Kim Kitae, Sano Madoka, Hayashi Hideyuki, Suganuma Naoko, Tani Tomoko, Furukawa Yutaka
Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.
Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Japan.
J Med Ultrason (2001). 2025 Apr;52(2):197-207. doi: 10.1007/s10396-025-01526-3. Epub 2025 Mar 19.
Reports on the usefulness of abdominal aortic aneurysm (AAA) screening during transthoracic echocardiography (TTE) in Japan are limited. This study aimed to describe the prevalence of AAA among patients who underwent routine screening during TTE, as well as the long-term clinical outcomes of patients in whom AAA was detected.
We screened 46,353 consecutive patients who underwent TTE for suspected cardiac disease at our institution. Among these, a total of 1133 patients were identified as having AAA, defined as an abdominal aorta diameter of 30 mm or greater. After excluding patients with prior aortic surgery, including endovascular repair (n = 104), those with known AAA (n = 569), and those with known aortic dissection (n = 25), the study population consisted of 435 patients, all diagnosed with AAA for the first time.
The overall prevalence of AAA among patients undergoing TTE was 0.94%. The mean age was 76.8 years, and the study population was predominantly males (81.6%). The prevalence of AAA in patients under 60 years of age was low: 0.24% for men and 0.076% for women. The left atrial volume index was 43.8 ± 23.1 ml/m, the left ventricular mass was 164.9 ± 52.0 g, and the diameter of the sinus of Valsalva was 32.6 ± 4.4 mm, all of which were numerically higher than the normal values observed in a healthy Japanese population. During the median follow-up period of 2.0 years, 43 surgical or endovascular repairs of AAA, six aorta-related deaths, and 90 all-cause deaths occurred. The cumulative incidence of surgical or endovascular repair of AAA was 5.3% at 1 year, 11.5% at 3 years, and 18.1% at 5 years. The cumulative incidence of aorta-related death was modest: 0.3% at 1 year, 0.8% at 3 years, and 1.6% at 5 years.
The prevalence of newly diagnosed AAA among patients who underwent routine screening during TTE for suspected cardiac disease was 0.94% in the Japanese population, with the majority being 60 years or older. Approximately 10% of patients diagnosed with AAA underwent surgical or endovascular repair during follow-up, suggesting that this approach may be effective in preventing deaths caused by AAA.
关于在日本经胸超声心动图（TTE）检查期间腹主动脉瘤（AAA）筛查有用性的报道有限。本研究旨在描述在TTE常规筛查患者中AAA的患病率，以及检测出AAA患者的长期临床结局。
我们对在我院因疑似心脏病接受TTE检查的46353例连续患者进行了筛查。其中，共有1133例患者被确定患有AAA，定义为腹主动脉直径≥30mm。在排除既往有主动脉手术史的患者，包括血管腔内修复术（n = 104）、已知患有AAA的患者（n = 569）以及已知患有主动脉夹层的患者（n = 25）后，研究人群包括435例患者，均为首次诊断为AAA。
接受TTE检查的患者中AAA的总体患病率为0.94%。平均年龄为76.8岁，研究人群以男性为主（81.6%）。60岁以下患者中AAA的患病率较低：男性为0.24%，女性为0.076%。左心房容积指数为43.8±23.1ml/m，左心室质量为164.9±52.0g，主动脉瓣窦直径为32.6±4.4mm，所有这些数值均高于健康日本人群的正常值。在中位随访期2.0年期间，发生了43例AAA的外科或血管腔内修复术、6例与主动脉相关的死亡以及90例全因死亡。AAA外科或血管腔内修复术的累积发生率在1年时为5.3%，3年时为11.5%，5年时为18.1%。与主动脉相关的死亡累积发生率较低：1年时为0.3%，3年时为0.8%，5年时为1.6%。
在日本人群中，因疑似心脏病接受TTE常规筛查的患者中新诊断AAA的患病率为0.94%，大多数患者年龄在60岁及以上。在随访期间，约10%被诊断为AAA的患者接受了外科或血管腔内修复术，这表明这种方法可能有效预防AAA导致的死亡。
