Mensel Birger, Mahnken Andreas H, Kaiser Erhard, Völzke Henry, Dörr Marcus, Felix Stephan B, Ittermann Till, Lieb Wolfgang, Lorbeer Roberto
Department of Diagnostic & Interventional Radiology, Philipps-University Marburg, Marburg, Germany.
Department of Diagnostic and Interventional Radiology and Neuroradiology, Central Hospital Bad Berka, Bad Berka, Germany.
Eur Radiol. 2025 Jan;35(1):427-437. doi: 10.1007/s00330-024-10965-4. Epub 2024 Jul 18.
Increased diameters of the aorta are associated with increased mortality risk. In the present analyses, we assessed whether aortic diameters are associated with cardiovascular and all-cause mortality in community-dwelling individuals free of known cardiovascular disease (CVD).
MRI-derived vascular parameters of the thoracic and abdominal aorta from 2668 participants (median age = 53 years; 51.1% women) of the population-based SHIP-START-2 and SHIP-TREND-0 cohorts without CVD were analyzed. Age- and sex-adjusted, as well as multivariable-adjusted Cox-proportional hazard models, were used to estimate associations of diameters of six different aortic segments to mortality.
Over a median follow-up time of 10.6 years (IQR: 8.7; 12.4), a total of 188 participants (126 men and 62 women) died, of which 38 deaths were due to CVD. In unadjusted models, mortality rates were higher in participants with aortic diameters above the median compared to below the median for all investigated aortic sections (all log-rank p < 0.001). In multivariable-adjusted models, the diameters of the ascending thoracic aorta (HR = 1.34 95% CI: 1.04; 1.72, p = 0.022) and of the infrarenal aorta (HR = 3.75 95% CI: 1.06; 13.3, p = 0.040), modeled continuously, were associated with greater cardiovascular mortality. The diameter of the subphrenic aorta was associated with higher cardiovascular mortality only in the age and sex-adjusted model (HR = 3.65 95% CI: 1.01; 13.3, p = 0.049). None of the investigated aortic segments were associated with all-cause mortality.
Non-indexed diameters of the ascending thoracic and infrarenal aorta were associated with higher cardiovascular mortality but not with all-cause mortality in a population sample free of clinically overt CVD at baseline.
Increased aortic diameter is associated with cardiovascular mortality and can help to identify high-risk patients.
Increased aortic diameter is associated with mortality. Non-indexed diameters of the ascending and infrarenal aorta are associated with cardiovascular mortality but not all-cause mortality. Aortic diameter measurements support the estimate of cardiovascular mortality.
主动脉直径增大与死亡风险增加相关。在本分析中，我们评估了在无已知心血管疾病（CVD）的社区居住个体中，主动脉直径是否与心血管疾病及全因死亡率相关。
对基于人群的SHIP-START-2和SHIP-TREND-0队列中2668名无CVD的参与者（年龄中位数 = 53岁；51.1%为女性）的胸主动脉和腹主动脉的MRI衍生血管参数进行了分析。采用年龄和性别调整以及多变量调整的Cox比例风险模型来估计六个不同主动脉节段直径与死亡率之间的关联。
在中位随访时间10.6年（四分位间距：8.7；12.4）内，共有188名参与者（126名男性和62名女性）死亡，其中38例死亡归因于CVD。在未调整模型中，所有研究的主动脉节段中，主动脉直径高于中位数的参与者的死亡率高于低于中位数的参与者（所有对数秩检验p < 0.001）。在多变量调整模型中，连续建模的升主动脉直径（HR = 1.34，95%CI：1.04；1.72，p = 0.022）和肾下腹主动脉直径（HR = 3.75，95%CI：1.06；13.3，p = 0.040）与更高的心血管死亡率相关。仅在年龄和性别调整模型中，膈下主动脉直径与更高的心血管死亡率相关（HR = 3.65，95%CI：1.01；13.3，p = 0.049）。所研究的主动脉节段均与全因死亡率无关。
在基线时无临床明显CVD的人群样本中，升主动脉和肾下腹主动脉的非指数化直径与更高的心血管死亡率相关，但与全因死亡率无关。
主动脉直径增加与心血管死亡率相关，有助于识别高危患者。
主动脉直径增加与死亡率相关。升主动脉和肾下腹主动脉的非指数化直径与心血管死亡率相关，但与全因死亡率无关。主动脉直径测量有助于估计心血管死亡率。
