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Longitudinal analysis of thoracic aortic expansion in non-syndromic real-world patients.
Ng, Josiah; Ewe, See Hooi; Tan, Ju Le; Chao, Victor Tt; Ding, Zee Pin; Ling, Lieng-Hsi; Sin, Kenny Yk; Chua, Terrance Sj; Sahlén, Anders.
Affiliation
  • Ng J; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Ewe SH; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Tan JL; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Chao VT; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Ding ZP; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Ling LH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
  • Sin KY; Department of Cardiology, National University Heart Centre Singapore, Singapore.
  • Chua TS; Department of Cardiology, National Heart Centre Singapore, Singapore.
  • Sahlén A; Department of Cardiology, National Heart Centre Singapore, Singapore.
Heliyon ; 9(5): e15823, 2023 May.
Article in En | MEDLINE | ID: mdl-37305473
ABSTRACT
Remodeling of the thoracic aorta is commonly seen and viewed as a precursor to an aortic aneurysm. However, while aneurysms have been shown to expand at a rate of approximately 1 mm annually, the expansion of the pre-aneurysmal aorta is poorly characterized, especially in relation to age, gender, and aortic size per se. We identified patients that had undergone echocardiography at least twice at a large university medical center. Diagnosis codes, medications, and blood test results were obtained from hospital records. Syndromic patients were excluded (e.g., Marfan's syndrome, bicuspid aortic valve). Final population comprised n = 24,928 patients (median age 61.2 years (inter-quartile range (IQR) 50.6-71.5); 55.8% males) that had undergone a median of 3 echocardiograms (2-4; range 2-27) during a median of 4.0 years (IQR 2.3-6.2). Hypertension was present in 39.6% of patients and diabetes in 20.7%, median LV ejection fraction was 56.0% (IQR 41.0-62.0). Aortic size measurements were analyzed in mixed models while clustering on individual patients. Mean expansion was determined for sinus of Valsalva as 1.93 (95% confidence interval; CI95 1.87-1.99) mm per decade, and for ascending aorta as 1.76 (CI95 1.70-1.82) mm per decade. Faster expansion was found in males, with larger aortic size, and younger age (p for interaction <0.05 for all). In conclusion, expansion of the thoracic aorta, in real world, non-syndromic patients, is slow and averages <2 mm per decade. This will help to inform management of this large patient group.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Heliyon Year: 2023 Document type: Article Affiliation country: Singapore

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Heliyon Year: 2023 Document type: Article Affiliation country: Singapore