Xiao Hui-Jun, Zhan A-Lai, Huang Qing-Wen, Huang Rui-Gang, Lin Wei-Hua
Department of Radiology, Zhangzhou Affiliated Hospital of Fujian Medical University, Zhangzhou, China.
Front Cardiovasc Med. 2023 Jan 9;9:1034334. doi: 10.3389/fcvm.2022.1034334. eCollection 2022.
To assess aortic dilatation and determine its related factors in infants with coarctation of the aorta (CoA) by using computed tomography angiography (CTA).
The clinical data of 55 infantile patients with CoA diagnosed by CTA were analyzed retrospectively. Aortic diameters were measured at six different levels and standardized as Z scores based on the square root of body surface area. The results of simple and complex CoA were compared. Univariate and multivariate logistic regression were used to analyze the effects of sex, age, hypertension, degree of coarctation, CoA type, bicuspid aortic valve (BAV), and other factors related to aortic dilatation.
In total, 52 infant patients with CoA were analyzed, including 22 cases of simple CoA and 30 cases of complex CoA. The ascending aorta of the infants in the simple CoA group and the complex CoA group were dilated to different degrees, but the difference was not statistically significant (50.00% vs. 73.33%, = 0.084, and 2.05 ± 0.40 vs. 2.22 ± 0.43 = 0.143). The infants in the complex CoA group had more aortic arch hypoplasia than those in the simple CoA group (33.33% vs. 9.09%, = 0.042). Compared to the ventricular septal defect (VSD) group, the Z score of the ascending aorta in the CoA group was significantly higher than that in the VSD group ( = 0.023 and = 0.000). A logistic retrospective analysis found that an increased degree of coarctation (CDR value) was an independent predictor of ascending aortic dilatation (adjusted OR = 0.002; = 0.034).
Infants with simple or complex CoA are at risk of ascending aortic dilatation, and the factors of ascending aortic dilatation depend on the degree of coarctation. The risk of aortic dilatation in infants with CoA can be identified by CTA.
采用计算机断层血管造影(CTA)评估主动脉缩窄(CoA)患儿的主动脉扩张情况并确定其相关因素。
回顾性分析55例经CTA诊断为CoA的婴儿患者的临床资料。在六个不同水平测量主动脉直径,并根据体表面积的平方根将其标准化为Z评分。比较单纯型和复杂型CoA的结果。采用单因素和多因素逻辑回归分析性别、年龄、高血压、缩窄程度、CoA类型、二叶式主动脉瓣(BAV)及其他与主动脉扩张相关因素的影响。
共分析了52例CoA婴儿患者,其中单纯型CoA 22例,复杂型CoA 30例。单纯型CoA组和复杂型CoA组婴儿的升主动脉均有不同程度扩张,但差异无统计学意义(50.00%对73.33%,P = 0.084;2.05±0.40对2.22±0.43,P = 0.143)。复杂型CoA组婴儿的主动脉弓发育不良比单纯型CoA组更多(33.33%对9.09%,P = 0.042)。与室间隔缺损(VSD)组相比,CoA组升主动脉的Z评分显著高于VSD组(P = 0.023和P = 0.000)。逻辑回归分析发现缩窄程度增加(CDR值)是升主动脉扩张的独立预测因素(校正OR = 0.002;P = 0.034)。
单纯型或复杂型CoA婴儿有升主动脉扩张风险,升主动脉扩张因素取决于缩窄程度。CTA可识别CoA婴儿的主动脉扩张风险。