Skip to main content
Top
Published in: Cardiovascular Ultrasound 1/2019

Open Access 01-12-2019 | Echocardiography | Research

Left ventricular geometric patterns in patients with type A aortic dissection

Authors: Soo-Jin Kim, Tae-Ho Park, Young-Rak Cho, Kyungil Park, Jong-Sung Park, Moo Hyun Kim, Young-Dae Kim

Published in: Cardiovascular Ultrasound | Issue 1/2019

Login to get access

Abstract

Background

Aortic dilatation is a major risk factor for aortic dissection. The aim of the present study was to assess the relationship between left ventricular (LV) geometry and maximal ascending aorta (MAA).

Methods

We reviewed data from patients who were diagnosed with acute type A aortic dissection and who underwent surgical management from December 2002 to March 2016 at Dong-A University Hospital. Among 151 patients with non-Marfan aortic dissection in the study, 50 who had echocardiography preoperatively were investigated and MAA diameter was analyzed by LV geometric patterns.

Results

Patients’ mean age was 59.6 ± 13.5 years and 38.0% were male. The mean MAA diameter was 52.9 ± 8.5 mm. MAA diameter was significantly correlated with LV mass index (r = 0.62, P < 0.001). On analysis by LV geometry, MAA diameter showed a significant difference between the 4 groups (P = 0.02), and the eccentric and concentric hypertrophy groups showed significantly larger MAA diameter than the other two groups.

Conclusion

MAA diameter was associated with LV mass index and was significantly different between LV geometry types. In this study, not only concentric hypertrophy but also eccentric LV hypertrophy was related to larger MAA in type A aortic dissection patients.
Literature
1.
go back to reference Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Pussman PL, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903.CrossRef Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ, Pussman PL, et al. The international registry of acute aortic dissection (IRAD): new insights into an old disease. JAMA. 2000;283:897–903.CrossRef
2.
go back to reference Khandheria BK. Aortic dissection: the last frontier. Circulation. 1993;87:1765–8.CrossRef Khandheria BK. Aortic dissection: the last frontier. Circulation. 1993;87:1765–8.CrossRef
3.
4.
go back to reference Roberts CS, Roberts WC. Aortic dissection with the entrance tear in the descending thoracic aorta: analysis of 40 necropsy patients. Ann Surg. 1991;213:356–68.CrossRef Roberts CS, Roberts WC. Aortic dissection with the entrance tear in the descending thoracic aorta: analysis of 40 necropsy patients. Ann Surg. 1991;213:356–68.CrossRef
5.
go back to reference Erbel R, Alfonso F, Boileau C, Dirsch O, Eber B, Haverich A, et al. Diagnosis and management of aortic dissection. Eur Heart J. 2001;22:1642–81.CrossRef Erbel R, Alfonso F, Boileau C, Dirsch O, Eber B, Haverich A, et al. Diagnosis and management of aortic dissection. Eur Heart J. 2001;22:1642–81.CrossRef
6.
go back to reference Kim EK, Choi SH, Sung K, Kim WS, Choe YH, Oh JK, et al. Aortic diameter predicts acute type a aortic dissection in patients with Marfan syndrome but not in patients without Marfan syndrome. J Thorac Cardiovascular Surg. 2014;147:1505–10.CrossRef Kim EK, Choi SH, Sung K, Kim WS, Choe YH, Oh JK, et al. Aortic diameter predicts acute type a aortic dissection in patients with Marfan syndrome but not in patients without Marfan syndrome. J Thorac Cardiovascular Surg. 2014;147:1505–10.CrossRef
7.
go back to reference Erbel R, Aboyans V, Boileau C, Bossone E, Di Cartolomeo R, Eggebrecht H, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic disease: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014;35:2873–926.CrossRef Erbel R, Aboyans V, Boileau C, Bossone E, Di Cartolomeo R, Eggebrecht H, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic disease: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. Eur Heart J. 2014;35:2873–926.CrossRef
8.
go back to reference Iarussi D, Caruso A, Galderisi M, Covino FE, Dialetto G, Bossone E, et al. Association of left ventricular hypertrophy and aortic dilation in patients with acute thoracic aortic dissection. Angiology. 2001;52:447–55.CrossRef Iarussi D, Caruso A, Galderisi M, Covino FE, Dialetto G, Bossone E, et al. Association of left ventricular hypertrophy and aortic dilation in patients with acute thoracic aortic dissection. Angiology. 2001;52:447–55.CrossRef
9.
go back to reference Milan A, Avenatti E, Tosello F, Lannaccone A, Lepme D, Magnino C, et al. Aortic root dilatation in essential hypertension: prevalence according to new reference values. J Hypertens. 2013;31:1189–95.CrossRef Milan A, Avenatti E, Tosello F, Lannaccone A, Lepme D, Magnino C, et al. Aortic root dilatation in essential hypertension: prevalence according to new reference values. J Hypertens. 2013;31:1189–95.CrossRef
10.
go back to reference Grossman W, Jones D, McLaurin LP. Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest. 1975;56:56–64.CrossRef Grossman W, Jones D, McLaurin LP. Wall stress and patterns of hypertrophy in the human left ventricle. J Clin Invest. 1975;56:56–64.CrossRef
11.
go back to reference Coady MA, Rizzo JA, Hammond GL, Mandapati D, Darr U, Kopf GS, et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms? J Thorac Cardiovasc Surg. 1997;113:476–91.CrossRef Coady MA, Rizzo JA, Hammond GL, Mandapati D, Darr U, Kopf GS, et al. What is the appropriate size criterion for resection of thoracic aortic aneurysms? J Thorac Cardiovasc Surg. 1997;113:476–91.CrossRef
12.
go back to reference Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102:470–9.CrossRef Lorell BH, Carabello BA. Left ventricular hypertrophy: pathogenesis, detection, and prognosis. Circulation. 2000;102:470–9.CrossRef
13.
go back to reference Dake MD, Thompson M, van Sambeek M, Vermassen F, Morales JP. DISSECT: a new mnemonic-based approach to the categorization of aortic dissection. Eur J Vasc Endovasc Surg. 2013;46:175–90.CrossRef Dake MD, Thompson M, van Sambeek M, Vermassen F, Morales JP. DISSECT: a new mnemonic-based approach to the categorization of aortic dissection. Eur J Vasc Endovasc Surg. 2013;46:175–90.CrossRef
14.
go back to reference Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–70.CrossRef Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American society of echocardiography and the European association of cardiovascular imaging. Eur Heart J Cardiovasc Imaging. 2015;16:233–70.CrossRef
15.
go back to reference Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necrosy findings. Am J Cardiol. 1986;57:450–8.CrossRef Devereux RB, Alonso DR, Lutas EM, Gottlieb GJ, Campo E, Sachs I, et al. Echocardiographic assessment of left ventricular hypertrophy: comparison to necrosy findings. Am J Cardiol. 1986;57:450–8.CrossRef
16.
go back to reference Lu TL, Huber CH, Rizzo E, Dehmeshki J, von Segesser LK, Qanadli SD, et al. Ascending aorta measurements as assessed by ECG gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies. Eur Radiol. 2009;19:664–9.CrossRef Lu TL, Huber CH, Rizzo E, Dehmeshki J, von Segesser LK, Qanadli SD, et al. Ascending aorta measurements as assessed by ECG gated multi-detector computed tomography: a pilot study to establish normative values for transcatheter therapies. Eur Radiol. 2009;19:664–9.CrossRef
17.
go back to reference Ocak I, Lacomis JM, Deible CR, Pealer K, Parag Y, Knollmann F, et al. The aortic root: comparison of measurements from ECG-gated CT angiography with transthoracic echocardiography. J Thorac Imaging. 2009;24:223–6.CrossRef Ocak I, Lacomis JM, Deible CR, Pealer K, Parag Y, Knollmann F, et al. The aortic root: comparison of measurements from ECG-gated CT angiography with transthoracic echocardiography. J Thorac Imaging. 2009;24:223–6.CrossRef
18.
go back to reference Freeman LA, Young PM, Foley TA, Williamson EE, Bruce CJ, Greason KL, et al. CT and MRI assessment of the aortic root and ascending aorta. AJR Am J Roentgenol. 2013;200:581–92.CrossRef Freeman LA, Young PM, Foley TA, Williamson EE, Bruce CJ, Greason KL, et al. CT and MRI assessment of the aortic root and ascending aorta. AJR Am J Roentgenol. 2013;200:581–92.CrossRef
19.
go back to reference Hirose Y, Hamada S, Takamiya M, Imakita S, Naito H, Nishimura T. Aortic aneurysms: growth rates measured with CT. Radiology. 1992;185:249–52.CrossRef Hirose Y, Hamada S, Takamiya M, Imakita S, Naito H, Nishimura T. Aortic aneurysms: growth rates measured with CT. Radiology. 1992;185:249–52.CrossRef
20.
go back to reference Parish LM, Gorman JH 3rd, Kahn S, Plappert T, St John-Sutton MG, Bavaria JE, et al. Aortic size in acute type a dissection: implications for preventive ascending aortic replacement. Eur J Cardiothorac Surg. 2009;35:941–5.CrossRef Parish LM, Gorman JH 3rd, Kahn S, Plappert T, St John-Sutton MG, Bavaria JE, et al. Aortic size in acute type a dissection: implications for preventive ascending aortic replacement. Eur J Cardiothorac Surg. 2009;35:941–5.CrossRef
21.
go back to reference Pape LA, Tsai TT, Isselbacher EM, Oh JK, O'gara PT, Evangelista A, et al. Aortic diameter >or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2007;116:1120–7.CrossRef Pape LA, Tsai TT, Isselbacher EM, Oh JK, O'gara PT, Evangelista A, et al. Aortic diameter >or = 5.5 cm is not a good predictor of type A aortic dissection: observations from the International Registry of Acute Aortic Dissection (IRAD). Circulation. 2007;116:1120–7.CrossRef
22.
go back to reference Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53:849–55.CrossRef Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53:849–55.CrossRef
23.
go back to reference Spittell PC, Spittell JA Jr, Joyce JW, Tajik AJ, Edwards WD, Schaff HV, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc. 1993;68:642–51.CrossRef Spittell PC, Spittell JA Jr, Joyce JW, Tajik AJ, Edwards WD, Schaff HV, et al. Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990). Mayo Clin Proc. 1993;68:642–51.CrossRef
24.
go back to reference Landenhed M, Engström G, Gottsäter A, Caulfield MP, Hedblad B, Newton-Cheh C, et al. Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study. J Am Heart Assoc. 2015;4:e001513.CrossRef Landenhed M, Engström G, Gottsäter A, Caulfield MP, Hedblad B, Newton-Cheh C, et al. Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study. J Am Heart Assoc. 2015;4:e001513.CrossRef
Metadata
Title
Left ventricular geometric patterns in patients with type A aortic dissection
Authors
Soo-Jin Kim
Tae-Ho Park
Young-Rak Cho
Kyungil Park
Jong-Sung Park
Moo Hyun Kim
Young-Dae Kim
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Cardiovascular Ultrasound / Issue 1/2019
Electronic ISSN: 1476-7120
DOI
https://doi.org/10.1186/s12947-019-0152-4

Other articles of this Issue 1/2019

Cardiovascular Ultrasound 1/2019 Go to the issue