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预测主动脉扩张的人口统计学和临床因素。何时应关注主动脉大小?

Demographical and Clinical Factors Predictive for Aortic Dilatation. When should we be Concerned about the Size?

作者信息

Urbanowicz Tomasz, Rajewska-Tabor Justyna, Olasińska-Wiśniewska Anna, Filipiak Krzysztof J, Michalak Michał, Rzesoś Patrycja, Szot Mateusz, Krasińska-Płachta Aleksandra, Krasińska Beata, Pyda Małgorzata, Tykarski Andrzej, Jemielity Marek, Krasiński Zbigniew

机构信息

Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, 61-848 Poznań, Poland.

Unit of Magnetic Resonance, I Department of Cardiology, Poznan University of Medical Sciences, 61-848 Poznań, Poland.

出版信息

Rev Cardiovasc Med. 2024 Apr 30;25(5):150. doi: 10.31083/j.rcm2505150. eCollection 2024 May.

Abstract

BACKGROUND

Thoracic aortic aneurysms are often an accidental finding and result from a degenerative process. Medical therapy includes pharmacological control of arterial hypertension and smoking cessation, that slows the growth of aneurysms. An association between the dilatation of the ascending and abdominal aorta has been already reported. The aim of the study was to identify possible demographic and clinical factors that may implicate further imaging diagnostics in patients with ascending aorta dilatation.

METHODS

There were 181 (93 (53%) males and 88 (47%) females) patients with a median age of 54 (41-62) years who underwent cardiac magnetic resonance due to non-vascular diseases, were enrolled into retrospective analysis.

RESULTS

Multivariable analysis revealed ascending aorta dilatation (odds ratios (OR) = 7.45, 95% confidence interval (CI): 1.98-28.0, = 0.003) and co-existence of coronary artery disease (OR = 8.68, 95% CI: 2.15-35.1, = 0.002) as significant predictors for thoracic descending aorta dilatation. In patients with abdominal aorta dilatation, the multivariable analysis showed a predictive value of ascending aortic dilatation (OR = 14.8, 95% CI: 2.36-92.8, = 0.004) and age (OR = 1.04, 95% CI: 1.00-1.08, = 0.027). In addition, cut-off values were established for age groups determining the risk of thoracic aorta dilatation over 49 years and abdominal aorta dilatation over 54 years.

CONCLUSIONS

The results of our analysis showed predictive factors, including ascending aorta dilatation and co-existence of coronary artery disease, particularly over 49 years of age for thoracic, while ascending aorta dilatation and age, particularly over 54 years, for abdominal aorta dilatation. These features may be considered to increase clinical vigilance in patients with aortic diameter abnormalities.

摘要

背景

胸主动脉瘤通常是偶然发现的,由退行性病变引起。药物治疗包括对动脉高血压的药物控制和戒烟,这可减缓动脉瘤的生长。升主动脉和腹主动脉扩张之间的关联已有报道。本研究的目的是确定可能提示升主动脉扩张患者需要进一步影像学诊断的人口统计学和临床因素。

方法

181例患者(93例(53%)男性和88例(47%)女性)因非血管疾病接受心脏磁共振成像检查,纳入回顾性分析,中位年龄为54岁(41 - 62岁)。

结果

多变量分析显示,升主动脉扩张(比值比(OR)= 7.45,95%置信区间(CI):1.98 - 28.0,P = 0.003)和冠状动脉疾病并存(OR = 8.68,95% CI:2.15 - 35.1,P = 0.002)是胸降主动脉扩张的重要预测因素。在腹主动脉扩张患者中,多变量分析显示升主动脉扩张(OR = 14.8,95% CI:2.36 - 92.8,P = 0.004)和年龄(OR = 1.04,95% CI:1.00 - 1.08,P = 0.027)具有预测价值。此外,确定了年龄组的临界值,以确定49岁以上胸主动脉扩张和54岁以上腹主动脉扩张的风险。

结论

我们的分析结果显示了预测因素,包括升主动脉扩张和冠状动脉疾病并存,胸主动脉扩张特别是49岁以上,而腹主动脉扩张是升主动脉扩张和年龄,特别是54岁以上。这些特征可被视为提高对主动脉直径异常患者的临床警惕性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/73b3/11267195/bf99670a88ca/2153-8174-25-5-150-g1.jpg

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