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Aortic wall thickness: an independent risk factor for aortic dissection?
The Journal of Heart Valve Disease
|May 1, 2014
Summary
Aortic medial wall thickness, not aneurysm size, is a key indicator for dissection risk in connective tissue disorders (CTD). Thinner aortic walls may predict dissection, potentially improving risk assessment with future imaging.
Area of Science:
- Cardiovascular Pathology
- Connective Tissue Disorders
- Aortic Aneurysm Research
Background:
- Aortic aneurysm size is a known risk factor for aortic complications in connective tissue disorders (CTD).
- Objective tools are needed to identify patients at highest risk of aortic dissection, reflecting aortic wall integrity.
Purpose of the Study:
- To evaluate aortic wall pathology in CTD patients with and without acute aortic dissection.
- To identify parameters, particularly aortic wall thickness, that influence dissection risk.
Main Methods:
- Retrospective review of aortic pathology in Marfan syndrome (MFS) patients without dissection and acute type A aortic dissection (AAAoD) patients.
- Inclusion of controls without cardiovascular death.
- Measurement of minimal aortic medial wall thickness and grading of medial myxoid degeneration and elastin loss.
Main Results:
- Aortic medial wall thickness was significantly thinner in AAAoD patients (438 ± 322 µm) compared to MFS patients (703 ± 256 µm) and controls (1625 ± 364 µm).
- Aortic root diameter did not correlate with aortic wall thickness.
- Medial myxoid degeneration and elastin loss did not significantly differ between CTD patient groups.
Conclusions:
- Diminished aortic medial wall thickness is associated with an increased risk of aortic dissection in CTD patients.
- Future high-resolution in vivo imaging may enable morphological assessment of aortic medial wall thickness for refined dissection risk prognostication.
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