Background/Aim. Hypertension is a known predictor of proximal aortic
dissection, but it is not commonly present in these patients on presentation.
The associations between ascending aorta with left ventricular hypertrophy,
cardiovascular risk factors and coronary atherosclerosis, and outcome of
these patients are not fully elucidated. Methods. This retrospective study
included 55 consecutive patients with acute type A aortic dissection treated
surgically in our institution during the last 2 years. The diagnosis was
based on imaging studies. Diameter of ascending aorta was measured with
echocardiography. Results. The mean age of the patients was 55.4 ? 12.19
years, and 72.7% were men. A history of arterial hypertension was present in
76.4% of the patients. Maximal ascending aorta diameter was 4.09 ? 0.59 cm,
while patients with frank aneurysm accounted for 5.5%. Systolic blood
pressure on admission was < 150 mmHg in 58.2% of the patients. Diastolic
blood pressure on admission was < 90 mmHg in 54.5% of the patients. Mean
arterial pressure on admission was 104.9 ? 24.6 mmHg. No correlations were
demonstrated between maximal ascending aorta diameter and diameter of the
left ventricular wall, any obtained risk factor and with coronary artery
atherosclerosis (p > 0.05). After six months 11 (20%) patients died, while
intrahospital mortality was 72%. According to logistic regression analysis
which included traditional risk factors, echo parameters, coronary artery
disease and logistic euro scor, mean arterial blood pressure was the
independent predictor of a six-month mortality [RR 0.956; CI (0.918-0.994 );
p = 0.024]. Conclusion. In our population the acute type A aortic dissection
occurred rarely in the setting of frank ascending aortic aneurysms > 5.0 cm.
The majority of patients had a history of arterial hypertension. A history of
arterial hypertension was not associated with maximal ascending aorta
diameter. Mean arterial blood pressure was the independent predictor of a
six-months mortality.