Demographical and Clinical Factors Predictive for Aortic Dilatation. When Should We Be Concerned About the Size?

Overview

Journal Rev Cardiovasc Med

Specialty Cardiology & Vascular Diseases

Date 2024 Jul 30

PMID 39076501

Authors

Tomasz Urbanowicz

Justyna Rajewska-Tabor

Anna Olasinska-Wisniewska

Krzysztof J Filipiak

Michal Michalak

Patrycja Rzesos

Mateusz Szot

Aleksandra Krasinska-Plachta

Beata Krasinska

Malgorzata Pyda

Andrzej Tykarski

Marek Jemielity

Zbigniew Krasinski

Affiliations

Soon will be listed here.

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.

References

Bossone E, Eagle K . Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes. Nat Rev Cardiol. 2020; 18(5):331-348. DOI: 10.1038/s41569-020-00472-6. View

Isekame Y, Gati S, Aragon-Martin J, Bastiaenen R, Seshasai S, Child A . Cardiovascular Management of Adults with Marfan Syndrome. Eur Cardiol. 2018; 11(2):102-110. PMC: 6159454. DOI: 10.15420/ecr/2016:19:2. View

Hernesniemi J, Vanni V, Hakala T . The prevalence of abdominal aortic aneurysm is consistently high among patients with coronary artery disease. J Vasc Surg. 2015; 62(1):232-240.e3. DOI: 10.1016/j.jvs.2015.02.037. View

Wang L, Djousse L, Song Y, Akinkuolie A, Matsumoto C, Manson J . Associations of Diabetes and Obesity with Risk of Abdominal Aortic Aneurysm in Men. J Obes. 2017; 2017:3521649. PMC: 5343258. DOI: 10.1155/2017/3521649. View

Ganapathi A, Ranney D, Peterson M, Lindsay M, Patel H, Pyeritz R . Location of Aortic Enlargement and Risk of Type A Dissection at Smaller Diameters. J Am Coll Cardiol. 2022; 79(19):1890-1897. DOI: 10.1016/j.jacc.2022.02.053. View

Erbel R, Aboyans V, Boileau C, Bossone E, Di Bartolomeo R, Eggebrecht H . [2014 ESC Guidelines on the diagnosis and treatment of aortic diseases]. Kardiol Pol. 2014; 72(12):1169-252. DOI: 10.5603/KP.2014.0225. View

Xiang B, Zhu S, Li J, Lai H, Wang C, Zhu K . Current Pharmacological Management of Aortic Aneurysm. J Cardiovasc Pharmacol. 2021; 78(2):211-220. DOI: 10.1097/FJC.0000000000001054. View

Prakash S, Pedroza C, Khalil Y, Milewicz D . Diabetes and reduced risk for thoracic aortic aneurysms and dissections: a nationwide case-control study. J Am Heart Assoc. 2012; 1(2). PMC: 3487378. DOI: 10.1161/JAHA.111.000323. View

Schanzer A, Oderich G . Management of Abdominal Aortic Aneurysms. N Engl J Med. 2021; 385(18):1690-1698. DOI: 10.1056/NEJMcp2108504. View

10.

Erbel R, Aboyans V, Boileau C, Bossone E, Di Bartolomeo R, Eggebrecht H . 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the.... Eur Heart J. 2014; 35(41):2873-926. DOI: 10.1093/eurheartj/ehu281. View

11.

Isselbacher E . Thoracic and abdominal aortic aneurysms. Circulation. 2005; 111(6):816-28. DOI: 10.1161/01.CIR.0000154569.08857.7A. View

12.

Garcier J, Petitcolin V, Filaire M, Mofid R, Azarnouch K, Ravel A . Normal diameter of the thoracic aorta in adults: a magnetic resonance imaging study. Surg Radiol Anat. 2003; 25(3-4):322-9. DOI: 10.1007/s00276-003-0140-z. View

13.

Song X, Fan L, Yan Z, Rui Y . Echocardiographic evaluation of the elasticity of the ascending aorta in patients with essential hypertension. J Clin Ultrasound. 2020; 49(4):351-357. DOI: 10.1002/jcu.22925. View

14.

Saeyeldin A, Velasquez C, Mahmood S, Brownstein A, Zafar M, Ziganshin B . Thoracic aortic aneurysm: unlocking the "silent killer" secrets. Gen Thorac Cardiovasc Surg. 2017; 67(1):1-11. DOI: 10.1007/s11748-017-0874-x. View

15.

Quintana R, Taylor W . Cellular Mechanisms of Aortic Aneurysm Formation. Circ Res. 2019; 124(4):607-618. PMC: 6383789. DOI: 10.1161/CIRCRESAHA.118.313187. View

16.

Kobeissi E, Hibino M, Pan H, Aune D . Blood pressure, hypertension and the risk of abdominal aortic aneurysms: a systematic review and meta-analysis of cohort studies. Eur J Epidemiol. 2019; 34(6):547-555. PMC: 6497813. DOI: 10.1007/s10654-019-00510-9. View

17.

Jauhiainen S, Kiema M, Hedman M, Laakkonen J . Large Vessel Cell Heterogeneity and Plasticity: Focus in Aortic Aneurysms. Arterioscler Thromb Vasc Biol. 2022; 42(7):811-818. DOI: 10.1161/ATVBAHA.121.316237. View

18.

Ehrman J, Fernandez A, Myers J, Oh P, Thompson P, Keteyian S . Aortic Aneurysm: DIAGNOSIS, MANAGEMENT, EXERCISE TESTING, AND TRAINING. J Cardiopulm Rehabil Prev. 2020; 40(4):215-223. DOI: 10.1097/HCR.0000000000000521. View

19.

DeRoo E, Stranz A, Yang H, Hsieh M, Se C, Zhou T . Endothelial Dysfunction in the Pathogenesis of Abdominal Aortic Aneurysm. Biomolecules. 2022; 12(4). PMC: 9030795. DOI: 10.3390/biom12040509. View

20.

Wilmink T, Quick C, Day N . The association between cigarette smoking and abdominal aortic aneurysms. J Vasc Surg. 1999; 30(6):1099-105. DOI: 10.1016/s0741-5214(99)70049-2. View