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Aortic wall thickness: an independent risk factor for aortic dissection?

Hadas Shiran, Justin Odegaard, Gerald Berry

    The Journal of Heart Valve Disease
    |May 1, 2014
    PubMed

    Insights

    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.
    Abstract

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