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Dilatación y disección aórtica en el síndrome de Turner
Lea Ann Matura1, Vincent B Ho, Douglas R Rosing
1Developmental Endocrinology Branch, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892, USA.
Circulation
|September 19, 2007
Resumen
Las mujeres con síndrome de Turner (TS) tienen un mayor riesgo de disección aórtica. El índice de tamaño aórtico > 2,0 cm/m2 indica una dilatación aórtica significativa y requiere una estrecha vigilancia del riesgo de disección.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Genética La genética.
- Endocrinología Endocrinología.
Sus antecedentes:
- El síndrome de Turner (TS) se asocia con un riesgo elevado de disección aórtica en mujeres jóvenes.
- La relación entre la dilatación aórtica y la disección aórtica aguda en TS sigue sin estar clara.
- Los predictores del deterioro aórtico en pacientes con TS requieren más investigación.
Objetivo del estudio:
- Para investigar si la dilatación aórtica precede a la disección aórtica en mujeres con síndrome de Turner.
- Para identificar mediciones específicas del diámetro aórtico que predicen eventos aórticos inminentes en TS.
- Evaluar la utilidad del índice de tamaño aórtico en la gestión del riesgo cardiovascular en TS.
Principales métodos:
- Análisis retrospectivo de 166 mujeres adultas con TS y 26 controles femeninos sanos.
- Diámetros ascendentes y descendentes de la aorta medidos mediante resonancia magnética, normalizados a la superficie corporal (índice de tamaño de la aorta).
- Seguimiento durante aproximadamente 3 años para registrar eventos de disección aórtica.
Principales resultados:
- Las mujeres con TS tenían diámetros aórticos absolutos similares, pero índices de tamaño aórtico significativamente mayores en comparación con los controles.
- El 32% de las mujeres TS exhibieron valores del índice de tamaño aórtico por encima del percentil 95 (> 2.0 cm/m2).
- Tres mujeres TS experimentaron disecciones aórticas, todas con diámetros aórticos ascendentes > 3.7 cm y índices de tamaño aórtico > 2.5 cm/m2.
Conclusiones:
- El riesgo de disección aórtica es sustancialmente mayor en mujeres jóvenes con TS.
- El índice de tamaño de la aorta es una medida preferida para detectar la dilatación en TS debido a su menor estatura.
- El índice de tamaño aórtico > 2,0 cm/m2 justifica una estrecha vigilancia cardiovascular; > 2,5 cm/m2 indica el mayor riesgo de disección.
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