JACC:升主动脉长度与主动脉不良事件的风险

2019-09-18 xing.T MedSci原创

由此可见,主动脉伸长11cm是ATAA的潜在干预标准,它比直径更可靠。AHI(包括长度和直径)比本研究中的任何单个参数更有价值

关于升主动脉瘤的纵向变化信息很少。近日,心血管领域权威杂志JACC上发表了一篇研究文章,该研究旨在概述基于升主动脉长度(AAL)的升主动脉瘤(ATAA)的自然史,并开发新的预测工具以更好地帮助进行危险分层。

研究人员采用综合统计学方法评估了522例ATAA患者的升主动脉直径和长度,以及长期主动脉不良事件(AAEs)(破裂、夹层和死亡)。

与AAL<9cm相比,AAL≥13cm与AAE平均年度发生率几乎增加5倍相关。在11.5和12.0cm之间以及12.5和13.0cm之间检测到两个AAL“拐点”,其AAE的估计概率急剧增加。平均估计的年度主动脉伸长率为0.18厘米/年,主动脉伸长率与年龄有关。由于夹层,主动脉直径增加18%,而AAL仅增加2.7%。由于引入了主动脉高度指数(AHI)(直径高度指数+长度高度指数),Logistic回归模型(受试者操作特征曲线下面积:0.810)的区分能力有显著改善。AHI<9.33、9.38-10.81、10.86-12.50和≥12.​​57cm/m与AAE的年度平均风险增加〜4%、~7%、〜12%和〜18%相关。

由此可见,主动脉伸长11cm是ATAA的潜在干预标准,它比直径更可靠。AHI(包括长度和直径)比本研究中的任何单个参数更有价值。

原始出处:

The Neglected Dimension.Journal of the American College of Cardiology.2019;http://www.onlinejacc.org/content/early/2019/09/12/j.jacc.2019.07.078

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    2019-10-04 医者仁心
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