此（0.71毫米/十年（0.00 - 1.42）对0.69毫米/十年（0.00 - 1.36），p = 0.008）。随访期间男性和女性人群主动脉直径的相对变化没有显著差异。年龄、男性性别、较高的体重指数（BMI）和较高的舒张压（DBP）显示出与AA和DA直径随时间增加具有统计学意义的独立关联。
在老年人群中，男性和女性的胸主动脉直径都会有一定程度的增加。与胸主动脉直径这种变化相关的因素是性别、年龄、BMI和DBP。
