主动脉扩张有多常见？,European Heart Journal - Cardiovascular Imaging

当前位置： X-MOL 学术 › Eur. Heart J. Cardiovasc. Imaging › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

主动脉扩张有多常见？
European Heart Journal - Cardiovascular Imaging ( IF 6.7 ) Pub Date : 2021-02-09 , DOI: 10.1093/ehjci/jeaa356.016
A Babu ₁ , Z Meng ₁ , O Oji ₁ , TJ Bowker ₁ , HB Xiao ₁

Affiliation

资金确认资金来源类型：无。简介主动脉扩张最常与高血压、二叶主动脉瓣和结缔组织疾病（如马凡氏病）相关。它是威胁生命的并发症的前兆，例如主动脉破裂或夹层。当前的 ESC 指南建议在马凡综合征 (Ic) 患者的主动脉直径 > 50 mm 和二尖瓣或主动脉瓣形态正常 (IIb) 的患者 > 55 mm 时进行手术干预。尽管有历史数据表明胸主动脉瘤的发病率为每 100,000 人中有 5.9 例，但目前缺乏关于主动脉扩张在普通人群甚至医院人群中患病率的文献。目的目的是通过超声心动图调查我们医院人群中主动脉扩张的患病率，这可能有助于为人群研究奠定基础，并确定可能决定手术干预时间的预后因素。方法利用我院数字超声心动图档案和电子病历系统进行回顾性调查。该调查涵盖 2016 年 10 月 1 日至 2018 年 11 月 1 日期间。出于随机目的，包括在此期间每周四进行的所有经胸超声心动图 (TTE)。所有有主动脉根部或升主动脉扩张超声心动图报告的患者均被纳入研究。收集了其他信息，包括超声心动图尺寸以及人口统计学和既往病史。结果在这 24 个月期间，我们共分析了 3019 个 TTE。据报道有 209 名患者（6.9%）有主动脉扩张。137 人（66%）为男性，中位年龄为 67 岁。平均身高和体重分别为 169 厘米和 80 公斤。10 名 (4.8%) 患者确认为二尖瓣主动脉瓣。132 (63%) 名患者有高血压病史。超声心动图显示，75 名 (36%) 患者出现室间隔肥大，26 名 (12.4%) 患者出现左心室扩张。结论我们的发现是独一无二的，据我们所知，我们首次报告了医院人群中主动脉扩张的超声心动图患病率（6.9%）。与主动脉瘤（主动脉扩张最可能的终点）的患病率相比，它增加了惊人的 40 倍。根据我们的数据，仅我们医院一年内就有至少400名主动脉扩张的患者。在我们的队列中，二尖瓣主动脉瓣的患病率（4.8%）几乎是普通人群中 1-2% 的三倍。我们的研究还强调了高血压和主动脉扩张之间的既定联系，与全球患病率（31%）相比，我们队列中的频率增加（63%）。鉴于主动脉扩张的破坏性后遗症及其在我们患者群体中的患病率增加，对这些患者进行常规监测非常重要，尤其是那些患有高血压的患者。我们的研究还强调了高血压和主动脉扩张之间的既定联系，与全球患病率（31%）相比，我们队列中的频率增加（63%）。鉴于主动脉扩张的破坏性后遗症及其在我们患者群体中的患病率增加，对这些患者进行常规监测非常重要，尤其是那些患有高血压的患者。我们的研究还强调了高血压和主动脉扩张之间的既定联系，与全球患病率（31%）相比，我们队列中的频率增加（63%）。鉴于主动脉扩张的破坏性后遗症及其在我们患者群体中的患病率增加，对这些患者进行常规监测非常重要，尤其是那些患有高血压的患者。

"点击查看英文标题和摘要"

How common is aortic dilatation?

Funding Acknowledgements Type of funding sources: None. Introduction Aortic dilatation is most commonly associated with hypertension, bicuspid aortic valve and connective tissue diseases such as Marfan’s. It is a precursor to life threatening complications such as rupture or dissection of the aorta. The current ESC Guidelines recommend surgical intervention once the aortic diameter is >50 mm in patients with Marfan syndrome (Ic) and >55 mm in patients with a bicuspid or normal aortic valve morphology (IIb). There is currently a lack of literature on the prevalence of aortic dilatation in the general or even hospital population although there is historical data suggesting the incidence of thoracic aortic aneurysm to be 5.9 cases per 100,000. Purpose The aim is to investigate the prevalence of aortic dilatation by echocardiography in our hospital population which may help lay the foundation for population studies and identify prognostic factors which may determine the time of surgical intervention. Methods We carried out a retrospective survey using the digital echocardiogram archive and the electronic patient record system at our hospital. This survey covered the period between 1st October 2016 and 1st November 2018. For randomisation purposes, all transthoracic echocardiograms (TTE) performed on every Thursday during this period were included. All patients with an echocardiographic report of aortic root or ascending aorta dilatation were enrolled. Other information including echocardiographic dimensions along with demographics and past medical history was collected. Results During this 24-month period, we analysed a total of 3019 TTEs. 209 patients (6.9%) were reported to have aortic dilatation. 137 (66%) were male and the median age was 67 years. The mean height and weight were 169cm and 80kg, respectively. A bicuspid aortic valve was confirmed in 10 (4.8%) patients. 132 (63%) patients had a history of hypertension. On echocardiogram, 75 (36%) patients had septal hypertrophy and 26 (12.4%) had a dilated left ventricle. Conclusion Our findings are unique and for the first time, to our knowledge, we report the echocardiographic prevalence of aortic dilatation in the hospital population (6.9%). It is a staggering 40-fold increase when compared to the the prevalence of aortic aneurysm, the most likely end point of aortic dilatation. Based on our figures, there would be at least 400 patients with a dilated aorta in a year in our hospital alone. The prevalence of bicuspid aortic valve in our cohort (4.8%) was nearly three times higher than the general population where it is quoted as 1-2%. Our study also emphasised the established link between hypertension and aortic dilatation with an increased frequency in our cohort (63%) compared to the global prevalence (31%). Given the devastating sequelae of aortic dilatation and its increased prevalence in our patient population, it will be very important to keep these patients under routine surveillance and particularly those with hypertension.

更新日期：2021-02-09

点击分享查看原文

点击收藏

阅读更多本刊新发论文