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Olukorode JO, Onwuzo CN, Otabor EO, Nwachukwu NO, Omiko R, Omokore O, Kristilere H, Oladipupo Y, Akin-Adewale R, Kuku O, Ugboke JO, Joseph-Erameh T. Aortic Size Index Versus Aortic Diameter in the Prediction of Rupture in Women With Abdominal Aortic Aneurysm. Cureus 2024; 16:e58673. [PMID: 38774170 PMCID: PMC11106735 DOI: 10.7759/cureus.58673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2024] [Indexed: 05/24/2024] Open
Abstract
Abdominal aortic aneurysms (AAAs) pose significant challenges in clinical management, particularly in female patients, whose unique anatomical and physiological characteristics influence rupture risk. While aortic diameter (AD) has traditionally been the primary metric for predicting rupture, its limitations, especially in women, have spurred exploration into alternative measures such as the aortic size index (ASI). This review examines the anatomy and physiology of AAAs in women, gender-specific challenges in diagnosis and management, and the comparative effectiveness of ASI versus AD in predicting rupture risk. ASI, calculated as AD divided by body surface area (BSA), offers a more nuanced assessment by adjusting for individual body size differences, potentially mitigating gender disparities in rupture rates. Comparative analyses indicate ASI's superiority in predicting adverse aortic events, particularly in women, thereby advocating for its integration into clinical practice to improve patient outcomes. Additionally, emerging techniques such as 3D volumetric measurements and biomechanical assessments show promise in enhancing rupture risk prediction, heralding a shift toward more personalized and effective management strategies for AAA patients.
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Affiliation(s)
- John O Olukorode
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Chidera N Onwuzo
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Emmanuel O Otabor
- Internal Medicine, University Hospital Coventry and Warwickshire, Coventry, GBR
| | - Nwachukwu O Nwachukwu
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Raymond Omiko
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Olutomiwa Omokore
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | - Heritage Kristilere
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
| | | | - Rolake Akin-Adewale
- Internal Medicine, College of Health Sciences, University of Ilorin, Ilorin, NGA
| | - Oluwatosin Kuku
- Internal Medicine, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Ogun, NGA
| | - Joshua O Ugboke
- Internal Medicine, College of Medicine, University of Lagos, Lagos, NGA
| | - Thummim Joseph-Erameh
- Internal Medicine, Benjamin S. Carson College of Health and Medical Sciences, Babcock University, Ilishan-Remo, NGA
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Gać P, Hajdusianek W, Żórawik A, Macek P, Poręba M, Poręba R. Thickness and Volume of Epicardial Adipose Tissue in Relation to Stiffness and Elasticity of Aorta Assessed by Computed Tomography Angiography. Biomedicines 2023; 11:1617. [PMID: 37371711 DOI: 10.3390/biomedicines11061617] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
PURPOSE The aim of the study was to assess the importance of the measurements of thickness and volume of epicardial adipose tissue (EAT) in coronary computed tomography angiography (CCTA) as a predictive factor of increased stiffness and impaired elasticity of aorta. METHODS AND MATERIALS The study involved a group of 97 patients (63.48 ± 8.50 years). In accordance with the medians of epicardial adipose tissue (EAT) parameters, aortic elasticity and stiffness parameters, patients were divided into subgroups: EAT thickness median 9.40 mm, EAT volume median 61.95 mL, EAT thickness index 5.08 mm/m2 and EAT volume index 34.33 mL/m2. RESULTS The mean coronary artery calcium score was 162.24 (±317.69). The mean aortic stiffness index was 4.18 (±0.81). The assessed mean aortic elasticity parameters were 3.29% (±2.37) and 0.12 cm2/dyn (±0.09) for strain and distensibility, respectively. A positive linear correlation was observed between EAT parameters and aortic stiffness (0.21), volume (0.51), thickness index (0.24), volume index (0.55) and, for aorta elasticity, a negative linear correlation between the following EAT parameters was observed: thickness (-0.32 and -0.30), volume (-0.49 and -0.48), thickness index (-0.34 and -0.31), volume index (-0.51 and -0.49) and aortic elasticity parameters (aorta strain and aorta distensibility, respectively). CONCLUSION The study showed that CCTA illustrates a relationship between the parameters of EAT and an increased stiffness of the aorta, while the most predictive factor of stiffness was the volume index.
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Affiliation(s)
- Paweł Gać
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland
- Centre of Diagnostic Imaging, 4th Military Hospital, Weigla 5, PL 50-981 Wroclaw, Poland
| | - Wojciech Hajdusianek
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland
| | - Aleksandra Żórawik
- Department of Population Health, Division of Environmental Health and Occupational Medicine, Wroclaw Medical University, Mikulicza-Radeckiego 7, PL 50-368 Wroclaw, Poland
| | - Piotr Macek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, PL 50-556 Wroclaw, Poland
| | - Małgorzata Poręba
- Department of Paralympic Sports, Wroclaw University of Health and Sport Sciences, Witelona 25a, PL 51-617 Wroclaw, Poland
| | - Rafał Poręba
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, Borowska 213, PL 50-556 Wroclaw, Poland
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Nesti L, Pugliese NR, Chiriacò M, Trico D, Baldi S, Natali A. Epicardial adipose tissue thickness is associated with reduced peak oxygen consumption and systolic reserve in patients with type 2 diabetes and normal heart function. Diabetes Obes Metab 2023; 25:177-188. [PMID: 36066008 PMCID: PMC10087544 DOI: 10.1111/dom.14861] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/02/2022] [Accepted: 09/04/2022] [Indexed: 12/14/2022]
Abstract
AIM To investigate the impact of epicardial adipose tissue (EAT) thickness on cardiopulmonary performance in patients with type 2 diabetes (T2D) and normal heart function. MATERIALS AND METHODS We analysed EAT thickness in subjects with T2D and normal biventricular systo-diastolic functions undergoing a maximal cardiopulmonary exercise test combined with stress echocardiography, speckle tracking and pulmonary function assessment, as well as serum N-terminal pro B-type natriuretic peptide (NT-proBNP). RESULTS In the 72 subjects enrolled, those with EAT thickness above the median (> 5 mm) showed higher body fat mass, smaller indexed left ventricular dimensions and marginally reduced diastolic function variables at rest. Higher EAT thickness was associated with lower peak oxygen uptake (VO2peak 17.1 ± 3.6 vs. 21.0 ± 5.7 ml/min/kg, P = .001), reduced systolic reserve (ΔS' 4.6 ± 1.6 vs. 5.8 ± 2.5 m/s, P = .02) and higher natriuretic peptides (NT-proBNP 64 [29-165] vs. 31 [26-139] pg/ml, P = .04), as well as chronotropic insufficiency and impaired heart rate recovery. Ventilatory variables and peripheral oxygen extraction were not different between groups. EAT was independently associated with VO2peak and linearly and negatively correlated with peak heart rate, heart rate recovery, workload, VO2 at the anaerobic threshold and at peak, and cardiac power output, and was directly correlated with natriuretic peptides. CONCLUSION Higher EAT thickness in T2D is associated with worse cardiopulmonary performance and multiple traits of subclinical cardiac systolic dysfunction.
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Affiliation(s)
- Lorenzo Nesti
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Cardiopulmonary Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Nicola Riccardo Pugliese
- Cardiopulmonary Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Martina Chiriacò
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Cardiopulmonary Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Domenico Trico
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Simona Baldi
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Andrea Natali
- Metabolism, Nutrition, and Atherosclerosis Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
- Cardiopulmonary Laboratory, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Adar A, Onalan O, Cakan F, Keles H, Akbay E, Akıncı S, Coner A, Haberal C, Muderrisoglu H. Evaluation of the relationship between para-aortic adipose tissue and ascending aortic diameter using a new method. Acta Cardiol 2022; 77:943-949. [PMID: 36189879 DOI: 10.1080/00015385.2022.2121537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Para-aortic adipose tissue (PAT) is the local adipose tissue that externally surrounds the aorta. It contributes significantly to aortic atherosclerosis and enlargement. Studies conducted with computed tomography and magnetic resonance have shown that individuals with aortic aneurysm had more PAT than healthy individuals. In this study, we measured PAT using transthoracic echocardiography (TTE). The aim of this study is to investigate the possible relationship of TTE measured PAT with ascending aortic width. METHODS PAT was defined as the hypoechoic space in front of ascending aortic 2 cm above the sinotubular junction at the end of the systole. Patients were divided into 2 groups according to the presence of dilatation in the ascending aorta using Roman's classification (aortic size index, ASI). ASI of less than 21 was considered no aortic dilation and an ASI of 21 mm/m2 or greater was considered to have aortic dilation. RESULTS A total of 321 unselected patients were divided into the ascending aortic dilatation (AAD) group (n = 96) and the normal ascending aorta diameter group (n = 225 patients). PAT was significantly higher in the AAD group compared with the non-ADD group (0.9 (0.48) vs. 0.7 (0.91) mm, p < 0.0001). Univariate and multivariate logistic regression analysis revealed that PAT (OR: 3.005, 95%CI (1.445-6.251)) were significantly associated with AAD. CONCLUSIONS This is the first study which evaluated PAT measured by TTE. We found a significant association between PAT measured by TTE and ascending aorta width.
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Affiliation(s)
- Adem Adar
- Department of Cardiology, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Orhan Onalan
- Department of Cardiology, Karabuk University Faculty of Medicine, Karabuk, Turkey.,Department of Radiology, Karabuk University Faculty of Medicine, Alanya, Turkey
| | - Fahri Cakan
- Department of Cardiology, Karabuk University Faculty of Medicine, Karabuk, Turkey.,Department of Radiology, Karabuk University Faculty of Medicine, Alanya, Turkey
| | - Hakan Keles
- Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Ertan Akbay
- Department of Cardiology, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Sinan Akıncı
- Department of Cardiology, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Ali Coner
- Department of Cardiology, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Cevahir Haberal
- Department of Cardiovascular Surgery, Baskent University Faculty of Medicine, Alanya, Turkey
| | - Haldun Muderrisoglu
- Department of Cardiology, Baskent University Faculty of Medicine, Alanya, Turkey
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Anfinogenova ND, Sinitsyn VE, Kozlov BN, Panfilov DS, Popov SV, Vrublevsky AV, Chernyavsky A, Bergen T, Khovrin VV, Ussov WY. Existing and Emerging Approaches to Risk Assessment in Patients with Ascending Thoracic Aortic Dilatation. J Imaging 2022; 8:jimaging8100280. [PMID: 36286374 PMCID: PMC9605541 DOI: 10.3390/jimaging8100280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/20/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022] Open
Abstract
Ascending thoracic aortic aneurysm is a life-threatening disease, which is difficult to detect prior to the occurrence of a catastrophe. Epidemiology patterns of ascending thoracic aortic dilations/aneurysms remain understudied, whereas the risk assessment of it may be improved. The electronic databases PubMed/Medline 1966–2022, Web of Science 1975–2022, Scopus 1975–2022, and RSCI 1994–2022 were searched. The current guidelines recommend a purely aortic diameter-based assessment of the thoracic aortic aneurysm risk, but over 80% of the ascending aorta dissections occur at a size that is lower than the recommended threshold of 55 mm. Moreover, a 55 mm diameter criterion could exclude a vast majority (up to 99%) of the patients from preventive surgery. The authors review several visualization-based and alternative approaches which are proposed to better predict the risk of dissection in patients with borderline dilated thoracic aorta. The imaging-based assessments of the biomechanical aortic properties, the Young’s elastic modulus, the Windkessel function, compliance, distensibility, wall shear stress, pulse wave velocity, and some other parameters have been proposed to improve the risk assessment in patients with ascending thoracic aortic aneurysm. While the authors do not argue for shifting the diameter threshold to the left, they emphasize the need for more personalized solutions that integrate the imaging data with the patient’s genotypes and phenotypes in this heterogeneous pathology.
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Affiliation(s)
- Nina D. Anfinogenova
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
- Correspondence: ; Tel.: +7-9095390220
| | | | - Boris N. Kozlov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
| | - Dmitry S. Panfilov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
| | - Sergey V. Popov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
| | - Alexander V. Vrublevsky
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
| | | | - Tatyana Bergen
- E. Meshalkin National Medical Research Center, Novosibirsk 630055, Russia
| | - Valery V. Khovrin
- Petrovsky National Research Centre of Surgery, Moscow 119991, Russia
| | - Wladimir Yu. Ussov
- Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences, Tomsk 634012, Russia
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Kawai Y, Banno H, Sato T, Ikeda S, Tsuruoka T, Sugimoto M, Niimi K, Kodama A, Matsui K, Matsui S, Komori K. Epicardial adipose tissue volume is associated with abdominal aortic aneurysm expansion. J Vasc Surg 2022; 76:1253-1260. [PMID: 35661742 DOI: 10.1016/j.jvs.2022.04.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/08/2022] [Indexed: 10/31/2022]
Abstract
BACKGROUND Epicardial adipose tissue volume (EATV) is associated with cardiovascular diseases such as coronary artery disease. However, no information is available regarding the relationship between EATV and abdominal aortic aneurysm (AAA) expansion. This study aimed to evaluate the association between EATV and the growth of AAA, and to identify predictors of AAA expansion. METHODS Between June 2009 and December 2019, a total of 906 patients underwent endovascular or open repair of AAA at our institution. Patients with previous cardiac surgery, previous ascending thoracic aortic surgery, ruptured AAA, infected AAA, inflammatory AAA, saccular aneurysm, solitary iliac aneurysm, or reintervention after treatment for AAA were excluded. Two hundred and thirty-seven patients with at least two preoperative computed tomography (CT) scans performed more than 180 days apart were included in this study. EATV within the pericardium was retrospectively quantified from preoperative non-contrast CT images using a 3D workstation. The EATV index was defined as EATV divided by body surface area. The AAA expansion rate was defined as the increase in AAA diameter per year, and patients were divided into the slow-expansion group, with an expansion rate < 5 mm/year, and the fast-expansion group, with an expansion rate ≥ 5 mm/year. The correlation between expansion rate and the EATV index was analyzed, and the cut-off value of the EATV index was determined using a receiver operating characteristics curve. Multivariate analysis was used to assess predictors of the AAA expansion rate. RESULTS The expansion rate of AAA was positively correlated with the EATV index (R = .237, P < .001). The initial aneurysm diameter (P < .001) and EATV index (P = .009) differed significantly between the two groups. The cut-off value of the EATV index was 60.3 cm3/m2 (area under the curve, .658; 95% confidence interval [CI], .568-.749; sensitivity, 1.000; specificity, .309). Multivariate analysis revealed that the initial aneurysm diameter and an EATV index > 60.3 cm3/m2 were significantly associated with the AAA expansion rate. CONCLUSIONS This study demonstrated that the EATV index was associated with AAA expansion.
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Affiliation(s)
- Yohei Kawai
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hiroshi Banno
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Tomohiro Sato
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuta Ikeda
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takuya Tsuruoka
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masayuki Sugimoto
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kiyoaki Niimi
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akio Kodama
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kota Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shigeyuki Matsui
- Department of Biostatistics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kimihiro Komori
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lin Y, Ding S, Chen Y, Xiang M, Xie Y. Cardiac Adipose Tissue Contributes to Cardiac Repair: a Review. Stem Cell Rev Rep 2021; 17:1137-1153. [PMID: 33389679 DOI: 10.1007/s12015-020-10097-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2020] [Indexed: 02/06/2023]
Abstract
Cardiac adipose tissue is a metabolically active adipose tissue in close proximity to heart. Recent studies emphasized the benefits of cardiac adipose tissue in heart remodeling, such as reducing infarction size, enhancing neovascularization and regulating immune response, through a series of cellular mechanisms. In the present manuscript, we provide a comprehensive review regarding the role of cardiac adipose tissue in cardiac repair. We focus on different cardiac adipose tissues according to their distinguished anatomical structures. This review summarizes the latest evidence on the relationship between cardiac adipose tissue and cardiac repair. Cardiac adipose tissues (CAT) were systematically reviewed in the current manuscript which focused on the components of CAT, debates about cardiac adipose stem cells and their effect on heart.
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Affiliation(s)
- Yan Lin
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Siyin Ding
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Yuwen Chen
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China
| | - Meixiang Xiang
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
| | - Yao Xie
- Department of Cardiology, Cardiovascular Key Laboratory of Zhejiang Province, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, 310009, Zhejiang, China.
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Kalaycıoğlu E, Çetin M, Özyıldız AG, Kırış T. Impaired left atrial mechanical functions as indicators for increased aortic root diameter in hypertensive and diabetic patients. Herz 2020; 46:272-279. [PMID: 33196863 DOI: 10.1007/s00059-020-04997-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/11/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Previous studies have demonstrated that increased aortic root diameter (ARD) is frequently associated with increased cardiovascular (CV) events and is a predictor of stroke. Two-dimensional speckle tracking echocardiography (2D-STE) provides a better evaluation of left atrial (LA) functions. Left atrial mechanical dispersion is a useful predictor of new-onset atrial fibrillation (AF) independent of LA enlargement and dysfunction. We aimed to investigate the relationship between ARD and LA mechanical functions. METHODS The present study included 93 consecutive patients with hypertension and diabetes. The relationships between ARD and LA functions was evaluated. RESULTS Study population was divided into two groups according to the mean ARD values: group 1 (ARD ≤30.03 mm, n = 53) and group 2 (ARD >30.03 mm, n = 40). In group 2, age, LA max volume (vol), LA pre A vol, LA min vol, LA emptying fraction, LA active ejection fraction (EF), and LA expansion index were significantly higher compared to group 1. S‑LAs and SR-LAs (peak LA strain and strain rate, respectively, during ventricular systole) and S‑LAe and SR-LAe (peak early diastolic LA strain and strain rate, respectively) were significantly lower in group 2 compared to group 1. Age, LA max vol, LA pre A vol, LA min vol, LA emptying fraction, LA active EF, LA expansion index, S‑LAs, S‑LAe, SR-LAs, and SR-LAe were significantly associated with increased ARD. In multivariate logistic regression analysis, age, LA expansion index, and SR-LAe were independent predictors for ARD. CONCLUSION Impaired LA mechanical functions determined by speckle tracking methods are related with increased ARD independent of LV diastolic dysfunction.
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Affiliation(s)
- Ezgi Kalaycıoğlu
- Ahi Evren Thoracic and Cardiovascular Surgery Education and Research Hospital, Department of Cardiology, University of Health Sciences Turkey, Trabzon, Turkey
| | - Mustafa Çetin
- Faculty of Medicine, Training and Research Hospital, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Ali Gökhan Özyıldız
- Faculty of Medicine, Training and Research Hospital, Department of Cardiology, Recep Tayyip Erdoğan University, Rize, Turkey.
| | - Tuncay Kırış
- Atatürk Training and Research Hospital, Department of Cardiology, İzmir Katip Çelebi University, İzmir, Turkey
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