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Sex Differences in Thoracic Aortic Aneurysm Growth.
Kevin E Boczar1, Katie Cheung2, Munir Boodhwani3
1From the Division of Cardiology, University of Ottawa Heart Institute, ON, Canada (K.E.B., L.B., K.C., T.C.).
Hypertension (Dallas, Tex. : 1979)
|December 21, 2018
Summary
Thoracic aortic aneurysm (TAA) growth is more than twice as fast in women. Increased aortic stiffness is linked to faster TAA expansion in women, but not men, highlighting a key sex-specific factor.
Area of Science:
- Cardiovascular Research
- Aortic Disease
- Sex-Specific Medicine
Background:
- Women with thoracic aortic aneurysms (TAAs) face higher risks of acute aortic syndromes and mortality compared to men.
- Previous research indicates accelerated TAA growth in women, contributing to observed sex differences in outcomes.
- Aortic stiffness is a critical indicator of aortic health and may play a role in TAA progression.
Purpose of the Study:
- To investigate the sex-specific association between aortic stiffness and the growth rate of thoracic aortic aneurysms.
- To determine if aortic stiffness influences TAA expansion differently in men and women.
Main Methods:
- Recruited 130 individuals with unoperated TAAs.
- Measured TAA growth rate using maximal aneurysm size from serial imaging studies.
- Assessed aortic stiffness via carotid-femoral pulse wave velocity (cfPWV) using applanation tonometry.
- Employed multivariable linear regression, adjusting for confounders, to analyze the relationship between cfPWV and TAA growth.
Main Results:
- TAA growth rate was significantly higher in women (0.96±1.00 mm/y) compared to men (0.45±0.58 mm/y).
- Aortic stiffness (cfPWV) was independently associated with TAA growth in the overall cohort.
- Sex-specific analysis revealed cfPWV was significantly linked to faster aneurysm growth in women (P=0.03) but not in men (P=0.94), with a significant sex×cfPWV interaction (P<0.0001).
Conclusions:
- Aneurysm growth in patients with TAA is more than twice as rapid in women compared to men.
- Greater aortic stiffness is a significant correlate of accelerated TAA expansion specifically in women.
- These findings underscore the importance of considering aortic stiffness in the management and risk stratification of TAA in women.
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