Aortic dilation, physician-made fenestration, and well-designed consternation

2021 ◽  
Vol 74 (4) ◽  
pp. 1098
Author(s):  
Ross Milner
Keyword(s):  
Aortic Dilation

scholarly journals Self-navigated 3D whole-heart MRA for non-enhanced surveillance of thoracic aortic dilation: a comparison to CTA

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Poskaite ◽  
M Pamminger ◽  
C Kranewitter ◽  
C Kremser ◽  
M Reindl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Dilation ◽  
Subjective Image Quality ◽  
Contrast Enhanced ◽  
Whole Heart ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Abstract Funding Acknowledgements Type of funding sources: None. Background The natural history of thoracic aortic aneurysm (TAA) is one of progressive expansion. Asymptomatic patients who do not meet criteria for repair require conservative management including ongoing aneurysm surveillance, mostly carried out by contrast-enhanced computed tomography angiography (CTA). Purpose To prospectively compare image quality and reliability of a prototype non-contrast, self-navigated 3D whole-heart magnetic resonance angiography (MRA) with contrast-enhanced computed tomography angiography (CTA) for sizing of thoracic aortic aneurysm (TAA). Methods Self-navigated 3D whole-heart 1.5 T MRA was performed in 20 patients (aged 67 ± 8.6 years, 75% male) for sizing of TAA; a subgroup of 18 (90%) patients underwent additional contrast-enhanced CTA on the same day. Subjective image quality was scored according to a 4-point Likert scale and ratings between observers were compared by Cohen’s Kappa statistics. Continuous MRA and CTA measurements were analyzed with regression and Bland-Altman analysis. Results Overall subjective image quality as rated by two observers was 1 [interquartile range (IQR) 1-2] for self-navigated MRA and 1.5 [IQR 1-2] for CTA (p = 0.717). For MRA a perfect inter-observer agreement was found for presence of artefacts and subjective image sharpness (κ=1). Subjective signal inhomogeneity correlated highly with objectively quantified inhomogeneity of the blood pool signal (r = 0.78-0.824, all p <0.0001). Maximum diameters of TAA as measured by self-navigated MRA and CTA showed excellent correlation (r = 0.997, p < 0.0001) without significant inter-method bias (bias -0.0278, lower and upper limit of agreement -0.74 and 0.68, p = 0.749). Inter- and intraobserver correlation of aortic aneurysm as measured by MRA was excellent (r = 0.963 and 0.967, respectively) without significant bias (all p ≤ 0.05). Conclusion Self-navigated 3D whole-heart MRA enables reliable contrast- and radiation free aortic dilation surveillance without significant difference to standardized CTA while providing predictable acquisition time and by offering excellent image quality. Abstract Figure.

High prevalence of ascending aortic dilation in adults with repaired coarctation of the aorta

2021 ◽  
pp. 1-6
Author(s):  
Daniel Rinnström ◽  
Mikael Dellborg ◽  
Ulf Thilén ◽  
Peder Sörensson ◽  
Niels-Erik Nielsen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Aortic Valve ◽  
Aortic Valve Disease ◽  
Congenital Heart ◽  
Coarctation Of The Aorta ◽  
Valve Disease ◽  
Aortic Dilation ◽  
Factors Associated ◽  
High Prevalence ◽  
Life Threatening

Abstract Background: Ascending aortic dilation is a feared complication in adults with repaired coarctation of the aorta, as the condition is associated with life-threatening complications such as aortic dissection and rupture. However, the data are currently limited regarding factors associated with ascending aortic dilation in these patients. Methods and results: From the national register of congenital heart disease, 165 adult patients (≥ 18 years old) with repaired coarctation of the aorta, and echocardiographic data on aortic dimensions, were identified (61.2% male, mean age 35.8 ± 14.5 years). Aortic dilation (aortic diameters > 2 SD above reference mean) was found in 55 (33.3%) of the 165 included patients, and was associated with manifest aortic valve disease in univariable logistic regression analysis (OR 2.44, 95% CI [1.23, 4.83]). Conclusions: Aortic dilation is common post-repair of coarctation of the aorta, and is associated with manifest aortic valve disease and thus indirectly with the presence of a bicuspid aortic valve. However, no association was found between aortic dilation and age or blood pressure.

Serial echocardiography for valve dysfunction and aortic dilation in bicuspid aortic valves

2021 ◽  
Vol 38 (3) ◽  
pp. 394-401
Author(s):  
Matthew W. Parker ◽  
Renee Dallasen Muchnik ◽  
Adedotun Ogunsua ◽  
Amartya Kundu ◽  
Suvasini Lakshmanan ◽  
...  
Keyword(s):  
Aortic Dilation ◽  
Aortic Valves ◽  
Valve Dysfunction ◽  
Bicuspid Aortic Valves

Association of Left Ventricular Hypertrophy and Aortic Dilation in Patients with Acute Thoracic Aortic Dissection

Angiology ◽  
2001 ◽  
Vol 52 (7) ◽  
pp. 447-455 ◽  
Author(s):  
Diana Iarussi ◽  
Aurelio Caruso ◽  
Maurizio Galderisi ◽  
Franco Enrico Covino ◽  
Giovanni Dialetto ◽  
...  
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Aortic Dissection ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
Aortic Dilation ◽  
Thoracic Aortic Dissection

scholarly journals Intracellular retention of mutant lysyl oxidase leads to aortic dilation in response to increased hemodynamic stress

JCI Insight ◽  
2019 ◽  
Vol 4 (15) ◽  
Author(s):  
Vivian S. Lee ◽  
Carmen M. Halabi ◽  
Thomas J. Broekelmann ◽  
Philip C. Trackman ◽  
Nathan O. Stitziel ◽  
...  
Keyword(s):  
Lysyl Oxidase ◽  
Aortic Dilation ◽  
Hemodynamic Stress

scholarly journals GSDMD Deficiency Protects Against Aortic Rupture

2021 ◽  
Author(s):  
Dien Ye ◽  
Deborah Howatt ◽  
Zhenyu Li ◽  
Alan Daugherty ◽  
Hong S. Lu ◽  
...  
Keyword(s):  
Drinking Water ◽  
Viral Vectors ◽  
Aortic Rupture ◽  
Initial Study ◽  
Aortic Aneurysms ◽  
Aortic Dilation ◽  
Abdominal Aortic ◽  
Aortic Pathologies ◽  
Deficient Mice ◽  
Macrophage Accumulation

Objective: Aortic ruptures are fatal consequences of aortic aneurysms with macrophage accumulation being a hallmark at the site of ruptures. Pyroptosis is critical in macrophage-mediated inflammation. This study determined effects of pyroptosis on aortic dilation and rupture using GSDMD deficient mice. Approach and Results: In an initial study, male Gsdmd+/+ and Gsdmd-/- mice in C57BL/6J background (8 to 10 weeks old) were infected with adeno-associated viral vectors encoding mouse PCSK9D377Y gain-of-function mutation and fed a Western diet to induce hypercholesterolemia. After two weeks of AAV infection, angiotensin II (AngII, 1,000 ng/kg/min) was infused. During the 4 weeks of AngII infusion, 5 of 13 Gsdmd+/+ mice died of aortic rupture, whereas no aortic rupture occurred in Gsdmd-/- mice. In surviving mice, no differences in either ascending or abdominal aortic dilation were observed between Gsdmd+/+ and Gsdmd-/- mice. To determine whether protection of GSDMD deficiency against aortic rupture is specific to AngII infusion, we subsequently examined aortic pathologies in mice administered beta-aminopropionitrile (BAPN). BAPN (0.5% wt/vol) was administered in drinking water to male Gsdmd+/+ and Gsdmd-/- mice (4 weeks old) for 4 weeks. Six of 13 Gsdmd+/+ mice died of aortic rupture, whereas no aortic rupture occurred in Gsdmd-/- mice. In mice survived, no differences of diameters in the ascending, arch, or abdominal aortic regions were observed between Gsdmd+/+ and Gsdmd-/- mice. Conclusions: GSDMD deficiency protects against AngII or BAPN-induced aortic ruptures in mice.

Tracheal compression by aortic dilation in double inlet ventricle with pulmonary atresia

2006 ◽  
Vol 16 (5) ◽  
pp. 513-514
Author(s):  
Takayasu Nomura ◽  
Kazushi Yasuda ◽  
Norihisa Koyama
Keyword(s):  
Pulmonary Atresia ◽  
Aortic Dilation ◽  
Tracheal Compression

scholarly journals Associations of IGF1 and its binding proteins with abdominal aortic aneurysm and aortic diameter in older men

2012 ◽  
Vol 166 (2) ◽  
pp. 191-197 ◽  
Author(s):  
Bu B Yeap ◽  
S A Paul Chubb ◽  
Kieran A McCaul ◽  
Leon Flicker ◽  
Ken K Y Ho ◽  
...  
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Binding Proteins ◽  
Older Men ◽  
Community Dwelling ◽  
Aortic Diameter ◽  
Aortic Dilation ◽  
Cross Sectional ◽  
Gh Secretion ◽  
Abdominal Aortic

ObjectiveAbdominal aortic aneurysm (AAA) is most prevalent in older men. GH secretion declines with age resulting in reduced IGF1 levels. IGF1 and its binding proteins (IGFBPs) are expressed in vasculature, and lower IGF1 levels have been associated with cardiovascular risk factors and disease. However, the relationship of the IGF1 system with aortic dilation and AAA is unclear. We tested the hypothesis that circulating IGF1 and IGFBPs are associated with AAA and aortic diameter in older men.DesignA cross-sectional analysis involving 3981 community-dwelling men aged 70–89 years was performed.MethodsAbdominal aortic diameter was measured by ultrasound. Plasma total IGF1, IGFBP1 and IGFBP3 were measured by immunoassays.ResultsAfter adjustment for age, body mass index, waist:hip ratio, smoking, hypertension, dyslipidemia, diabetes, coronary heart disease and serum creatinine, a higher IGF1 level was associated with AAA (odds ratio (OR)/1 s.d. increase 1.18, 95% confidence interval (CI) 1.05–1.33, P=0.006), as was the ratio of IGF1/IGFBP3 (OR=1.22, 95% CI 1.10–1.35, P<0.001). Highest IGF1 concentrations compared with lowest quintile were significantly associated with AAA (quintile (Q) 5 vs Q1: OR=1.80, 95% CI 1.20–2.70, P=0.004) as were IGF1/IGFBP3 ratios (Q5 vs Q1: OR=2.52, 95% CI 1.59–4.02, P<0.001). IGF1 and IGFBP1 were independently associated with aortic diameter (β=0.200, 95% CI 0.043–0.357, P=0.012 and β=0.274, 95% CI 0.098–0.449, P=0.002 respectively).ConclusionsIn older men, higher IGF1 and an increased ratio of IGF1/IGFBP3 are associated with AAA, while IGFBP1 is independently associated with increased aortic diameter. Components of the IGF1 system may contribute to, or be a marker for, aortic dilation in ageing men.

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