Katsarou Maria, Mandigers Tim J, Berczeli Marton, Mujeeb Zubair M, Belvroy Viony M, Bissacco Daniele, van Herwaarden Joost A, Trimarchi Santi, Bismuth Jean
Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, TX, USA.
Section of Vascular Surgery, Cardio Thoracic Vascular Department, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Milan, Italy.
J Endovasc Ther. 2023 Nov 8:15266028231210228. doi: 10.1177/15266028231210228.
In many studies on aortic disease, women are underrepresented. The present study aims to assess sex-specific morphometric differences and gain more insight into endovascular treatment of the ascending aorta (AA) and arch.
Electrocardiogram-gated cardiac computed tomography scans of 116 consecutive patients who were evaluated for transcatheter aortic valve replacement were retrospectively reviewed. Measurements of the AA and aortic arch were made in multiplanar views, perpendicular to the semi-automatic centerline. Multiple linear regression analysis was performed to identify predictors affecting AA and aortic arch diameter in men and women. Propensity score matching was used to investigate whether sex influences aortic morphology.
In both sexes, body surface area (BSA) was identified as a positive predictor and diabetes as a negative predictor for aortic diameters. In men, age was identified as a positive predictor and smoking as a negative predictor for aortic diameters. Propensity score matching identified 40 pairs. Systolic and diastolic mean diameters and AA length were significantly wider in men. On average, male aortas were 7.4% wider than female aortas, both in systole and diastole.
The present analysis demonstrates that, in women, increased BSA is associated with increased aortic arch diameters, while diabetes is associated with decreased AA and arch diameters. In men, increased BSA and age are associated with increased AA and arch diameters, while smoking and diabetes are associated with decreased AA and arch diameters. Men were confirmed to have 7.4% greater AA and arch diameters than women.
Men had 7.4% greater ascending aorta and arch diameters than women in a retrospective cohort, gated computed tomography-based study of 116 patients. Sex-specific differences in ascending aortic and arch size should be considered by aortic endovascular device manufacturers and physicians when developing ascending and arch endografts and planning aortic interventions.
在许多关于主动脉疾病的研究中，女性的代表性不足。本研究旨在评估性别特异性形态学差异，并更深入地了解升主动脉（AA）和主动脉弓的血管内治疗。
回顾性分析了116例因经导管主动脉瓣置换术而接受评估的连续患者的心电图门控心脏计算机断层扫描。在多平面视图中，垂直于半自动中心线对AA和主动脉弓进行测量。进行多元线性回归分析以确定影响男性和女性AA和主动脉弓直径的预测因素。使用倾向评分匹配来研究性别是否影响主动脉形态。
在两性中，体表面积（BSA）被确定为主动脉直径的正性预测因素，而糖尿病被确定为负性预测因素。在男性中，年龄被确定为主动脉直径的正性预测因素，吸烟被确定为负性预测因素。倾向评分匹配确定了40对。男性的收缩期和舒张期平均直径以及AA长度明显更宽。平均而言，男性主动脉在收缩期和舒张期均比女性主动脉宽7.4%。
本分析表明，在女性中，BSA增加与主动脉弓直径增加相关，而糖尿病与AA和主动脉弓直径减小相关。在男性中，BSA增加和年龄增加与AA和主动脉弓直径增加相关，而吸烟和糖尿病与AA和主动脉弓直径减小相关。证实男性的AA和主动脉弓直径比女性大7.4%。
在一项基于门控计算机断层扫描的对116例患者的回顾性队列研究中，男性的升主动脉和主动脉弓直径比女性大7.4%。主动脉血管内装置制造商和医生在开发升主动脉和主动脉弓内移植物以及规划主动脉干预措施时，应考虑升主动脉和主动脉弓大小的性别特异性差异。
