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Atherosclerosis of the aorta in patients with acute thoracic aortic dissection

John Barbetseas1, Nikolaos Alexopoulos, Stella Brili

  • 1First Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece.

Circulation Journal : Official Journal of the Japanese Circulation Society
|October 4, 2008
PubMed

Insights

Aortic atherosclerosis is more common in distal (type B) than proximal (type A) thoracic aortic dissections. This finding helps differentiate dissection types using imaging of aortic plaque characteristics.

Area of Science:

  • Cardiovascular Imaging
  • Vascular Surgery
  • Atherosclerosis Research

Background:

  • The association between atherosclerosis and thoracic aortic dissection (TAD) remains unclear.
  • Transesophageal echocardiography (TEE) is crucial for diagnosing TAD and evaluating aortic atherosclerotic plaques.
  • TEE can assess plaque size and characteristics, potentially aiding in understanding TAD etiology.

Purpose of the Study:

  • To investigate the relationship between aortic atherosclerosis and the type of thoracic aortic dissection.
  • To determine if atherosclerotic plaque characteristics differ between proximal (Stanford type A) and distal (Stanford type B) dissections.

Main Methods:

  • Retrospective analysis of 100 consecutive patients with TAD undergoing TEE.
  • Classification of dissections into proximal (type A) and distal (type B).
  • Assessment of the presence and severity of aortic atherosclerosis using TEE imaging.

Main Results:

  • Aortic atherosclerosis was more prevalent in patients with distal dissection (94%) compared to proximal dissection (67%).
  • Patients with proximal dissection (type A) were younger than those with distal dissection (type B).
  • Severe atherosclerosis significantly increased the likelihood of distal (type B) dissection (OR 7.6, p<0.001).

Conclusions:

  • Aortic atherosclerosis is significantly more associated with distal (type B) than proximal (type A) thoracic aortic dissection.
  • TEE assessment of aortic atherosclerosis may provide insights into the underlying mechanisms of different TAD types.
Abstract

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