Male-female differences in thoracic aortic diameters at presentation of acute type A aortic dissection.

Autor:	Meccanici F; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands., Bom AW; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands., Knol WG; Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands.; Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands., Gökalp AL; Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands., Thijssen CGE; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands.; Department of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands., Bekkers JA; Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands., Geuzebroek GSC; Department of Cardiothoracic Surgery, Radboud University Medical Centre, Nijmegen, Netherlands., Mokhles MM; Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands.; Department of Cardiothoracic Surgery, Utrecht University Medical Centre, Utrecht, Netherlands., van Kimmenade RRJ; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands.; Department of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands., Budde RPJ; Department of Radiology and Nuclear Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands., Takkenberg JJM; Department of Cardiothoracic Surgery, Erasmus University Medical Centre, Rotterdam, Netherlands., Roos-Hesselink JW; Department of Cardiology, Erasmus University Medical Centre, Rotterdam, Netherlands.
Jazyk:	angličtina
Zdroj:	International journal of cardiology. Heart & vasculature [Int J Cardiol Heart Vasc] 2023 Oct 29; Vol. 49, pp. 101290. Date of Electronic Publication: 2023 Oct 29 (Print Publication: 2023).
DOI:	10.1016/j.ijcha.2023.101290
Abstrakt:	Background: Acute type A aortic dissection (ATAAD) is a highly lethal event, associated with aortic dilatation. It is not well known if patient height, weight or sex impact the thoracic aortic diameter (TAA) at ATAAD. The study aim was to identify male-female differences in TAA at ATAAD presentation. Methods: This retrospective cross-sectional study analysed all adult patients who presented with ATAAD between 2007 and 2017 in two tertiary care centres and underwent contrast enhanced computed tomography (CTA) before surgery. Absolute aortic diameters were measured at the sinus of Valsalva (SoV), ascending (AA) and descending thoracic aorta (DA) using double oblique reconstruction, and indexed for body surface area (ASI) and height (AHI). Z-scores were calculated using the Campens formula. Results: In total, 59 % (181/308) of ATAAD patients had CT-scans eligible for measurements, with 82 female and 99 male patients. Females were significantly older than males (65.5 ± 12.4 years versus 60.3 ± 2.3, p = 0.024). Female patients had larger absolute AA diameters than male patients (51.0 mm [47.0-57.0] versus 49.0 mm [45.0-53.0], p = 0.023), and larger ASI and AHI at all three levels. Z-scores for the SoV and AA were significantly higher for female patients (2.99 ± 1.66 versus 1.34 ± 1.77, p < 0.001 and 5.27 [4.38-6.26] versus 4.06 [3.14-5.02], p < 0.001). After adjustment for important clinical factors, female sex remained associated with greater maximal TAA (p = 0.019). Conclusion: Female ATAAD patients had larger absolute ascending aortic diameters than males, implying a distinct timing in disease presentation or selection bias. Translational studies on the aortic wall and studies on growth patterns should further elucidate these sex differences. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors. Published by Elsevier B.V.)
Databáze:	MEDLINE
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