在以人口为基础的设置中,非综合征上升胸前动脉:为期5年的前性队列研究
Lasse M Obel1, Axel C P Diederichsen2, Joachim S S Kristensen1
1Elite Centre for Individualized Medicine in Arterial Disease, Odense University Hospital, Odense, Denmark; Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Journal of the American College of Cardiology
|January 8, 2025
概括
在60-74岁的男性中,上升性大动脉生长缓慢,质疑常规监测. 大多数主动脉不良事件 (AEE) 发生在直径小于50mm的病例中,这表明需要进行超出单独大小的个性化风险评估.
科学领域:
- 心血管医学 心血管医学
- 放射学 放射学是一门学科.
- 流行病学 流行病学
背景情况:
- 关于上升胸前动脉的临床过程的前性数据有限.
- 了解上升性大动脉生长和不良事件对于心血管健康管理至关重要.
研究的目的:
- 在一般人群中估计上升性大动脉增长率.
- 评估大动脉不良事件 (AAE) 的发生,包括破裂,剖析和大动脉相关死亡.
- 评估大动脉直径和AAE之间的关系.
主要方法:
- 基于人口的前性多中心队列研究 (DANCAVAS I和II).
- 使用心电图门,非对比计算断层扫描 (CT) 来进行大动脉测量.
- 用丹麦医疗保健注册结果补充临床数据,随访时间中位数为4.5-5.0年.
主要成果:
- 男性的平均上升性大动脉增长率为0.07毫米/年,女性为0.13毫米/年,直径较大的人的增长没有显著增加.
- 每10万人/年,AAE的总发病率为31例,基线直径为45.0-49.9毫米的个体中有1.4%患有AAE.
- 对AAE的调整后危险比率在直径每增加1毫米时都会增加,对于有大动脉动脉瘤家族史的人来说显著更高.
结论:
- 60-74岁男性中慢慢上升的大动脉生长表明,目前的监测间隔可能需要重新评估.
- 大多数AAE发生在上升大动脉直径小于50.0毫米的个体中,强调需要个性化风险分层超越直径.
- 进一步的前性研究是有必要的,以调查女性的动脉瘤疾病.
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