Abstract 17191: Comparison of Progression Rate Between Thoracic And Abdominal Aortic Diameter in a High-risk Asian Population for Aortic Aneurysm: a Prospective, 3 Year Follow-up Study With Non-contrast Computed Tomography
Introduction: Screening strategies for aortic aneurysm according to risk factors and ethnicity are controversial.
Hypothesis: This study aimed to investigate progression rate of thoracic and abdominal aortic diameter in a high risk population for aortic aneurysm among Asian male and explored predictors for rapid dilation of thoracic and abdominal aorta diameter by serial screening of whole aorta using non-contrast computed tomography (CT).
Methods: We prospectively performed baseline non-contrast CT scan of whole aorta from June 2012 to April 2013 and follow-up scan at 3 year interval in 224 elderly male patients with hypertension. Patients with TAMAX ≥ 55 mm or AAMAX ≥ 60 mm at baseline scan were excluded. Ascending thoracic aorta diameter (ATAPAB) and descending thoracic aorta diameter (DTAPAB) were measured at pulmonary artery bifurcation level and abdominal aorta diameter (AASMA) was measured at superior mesenteric artery. Maximal thoracic aorta diameter (TAMAX) and abdominal aorta diameter (AAMAX) were also measured.
Results: During median follow-up of 37 months (Interquartile range: 35-40 months), ATAPAB, DTAPAB and AASMA changed from 38.3 ± 4.1 mm to 39.5 ± 4.4 mm (p < 0.001), from 28.0 ± 2.4 mm to 29.3 ± 3.1 mm (p < 0.001), and from 21.2 ± 2.7 mm to 23.4 ± 3.9 mm (p < 0.001), respectively. TAMAX and AAMAX increased from 39.1 ± 4.3 mm to 39.5 ± 4.5 mm (p = 0.009) and from 22.4 ± 4.3 mm to 29.3 ± 5.1 mm (p < 0.001), respectively. AASMA increase was significantly higher compared to ATAPAB or DTAPAB (all, p < 0.001). Similarly, AAMAX increase was significantly higher compared to TAMAX increase (6.8 ± 3.7 mm vs. 0.5 ± 1.9 mm, p < 0.001). In multivariate linear regression analysis, diastolic blood pressure was the only independent predictor for AAMAX increase, even after adjusting for age and dyslipidemia (p = 0.006), whereas no predictors existed for TAMAX increase.
Conclusions: Progression rate of aortic dilation was much faster in abdominal aorta compared to thoracic aorta. TAMAX increase was negligible during 3 year follow-up in Asian, even in a high-risk population of elderly male with hypertension. Contrarily, AAMAX increase was much faster even with small aortic diameter and close monitoring might be needed, especially in patients with high diastolic blood pressure.
Author Disclosures: I. Cho: None. H. Chang: None. S. Lee: None. C. Shim: None. G. Hong: None. N. Chung: None.
- © 2016 by American Heart Association, Inc.