Aortic morphology post type A acute aortic syndrome: Prognosis significance and association with 24-hour blood pressure-monitoring parameters.

Tytuł:: Aortic morphology post type A acute aortic syndrome: Prognosis significance and association with 24-hour blood pressure-monitoring parameters.
Autorzy:: Delsart P; CHU Lille, Institut Cœur Poumon, Lille, France.
Soquet J; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Inserm U1011, Lille, France.
Ramdane N; METRICS: Évaluation des Technologies de Santé et des Pratiques Médicales, University of Lille, CHU Lille, ULR 2694, Lille, France.
Ramond C; CHU Lille, Institut Cœur Poumon, Lille, France.
Mugnier A; CHU Lille, Institut Cœur Poumon, Lille, France.
Rousse N; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Inserm U1011, Lille, France.
Ledieu G; CHU Lille, Institut Cœur Poumon, Lille, France.
Bical A; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Lille, France.
Loobuyck V; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Inserm U1011, Lille, France.
Jegou B; CHU Lille, Institut Cœur Poumon, Lille, France.
Modine T; CHU Lille, Institut Cœur Poumon, Lille, France.
Hysi I; Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France.
Fabre O; Department of Cardiac Surgery of Artois, Centre Hospitalier de Lens et Hôpital Privé de Bois Bernard, Ramsay Générale de Santé, Lens, France.
Juthier F; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Inserm U1011, Lille, France.
Vincentelli A; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Inserm U1011, Lille, France.
Mounier-Vehier C; CHU Lille, Institut Cœur Poumon, Lille, France.; University of Lille, CHU Lille, Lille, France.
Źródło:: Journal of cardiac surgery [J Card Surg] 2020 May; Vol. 35 (5), pp. 981-987. Date of Electronic Publication: 2020 Mar 16.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Publication: Hoboken, NJ : Wiley-Blackwell
Original Publication: Mount Kisco, N.Y. : Futura Pub. Co., Inc., [c1986-
MeSH Terms:: Blood Pressure*
Blood Pressure Monitoring, Ambulatory*
Aortic Dissection/*pathology
Aortic Dissection/*physiopathology
Aorta, Thoracic/*diagnostic imaging
Aorta, Thoracic/*pathology
Aged ; Aortic Dissection/diagnostic imaging ; Aorta ; Computed Tomography Angiography ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Retrospective Studies ; Risk
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Contributed Indexing:: Keywords: aortic dissection; blood pressure monitoring; false lumen; prognosis
Entry Date(s):: Date Created: 20200317 Date Completed: 20201005 Latest Revision: 20221207
Update Code:: 20240105
DOI:: 10.1111/jocs.14512
PMID:: 32176383
: Czasopismo naukowe

Pełny tekst

Background: After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome.
Methods: The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis.
Results: The population included 79 males, with an overall mean age of 60 ± 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg ± 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P < .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24).
Conclusion: The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
(© 2020 Wiley Periodicals, Inc.)

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