Sex-specific distributions and determinants of thoracic aortic diameters in the elderly

Heart ◽  
2019 ◽  
Vol 106 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Lidia R Bons ◽  
Oscar L Rueda-Ochoa ◽  
Khalid El Ghoul ◽  
Sofie Rohde ◽  
Ricardo PJ Budde ◽  
...  
Keyword(s):  
Cardiac Ct ◽  
The Elderly ◽  
Population Based ◽  
Aortic Diameter ◽  
Rotterdam Study ◽  
Descending Aorta ◽  
Specific Distribution ◽  
The Mean ◽  
Male Sex ◽  
Ascending Aortic Diameter

ObjectiveTo provide population-based distributions of thoracic aortic diameters in men and women aged 55 years or older and to identify determinants of thoracic aortic diameters.MethodsFrom 2003 to 2006, 2505 participants (1208 men, mean age 69.1±6.8 years) from the prospective population-based Rotterdam Study underwent non-enhanced cardiac CT. The diameter of the ascending (AA) and descending aorta (DA) was measured at the level of the pulmonary bifurcation.ResultsThe mean diameter of the ascending and descending aorta was substantially larger in men (38±4 mm and 30±2 mm) than in women (35±3 mm and 27±2 mm). An ascending aortic diameter of larger than 40 mm was found in 228 (18.9%) men and 76 (5.9%) women and a descending aortic diameter larger than 40 mm was found in two men and no women. Male sex was found to be independently associated with larger DA diameter (standardised β 0.24, 95% CI 0.19 to 0.30), while a statistically non-significant trend was found for the AA diameter (standardised β 0.06, 95% CI 0.00 to 0.12). Age, height, weight and traditional cardiovascular risk factors were also associated with larger AA and/or DA diameters. Diabetes was associated with smaller AA and DA diameters. We found no evidence for effect modification by sex.ConclusionsIn persons aged 55 years or older, an ascending aortic diameter of 40 mm or larger was found in 18.9% of men and 5.9% of women. Given the importance of sex, sex-specific distribution values may prove useful in clinical practice, even when correcting for body surface area or height.

scholarly journals FACTORS LINKED TO THE PRACTICE OF PHYSICAL ACTIVITY AMONG THE ELDERLY IN SOUTHERN BRAZIL

2019 ◽  
Vol 25 (3) ◽  
pp. 216-219
Author(s):  
Alisson Padilha de Lima ◽  
Ezequiel Vitório Lini ◽  
Marilene Rodrigues Portella ◽  
Marlene Doring ◽  
Fabrício Bruno Cardoso
Keyword(s):  
Physical Activity ◽  
Urban Environment ◽  
Elderly People ◽  
The Elderly ◽  
Population Based ◽  
Level Of Evidence ◽  
Population Based Study ◽  
Multivariable Analyses ◽  
The Mean ◽  
The City

ABSTRACT Introduction The increase in chronic diseases and physical inactivity are major public health problems among elderly populations worldwide. Objective This article aimed to determine the prevalence and factors associated with the practice of physical activity (PA) among elderly people living in urban environment. Methods A cross-population-based study was conducted in 2014, with 196 elderly people aged ≥ 60 years of age living in urban environment in the city of Passo Fundo, in the State of Rio Grande do Sul. Gross and multivariable analyses were conducted using Poisson regression, estimating the ratios of gross and adjusted prevalence and calculating their respective 95% confidence intervals. Results The mean age was 71.3 (± 8.4). The gross prevalence for the practice of PA was 56.1%. After adjusted analysis, only the variable independent in activities of daily living (ADLs) remained significant (95% CI 1.05 to 4.83) (p = 0.037). Conclusions This research showed an association between the practice of PA and independence in ADLs. Level of Evidence II, Economic and decision analysis - Development of economic model or decision.

scholarly journals Serum caeruloplasmin as a coronary risk factor in the elderly: the Rotterdam Study

1999 ◽  
Vol 81 (2) ◽  
pp. 139-144 ◽  
Author(s):  
Kerstin Klipstein-Grobusch ◽  
Diederick E. Grobbee ◽  
J. F. Koster ◽  
J. Lindemans ◽  
Heiner Boeing ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
The Elderly ◽  
Population Based ◽  
Oxidative Modification ◽  
Substantial Part ◽  
Rotterdam Study ◽  
Reactive Protein ◽  
Study Population ◽  
Independent Risk Factors ◽  
First Myocardial Infarction

Serum Cu and caeruloplasmin levels have been suggested to be independent risk factors for CHD operating through oxidative modification of LDL. However, given its function as an acute-phase protein, the question has been raised whether an elevated caeruloplasmin level is not merely an indicator of inflammation. In the current study, we investigated whether serum caeruloplasmin was associated with subsequent myocardial infarction, taking into account indices of inflammation. The study population consisted of 210 cases of first myocardial infarction and controls, frequency-matched on age (5-year categories) and sex, selected from the population-based cohort of the Rotterdam Study. Serum caeruloplasmin levels were significantly elevated in cases of myocardial infarction compared with controls (510 (sd 110) v. 470 (sd 100) mg/1; P = 0·007). Risk of myocardial infarction for the highest compared with the lowest quartile of caeruloplasmin was 2·46 (95 % CI 1·04, 6·00; Ptrend = 0·043) after adjustment for age, sex, BMI, pack-years smoked, serum cholesterol, systolic blood pressure, and income. The relative risk was most evident in current smokers. Adjustment for C-reactive protein and leucocyte count reduced the excess risk by 33 %. This suggests that a substantial part of the observed association between serum caeruloplasmin and CHD may be attributed to inflammation processes rather than to the pro-oxidant activity of caeruloplasmin.

The DASH and the QuickDASH instruments. Normative values in the general population in Norway

2013 ◽  
Vol 39 (2) ◽  
pp. 140-144 ◽  
Author(s):  
T. Aasheim ◽  
V. Finsen
Keyword(s):  
General Population ◽  
Normative Data ◽  
The Elderly ◽  
Population Based ◽  
Normative Values ◽  
Confidence Limits ◽  
Mean Values ◽  
Co Morbidity ◽  
The Mean ◽  
Spearman’S Correlation

We collected population-based normative data for the DASH (disabilities of the arm, shoulder and hand ) and QuickDASH questionnaires in order to determine the co-morbidity to be expected in a group of patients. We also studied the correlation between the two scores. A total of 2000 DASH forms and 800 QuickDASH forms were mailed to 1400 men and 1400 women. They were selected randomly in groups of 200 men and women in each age decade from 20–29 to over 80 years old. A total of 50% of the DASH forms and 56% of the QuickDASH forms were returned ( p < 0.005). The mean DASH scores for women rose with age from 5 among those aged 20–29, to 22 among those aged 70–79 and 36 for those over 80. The corresponding mean values for men were 5, 13 and 22. The mean DASH and QuickDASH scores extracted from the DASH forms were very similar in each age decade. Spearman’s correlation coefficient for the two forms was 0.965 for all 992 forms and 0.930 for the 174 forms with scores of 30 or more. There were, however, wide confidence limits for the agreement between scores in individual patients. The high average scores in the general population, particularly among the elderly, should be borne in mind when evaluating scores among patients. The QuickDASH should be preferred to the full DASH as it gives the same information, but is shorter and completed more often.

scholarly journals Association between ascending aortic diameter and coronary artery dilation: a demographic data analysis

2016 ◽  
Vol 44 (6) ◽  
pp. 1349-1358 ◽  
Author(s):  
Ali Can Hatemi ◽  
Aybala Tongut ◽  
Zeki Özyedek ◽  
İsmail Çerezci ◽  
İlhan Özgöl ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Demographic Data ◽  
Calcium Score ◽  
Coronary Calcium ◽  
Aortic Diameter ◽  
Coronary Calcium Score ◽  
Computed Tomographic ◽  
Male Sex ◽  
Computed Tomographic Coronary Angiography ◽  
Ascending Aortic Diameter

Objective Coronary artery dilations (CDs), a subgroup of coronary artery anomalies (CAAs), are relatively rare but important cardiac pathologies. They are considered to be linked to coronary atherosclerosis in most cases. Methods The demographic data, multi-slice computed tomographic coronary angiography data, coronary calcium score, and ascending aortic diameter (AAD) of 1538 patients were reviewed. In total, 197 (12.8%) patients (166 men, 31 women; age 15 – 84 years; mean 55.78 ± 12.32 years) with CAAs were identified, and 81 (5.3%) patients (70 men, 11 women; age 27 – 80 years; mean 56.63 ± 12.06 years) had CDs. Multiple regression and correlation analyses were performed in all 1538 patients to predict the association between the AAD and the presence of CD and thus their correlation with atherosclerosis. Results The AAD was significantly larger in patients with than without CAAs and CDs. Male sex was significantly more prevalent in patients with CAAs and CDs. According to the multiple logistic regression model, male sex increased the risk of CD by 2.650 and the risk of CAA by 2.017, while hyperlipidaemia decreased the risk of CAA by 0.681. While a moderately weak correlation between the AAD and age was observed in patients with CDs, no correlation was found between the AAD and coronary calcium score. Conclusion Although the natural history and physiopathology of CDs is not yet fully understood, the present study shows an association between the AAD and the presence of CDs but a lack of association between atherosclerosis and CDs.

scholarly journals Male-female specific aortic growth after 10 year follow-up in an aged population

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Thijssen ◽  
F.O Mutluer ◽  
J.E Van Der Toorn ◽  
L.R Bons ◽  
A.L Gokalp ◽  
...  
Keyword(s):  
Growth Rate ◽  
General Population ◽  
The Netherlands ◽  
Growth Rates ◽  
Cardiac Ct ◽  
Rotterdam Study ◽  
Antithrombotic Agents ◽  
Descending Aorta ◽  
Factors Associated

Abstract Background Aortic diameters are known to increase with age. However, longitudinal data on normal thoracic aortic growth rate over the adult life course are lacking. To better understand and recognize pathological aortic growth and factors influencing aortic dilatation, it is crucial to study aortic growth patterns in the general population. Purpose To study sex- and age-specific aortic growth rates in the general population, and to identify factors associated with aortic growth rate and developing aortic pathology. Methods Participants of the prospective population-based Rotterdam Study who underwent non-enhanced cardiac CT (2003–2006) were invited for a follow-up non-enhanced cardiac CT (2018–2019). On both CT-scans, diameters of the ascending (AA) and descending aorta (DA) were measured at the level of the pulmonary bifurcation. Mean aortic growth rates and 95th percentiles were calculated. Linear regression models were built to identify factors associated with aortic growth. Results In this preliminary analysis, 933 participants were included (52% females, median age 65 years). During a mean follow-up time of 14 years, the mean aortic growth rates of the ascending aorta (AA) were 0.08 mm/year in males and 0.07 mm/year in females. For the descending aorta (DA) these were 0.07 mm/year in males and 0.05mm/year in females. Participants with AA diameters of ≥40 mm (n=147) or DA diameters of ≥35 mm (n=11) at baseline did not show accelerated growth compared to the other participants. Higher systolic blood pressure (SBP), and use of antithrombotic agents were associated with less AA growth. Age, diastolic blood pressure (DBP) and male sex were associated with more AA growth. For the DA, higher DBP and smoking were associated with a higher growth rate. Higher SBP, diabetes and use of antithrombotic agents were associated with less DA growth. Conclusion Thoracic aortic growth rates in the general population are low. Differences in growth were found between men and women, although these differences may not be clinically relevant. Antithrombotic medication use was related to lower thoracic aortic growth rates, emphasizng the need for further investigation into the potential effect of this treatment. Funding Acknowledgement Type of funding source: Other. Main funding source(s): The Rotterdam Study is funded by Erasmus MC and Erasmus University, Rotterdam, the Netherlands; the Netherlands Organisation for Scientific Research (NWO); the Netherlands Organisation for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Ministry of Education, Culture and Science; the Ministry for Health, Welfare and Sports; the European Commission (DG XII); and the Municipality of Rotterdam. MK is supported by a VENI grant (91616079) from ZonMw. JWR-H, LRB, CGET, ALG, MMM and JJMT are supported by the Dutch Heart Foundation (2013T093) and ZonMW (849200014).

scholarly journals Predictors of Orthostatic Hypotension in the Elderly: Results from the Amirkola Health and Ageing Project (AHAP) Study

2019 ◽  
Author(s):  
Mehdi Safarpour ◽  
Akbar Fotouhi ◽  
Seyed Reza Hosseini ◽  
Masume Mohamadzade ◽  
Ali Bijani
Keyword(s):  
Orthostatic Hypotension ◽  
The Elderly ◽  
Population Based ◽  
Cognitive Status ◽  
Elderly Subjects ◽  
Population Based Study ◽  
Final Model ◽  
Significant Burden ◽  
Important Health ◽  
The Mean

Background: Orthostatic hypotension (OH) in the elderly is an important health challenge that poses a significant burden. We sought to determine the prevalence and correlates of OH in an elderly population-based study. Methods: This study was conducted within the framework of the Amirkola Health and Ageing Project (AHAP) on 1,588 elderly individuals aged ≥60 years. The baseline measurement was performed from April 2011 to July 2012. The relationships between OH (dependent variable) and age, sex, diabetes, hypertension, and cognitive status (independent variables) were investigated by logistic regression. Results: The mean age of the participants was 69.37±7.42 years (men: 69.96±7.68 y, women: 68.66±7.02 y). The prevalence of OH was 10.7%: 8.4% in the male and 13.7% in the female patients. In the final model, hypertension (OR=2.4, 95% CI: 1.6–3.7), diabetes (OR=1.3, 95% CI: 1.0–1.9), age (OR=2.9, 95% CI: 1.7–4.8), and female sex (female [OR=1.6, 95% CI: 1.1–2.3]) were significantly correlated with OH. Conclusion: The prevalence of OH in our elderly subjects increased with age. Additionally, the older participants with diabetes and hypertension had a higher likelihood of having this OH.   J Teh Univ Heart Ctr 2019;14(4):165-170   This paper should be cited as: Safarpour M, Fotouhi A, Hosseini SR, Mohamadzade M, Bijani A. Predictors of Orthostatic Hypotension in the Elderly: Results from the Amirkola Health and Ageing Project (AHAP) Study. J Teh Univ Heart Ctr 2019;14(4): 165-170

Seasonal Variation in Fibrinogen in the Rotterdam Study

1997 ◽  
Vol 78 (03) ◽  
pp. 1059-1062 ◽  
Author(s):  
J G van der Bom ◽  
M P M de Maat ◽  
M L Bots ◽  
A Hofman ◽  
C Kluft ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Seasonal Variation ◽  
Hdl Cholesterol ◽  
The Elderly ◽  
Population Based ◽  
Seasonal Difference ◽  
Risk Indicator ◽  
Rotterdam Study ◽  
Outdoor Temperature ◽  
Cross Sectional

SummaryAs evidence accumulates to implicate fibrinogen as a risk indicator for cardiovascular disease, it is of interest to study its seasonal variation. A population based cross-sectional study was performed among participants of the Rotterdam Study, a cohort of 7,983 men and women, aged 55 years and over. Fibrinogen levels were measured by the prothrombin time derived method in the first 2,325 participants of the study. Fibrinogen levels were considerably higher in winter. The seasonal difference was 0.34 g/1 (95% confidence interval 0.29,0.39) and was more pronounced in subjects aged 75 years and over than in subjects aged 55 to 75 years, 0.43 g/1 (0.34,0.52) and 0.29 g/1 (0.24,0.35), respectively. Additional adjustment for body mass index, systolic and diastolic blood pressure, and total and HDL cholesterol did not materially change the findings. After adjustment for seasons, outdoor temperature was not associated with fibrinogen. Adjustment for outdoor temperature did not change the seasonal variation of fibrinogen, seasonal difference 0.31 g/1 (0.24, 0.37). In conclusion, fibrinogen levels are highest in Winter. The seasonal variation of fibrinogen is more pronounced in the elderly. Outdoor temperature does not seem to play a role in the seasonal variation of fibrinogen. Seasonal variation of fibrinogen may partly explain the increased cardiovascular disease mortality in Winter.

scholarly journals Thoracic Endovascular Aortic Repair for Retrograde Type A Aortic Intramural Hematoma

2021 ◽  
Vol 8 ◽  
Author(s):  
Gen Li ◽  
Xia Xu ◽  
Jun Li ◽  
Sizheng Xiong
Keyword(s):  
Overall Survival ◽  
Intramural Hematoma ◽  
Type A ◽  
Thoracic Endovascular Aortic Repair ◽  
Endovascular Aortic Repair ◽  
Aortic Diameter ◽  
Descending Aorta ◽  
Aortic Repair ◽  
The Mean ◽  
Aortic Intramural Hematoma

Objectives: To evaluate the effects of thoracic endovascular aortic repair (TEVAR) in descending aorta for retrograde type A aortic intramural hematoma (re-TAIMH).Methods: From January 2013 to September 2019, 65 consecutive patients diagnosed with re-TAIMH and treated by TEVAR were enrolled in this retrospective cohort study, of whom 44 patients presented with entry tear in descending aorta (Group A) and 21 with penetrating atherosclerotic ulcer (Group B). The clinical data, including baseline characteristics, adverse events, aortic remolding, and overall survival were reviewed.Results: The mean age of all the patients was 52.0 ± 8.3 years, and 54 (83.1%) patients were men. The mean maximal ascending aortic diameter (MAAD) was 43.1 ± 5.4 mm, and the mean maximal ascending aortic hematoma thickness (MAAHT) was 9.6 ± 4.7 mm. TEVAR was performed under general anesthesia in 53 (81.5%) patients, while 12 (18.5%) patients were treated under local anesthesia. There were two deaths during hospitalization (one with rupture and another with multiple organ dysfunction syndrome), and overall survival at 1, 4, and 7 years for all 65 patients was 93.8, 92.0, and 87.4%, respectively. The MAAD and MAATH decreased significantly after TEVAR (p &lt; 0.05) in the two groups, so did the mean descending aortic diameter at the pulmonary bifurcation level. Type I endoleak, dialysis, progression to type A aortic dissection, and enlargement in MAAHT and MAAD were more common complications, which occurred in four, three, two, and two patients, respectively.Conclusion: Patients with retrograde TAIMH treated by TEVAR had a favorable prognosis including late survival and aortic remolding. However, some post-intervention complications were not negligible.

scholarly journals Feasibility of a Single Contrast Bolus High-Pitch Pulmonary CT Angiography Protocol Followed by Low-Dose Retrospectively ECG-Gated Cardiac CT in Patients with Suspected Pulmonary Embolism

2018 ◽  
Vol 190 (06) ◽  
pp. 542-550 ◽  
Author(s):  
Julia Schäfer ◽  
Holger Haubenreisser ◽  
Mathias Meyer ◽  
Joachim Grüttner ◽  
Thomas Walter ◽  
...  
Keyword(s):  
Low Dose ◽  
Cardiac Ct ◽  
Main Pulmonary Artery ◽  
Suspected Pulmonary Embolism ◽  
High Pitch ◽  
Descending Aorta ◽  
The Mean ◽  
Contrast Bolus ◽  
Attenuation Values ◽  
Rv Function

Introduction To prospectively evaluate the feasibility of single contrast bolus high-pitch CT pulmonary angiography (CTPA) subsequently followed by low-dose retrospectively ECG-gated cardiac CT (4D-cCT) in patients with suspected pulmonary embolism (PE) to accurately evaluate right ventricular (RV) function. Materials and Methods 62 patients (33 female, age 65.1 ± 17.5 years) underwent high-pitch CTPA examination with 80cc of iodinated contrast material. 5 s after the end of the high-pitch CTPA study, a low-dose retrospectively ECG-gated cardiac CT examination was automatically started. The volume CT dose index (CTDI vol) and dose length product (DLP) were recorded in all patients and the effective dose was calculated. For the assessment of image quality, attenuation was measured as Hounsfield units (HUs) within various regions of interest (ROIs). These ROIs were used to calculate the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). Subjective image quality was assessed using a five-point Likert scale. On 4D-cCT, the ejection fraction of both ventricles (RVEF, LVEF) as well as the ratio of RVEF and LVEF (RVEF/LVEF) was assessed. The statistical difference of all parameters between the PE and non-PE group was calculated. Results The mean effective radiation dose was 4.22 ± 2.05 mSv. Attenuation measurements on CTPA showed the highest attenuation values in the main pulmonary artery (442.01 ± 187.64). On 4D-cCT attenuation values were highest in the descending aorta (560.59 ± 208.81). The CNR and SNR values on CTPA were highest within the main pulmonary artery (CNR = 12.43 ± 4.57; SNR = 15.14 ± 4.90). On 4D-cCT images, the highest SNR and CNR could be measured in the descending aorta (CNR = 10.26 ± 5.57; SNR = 10.86 ± 5.17). The mean LVEF was 60.73 %± 14.65 %, and the mean RVEF was 44.90 %± 9.54 %. The mean RVEF/LVEF was 0.79 ± 0.29. There was no significant difference between the PE and non-PE group for either of the parameters. Conclusion The investigated combined CTPA and 4D-cCT protocol is feasible using a single contrast bolus and allows the evaluation of RV function in patients with suspected PE. Further studies have to evaluate the additional value of this protocol regarding risk stratification in patients with PE. Key Points:  Citation Format

scholarly journals Assessment of thoracic aorta in different cardiac phases in patients with non-aorta diseases using cardiac CT

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xue Zheng ◽  
Yu-jiao Deng ◽  
Fu-Gang Han ◽  
Jin-Rong Zhou ◽  
Li Luo ◽  
...  
Keyword(s):  
Thoracic Aorta ◽  
Mixed Model ◽  
Cardiac Ct ◽  
Linear Mixed Model ◽  
Main Pulmonary Artery ◽  
Aortic Disease ◽  
Aortic Diameter ◽  
Maximum Diameter ◽  
Cardiac Phase ◽  
Descending Aorta

AbstractThe aim was to evaluate the thoracic aorta in different cardiac phases to obtain the correct cardiac phase for measuring the maximum diameter required to predict aortic disease. Cardiac CT was performed on 97 patients for suspected coronary artery disease. The average diameter of ascending (AAD) and descending aorta (DAD) in the plane of pulmonary bifurcation, in the plane of the sinus junction (AAD [STJ] and DAD [STJ]), descending aorta in the plane of the diaphragm (DAD [Dia]), the diameter of the main pulmonary artery (MPAD), distance from the sternum to the spine (S-SD), and distance from the sternum to the ascending aorta (S-AAD) were assessed at 20 different time points in the cardiac cycle. Differences in aortic diameter in different cardiac phases and the correlation between aortic diameter and traditional risk factors were analyzed by the general linear mixed model. The diameter of the thoracic aorta reached the minimum at the phase of 95–0%, and reached the maximum at 30–35%. The maximum values of AAD, AAD (STJ), DAD, DAD (STJ), and DAD (Dia) were 32.51 ± 3.35 mm, 28.86 ± 3.01 mm, 23.46 ± 2.88 mm, 21.85 ± 2.58 mm, and 21.09 ± 2.66 mm, respectively. The maximum values of MPAD/AAD and DAD/AAD (STJ) were 0.8140 ± 0.1029, 0.7623 ± 0.0799, respectively. The diameter of the thoracic aorta varies with the cardiac phase. Analyzing the changes in aortic diameter, which can be done using cardiac CT, could provide a more accurate clinical measurement for predicting aortic disease.

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