Thoracic and Abdominal Aortic Diameter Measurement by MRI Using Plain Axial Volumetric Interpolated Breath-hold Examination in Epidemiologic Research

Abstract. Background: Biomarkers reflecting diverse pathophysiological pathways may play an important role in the pathogenesis of abdominal aortic aneurysm (aortic diameter ≥30 mm, AAA), levels of many biomarkers are elevated and correlated to aortic diameter among 65-year-old men undergoing ultrasound (US) screening for AAA. Probands and methods: To evaluate potential relationships between biomarkers and aortic dilatation after long-term follow-up, levels of C-reactive protein (CRP), proneurotensin (PNT), copeptin (CPT), lipoprotein-associated phospholipase 2 (Lp-PLA2), cystatin C (Cyst C), midregional proatrial natriuretic peptide (MR-proANP), and midregional proadrenomedullin (MR-proADM) were measured in 117 subjects (114 [97 %] men) aged 47–49 in a prospective population-based cohort study, and related to aortic diameter at US examination of the aorta after 14–19 years of follow-up. Results: Biomarker levels at baseline did not correlate with aortic diameter after 14–19 years of follow up (CRP [r = 0.153], PNT [r = 0.070], CPT [r = –.156], Lp-PLA2 [r = .024], Cyst C [r = –.015], MR-proANP [r = 0.014], MR-proADM [r = –.117]). Adjusting for age and smoking at baseline in a linear regression model did not reveal any significant correlations. Conclusions: Tested biomarker levels at age 47–49 were not associated with aortic diameter at ultrasound examination after 14–19 years of follow-up. If there are relationships between these biomarkers and aortic dilatation, they are not relevant until closer to AAA diagnosis.

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Endovascular stentgrafting to improve the outcome of a highly morbid cohort of patients with combined thoracic and abdominal aortic pathologies

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2005-862182 ◽

2005 ◽

Vol 53 (S 01) ◽

Author(s):

D Mayer ◽

E Gasal ◽

T Pfammatter ◽

R Pfiffner ◽

M Turina ◽

...

Keyword(s):

Abdominal Aortic ◽

Thoracic And Abdominal ◽

Aortic Pathologies

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Determinants of central aortic pressure and pulse pressure amplification changes in patients with aortic aneurysm: the role of aortic diameter and aortic aneurysm location level

European Heart Journal ◽

10.1093/ehjci/ehaa946.2311 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A Gurevich ◽

I Emelyanov ◽

N Zherdev ◽

D Chernova ◽

A Chernov ◽

...

Keyword(s):

Blood Pressure ◽

Aortic Aneurysm ◽

Pulse Pressure ◽

Pulse Wave ◽

Augmentation Index ◽

Aortic Pressure ◽

Aortic Diameter ◽

Maximum Diameter ◽

Central Aortic Pressure ◽

Abdominal Aortic

Abstract Background The presence of aortic aneurysm can alters pulse wave propagation and reflection, causing changes in central aortic pressure and pulse pressure amplification (PPA) between the aorta and the brachial artery that might be associated with unfavorable hemodynamic effects for the central arteries and the heart. However, the impact of the location of the aneurysm and increase of the aortic diameter on central blood pressure (CBP) is not fully understood. Objective To investigate central aortic pressure and PPA regarding to association with arterial stiffness and aortic diameter in patients with ascending aortic aneurysm (AA), descending thoracic and abdominal aortic aneurysm (TAA and AAA). Methods 122 patients (96 males, 65±11 years) with aortic aneurysm were enrolled before aortic repair. The parameters of the aorta were evaluated by MSCT angiography: 44 patients (30 males, 55±13 years) had AA (the maximum diameter: 59.9±14.2 mm), 13 patients (11 males, 62±11 years) had TAA (the maximum diameter: 62.8±8.0 mm) and 65 patients (54 males, 69±8 years) had AAA (the maximum diameter: 52.3±17.2 mm). Brachial blood pressure (BBP) was measured by OMRON. CBP, augmentation index (AIx), carotid-femoral pulse wave velocity (PWV) were assessed by SphygmoCor. PPA was calculated as a difference between the values of central and brachial pulse pressure (CPP and BPP). Results Patients of the three groups did not differ in BPP (AA: 59.2±17.6; TAA 56.8±12.8; AAA: 59.3±11.4 mm Hg; P=0.5). Intergroup comparison revealed a difference in CPP between the three patients groups: CPP was higher in patients with AA and AAA, lower in patients with TAA (AA: 50.3±16.2; TAA 43.8±10.8; AAA: 50.0±11.2 mm Hg; P=0.05). PPA was lower in patients with AA and AAA than in patients with TAA (9.6±6.7 and 9.3±4.2 vs. 13.0±6.5 mm Hg; P=0.05 and P=0.04, respectively). IAx was higher in patients with AA and AAA than in patients with TAA (25.2±8.1 and 27.6±8.2 vs. 17.2±8.2 mm Hg; P=0.008 and P=0.001, respectively). A decrease of PPA across all patients correlated with an increase of IAx (r = - 0.268; P=0.003). CPP decreased with an increase of the aortic diameter for each level of the aneurysm (AA: r = - 0.460, P=0.016; TAA: r = - 0.833, P=0.003; AAA: r = - 0.275, P=0.05). PWV decreased with the expansion of the maximum aortic diameter at the level of the AA, TAA and AAA: (r = - 0.389, P=0.03; r = - 0.827, P=0.02 and r = - 0.350, P=0.01, respectively). Conclusion In patients with aortic aneurysm measurements of lower central pulse pressure and reduced PWV indicate an association with increased diameter of the aneurysm. An increase in augmentation index, early return of reflected waves, thus smaller PP amplification and higher CPP were identified in patients with ascending and abdominal aortic aneurysm compared by patients with descending thoracic aortic aneurysm. Funding Acknowledgement Type of funding source: None

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Thoracic and abdominal aortic diameters in a general population: MRI-based reference values and association with age and cardiovascular risk factors

European Radiology ◽

10.1007/s00330-015-3926-6 ◽

2015 ◽

Vol 26 (4) ◽

pp. 969-978 ◽

Cited By ~ 11

Author(s):

Birger Mensel ◽

Lydia Heßelbarth ◽

Michael Wenzel ◽

Jens-Peter Kühn ◽

Marcus Dörr ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Reference Values ◽

Abdominal Aortic ◽

Thoracic And Abdominal

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Sex-specific reference values and determinants of infra-renal abdominal aortic diameter among women and men from general population

European Heart Journal ◽

10.1093/ehjci/ehaa946.2841 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

F Zhu ◽

B Arshi ◽

M Ikram ◽

R De Knegt ◽

M Kavousi

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

General Population ◽

Cardiovascular Risk Factors ◽

Reference Values ◽

Aortic Diameter ◽

Funding Source ◽

Men And Women ◽

Abdominal Aortic

Abstract Introduction Abdominal aortic diameter has shown to be a marker of adverse cardiovascular outcomes. Among the non-aneurysmal populations, studies regarding abdominal aortic diameter normal reference values are sparse. Moreover, data regarding the associations between cardiovascular risk factors and aortic diameter among men and women are limited. Purpose To establish age- and sex-specific distribution of the infra-renal abdominal aortic diameters among non-aneurysmal older adults from the general population and to investigate the associations between cardiovascular risk factors and aortic diameters in men and women. Methods From a population-based cohort, 4032 participants (mean age, 67.2 years; 60.4% women) with infra-renal diameter assessment and without history of cardiovascular disease were included. Mean and quantile values of diameters were calculated in different age groups. Multiple linear regression analysis was used to detect the association of cardiovascular risk factors with diameters in men and women. Results The mean crude diameter was larger in men [mean (SD): 19.5 (2.6) mm] compared to women [17.0 (2.4)mm] but after adjustment for body surface area (BSA), the differences were small. There was a non-linear relationship between age and diameter (p<0.001). After 66 years of age, the increase in diameter with increasing age was attenuated. After age 74 years in women and 71 years in men, the relationship between age and infra-renal aortic diameter was no longer statistically significant (Figure). Waist [standardized β (95% CI): 0.02 (0.0–0.04) in women and 0.03 (0.01–0.06) in men] and diastolic blood pressure [0.04 (0.02–0.05) in women and 0.02 (0.0–0.04) in men] were the risk factors for diameters in both sexes. Body mass index [0.02 (0.01–0.09)], systolic blood pressure [−0.01 (−0.02 to −0.01)], smoking status [0.21 (0.02–0.39)], cholesterol [−0.19 (−0.29 to −0.09)], and lipid-lowering medication [−0.47 (−0.71 to −0.23)] were significantly associated with aortic diameter only in women. Conclusion The differences in the crude abdominal aortic diameter between women and men diminished after taking into account the BSA. The abdominal aortic diameter increased steeply with advancing age and up to 66 years of age. However, after 74 years in women and 71 years in men, the diameter values reached a plateau. We also observed sex differences in the associations of cardiovascular risk factors with abdominal aortic diameter. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Netherlands Organization for the Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE)

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Abstract P247: Ethnic Differences in Infrarenal Aortic Diameter and Area in a Population-Based Study

Circulation ◽

10.1161/circ.125.suppl_10.ap247 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

David E Timaran ◽

Eric B Rosero ◽

Adriana J Higuera ◽

Ron Peshock ◽

R James Valentine ◽

...

Keyword(s):

Body Size ◽

Ethnic Differences ◽

Population Based ◽

Aortic Diameter ◽

Hispanic Ethnicity ◽

Female Sex ◽

Abdominal Aortic ◽

Aortic Area ◽

Blacks And Whites ◽

Lower Height

Objective: Abdominal aortic aneurysms are defined as a 50% or greater increase in infrarenal aortic diameter (IAD). However, normal IAD has not been defined for all ethnic groups as minorities have been underrepresented in most studies. The aim of the study was to assess ethnic differences in IAD and infrarenal aortic area (AoA) adjusting for the effects of age, gender and body size in the general population. Methods: Participants (2,515) in a population based study underwent high-resolution magnetic resonance imaging (MRI) of the abdominal aorta. Analyses of variance and multiple regression analyses were used to assess the relationship between race/ethnicity, age, gender and body size and IAD and aortic area. Subjects with AAA detected by MRI (defined as IAD ≥ 3.0 cm) were excluded from the analysis. Results: Decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced IAD by multivariate linear regression (all P < 0.001). Of these, female sex and Hispanic ethnicity were the factors more strongly associated with aortic size. Female sex was associated with 0.27 cm reduction in IAD and Hispanic ethnicity with 0.39 cm reduction in IAD. Similarly, decreasing age, female sex, Hispanic ethnicity, and lower height were independent predictors of reduced AoA. Female sex was associated with a 51 cm 2 reduction in AoA and Hispanic ethnicity with 11.1 cm 2 reduction in AoA. Although Hispanics had higher BMI than blacks and whites ( P =.01), and lower height values than blacks and whites (P<.0001), IADs and AoAs were consistently lower among Hispanics. Conclusions: Ethnic differences exist in infrarenal aortic diameter. Despite larger body size, Hispanics have significantly lower IAD than blacks and whites in the general population. The reduced aortic size in Hispanics suggests that the thresholds for abdominal aortic aneurysm diagnosis, rupture and repair may be lower and need to be established.

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Regression of a Descending Thoracoabdominal Aortic Dissection following Staged Deployment of Thoracic and Abdominal Aortic Endografts

Journal of Endovascular Therapy ◽

10.1177/15266028020090s215 ◽

2002 ◽

Vol 9 (2_suppl) ◽

pp. II-92-II-97 ◽

Cited By ~ 2

Author(s):

Rodney A. White ◽

Carlos Donayre ◽

Irwin Walot ◽

James Lee ◽

George E. Kopchok

Keyword(s):

Aortic Dissection ◽

Stent Graft ◽

False Lumen ◽

Acute Chest Pain ◽

Aortic Aneurysms ◽

Abdominal Aneurysm ◽

Entry Site ◽

Abdominal Aortic ◽

Thoracic And Abdominal ◽

Thoracic Stent Graft

Purpose: To describe the successful endovascular repair and regression of an extensive descending thoracoabdominal aortic dissection associated with thoracic and abdominal aortic aneurysms. Case Report: An 83-year-old man presented with acute chest pain and shortness of breath. A descending thoracoabdominal aortic dissection that extended from near the left subclavian artery (LSA) to the right common iliac artery was found on computed tomography. Separate aneurysms in the thoracic and abdominal aorta were also identified. Staged endovascular procedures were undertaken to (1) close the single entry site and exclude the aneurysm in the thoracic aorta with an AneuRx thoracic stent-graft, (2) exclude the abdominal aneurysm and distal re-entry site with a bifurcated AneuRx endograft, and (3) treat a newly dilated thoracic segment between the LSA and first thoracic stent-graft. At 1 year, the false lumen had completely disappeared, the thoracic aneurysm had collapsed onto the endograft, and the abdominal aneurysm had shrunk by 30%. Conclusions: The potential to treat extensive aortic dissections with the hope that they might regress is promising, but repair of highly complex lesions involving one or more aneurysms in addition to the dissection requires meticulous imaging studies both preoperatively and intraprocedurally.

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