초록접수 현황
| 15F-008 | 구연 발표 |
Changes in Aortic Diameter Over Time in the Enlarged Ascending Aorta: Echocardiographic Follow-up of 1439 Individuals
Joon Bum Kim¹,², Mark E. Lindsay², Thomas E. MacGillivray², Eric M. Isselbacher²,Thoralf M. Sundt III²
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea¹, Thoracic Aortic Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts²
Background : The dilated ascending aorta is believed to exhibit an increased expansion rate in proportion to baseline diameter, especially in individuals with bicuspid aortic valves (BAV), however, there have been few data to support this hypothesis.
Methods : Using an institutional echocardiography (ECHO) database, non-syndromic adults who had maximal ascending aortic diameter ≥ 40mm in baseline ECHO and had subsequent ECHO assessments on the native ascending aorta over ≥ 6 month-intervals were searched. Predictors of aortic expansion were determined by parametric (linear) and non-parametric (Loess) regression models.
Results : 1,439 individuals (65.8±13.4 years; 298 female) met enrollment criteria including 274 individuals (19.0%) with BAV. Baseline mean ascending aortic diameter was 42.5±2.9mm. Overall, data from 4,824 ECHO assessments were retrieved (3.4/patient) during a mean follow-up of 53.3±32.5 months. On multiple linear regression models (R2=0.016, P<0.001), female gender (β=0.088, P=0.001) and BAV (β=0.065, P=0.013) were significant and independent risk factors of aortic expansion while the baseline aortic diameter was inversely associated with the aortic expansion rate (β=-0.074, P=0.005). Loess models demonstrated a superior model fitness (R2=0.070) than parametric models that demonstrated a mixed relationship between baseline aortic diameter and aortic expansion rate: a positive correlation only in larger (>50mm) aorta (Figure). None of the systolic, diastolic and mean BP during follow-up (average 11.9 measurement/patient) were predictive of aortic expansion rates (P values, 0.52-0.95).
Conclusion : Gender and BAV were predictive of aortic expansion over time while baseline aortic diameter showed mixed associations with aortic expansion with a positive correlation only in larger (>50mm) aortas. Given that the statistical models only explain 7% (R2=0.070) of the variability in the aortic remodeling, further research is needed to determine more robust indicators of the aortic expansion.
Methods : Using an institutional echocardiography (ECHO) database, non-syndromic adults who had maximal ascending aortic diameter ≥ 40mm in baseline ECHO and had subsequent ECHO assessments on the native ascending aorta over ≥ 6 month-intervals were searched. Predictors of aortic expansion were determined by parametric (linear) and non-parametric (Loess) regression models.
Results : 1,439 individuals (65.8±13.4 years; 298 female) met enrollment criteria including 274 individuals (19.0%) with BAV. Baseline mean ascending aortic diameter was 42.5±2.9mm. Overall, data from 4,824 ECHO assessments were retrieved (3.4/patient) during a mean follow-up of 53.3±32.5 months. On multiple linear regression models (R2=0.016, P<0.001), female gender (β=0.088, P=0.001) and BAV (β=0.065, P=0.013) were significant and independent risk factors of aortic expansion while the baseline aortic diameter was inversely associated with the aortic expansion rate (β=-0.074, P=0.005). Loess models demonstrated a superior model fitness (R2=0.070) than parametric models that demonstrated a mixed relationship between baseline aortic diameter and aortic expansion rate: a positive correlation only in larger (>50mm) aorta (Figure). None of the systolic, diastolic and mean BP during follow-up (average 11.9 measurement/patient) were predictive of aortic expansion rates (P values, 0.52-0.95).
Conclusion : Gender and BAV were predictive of aortic expansion over time while baseline aortic diameter showed mixed associations with aortic expansion with a positive correlation only in larger (>50mm) aortas. Given that the statistical models only explain 7% (R2=0.070) of the variability in the aortic remodeling, further research is needed to determine more robust indicators of the aortic expansion.
책임저자: Joon Bum Kim
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
연락처 : Joon Bum Kim, Tel: 02-3010-3580 , E-mail : jbkim1975@amc.seoul.kr
