학술논문
Arterial Age and Early Vascular Aging, But Not Chronological Age, Are Associated With Faster Thoracic Aortic Aneurysm Growth.
Document Type
Academic Journal
Author
Mian O; Department of Internal Medicine University of Toronto Ontario Canada.; Santi N; Division of Cardiology University of Toronto Ontario Canada.; Boodhwani M; Division of Cardiac Surgery University of Ottawa Heart Institute Ontario Canada.; Beauchesne L; Division of Cardiology University of Ottawa Heart Institute Ontario Canada.; Chan KL; Division of Cardiology University of Ottawa Heart Institute Ontario Canada.; Dennie C; Department of Radiology The Ottawa Hospital Ontario Canada.; Wells GA; School of Epidemiology and Public Health University of Ottawa Ontario Canada.; Cardiovascular Research Methods Centre University of Ottawa Heart Institute Ontario Canada.; Coutinho T; Division of Cardiology University of Ottawa Heart Institute Ontario Canada.; School of Epidemiology and Public Health University of Ottawa Ontario Canada.; Division of Cardiac Prevention and Rehabilitation University of Ottawa Heart Institute Ontario Canada.
Source
Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
Subject
Language
English
Abstract
Background Aneurysm size is an imperfect risk assessment tool for those with thoracic aortic aneurysm (TAA). Assessing arterial age may help TAA risk stratification, as it better reflects aortic health. We sought to evaluate arterial age as a predictor of faster TAA growth, independently of chronological age. Methods and Results We examined 137 patients with TAA. Arterial age was estimated according to validated equations, using patients' blood pressure and carotid-femoral pulse wave velocity. Aneurysm growth was determined prospectively from available imaging studies. Multivariable linear regression assessed the association of chronological age and arterial age with TAA growth, and multivariable logistic regression assessed associations of chronological and arterial age with the presence of accelerated aneurysm growth (defined as growth>median in the sample). Mean±SD chronological and arterial ages were 62.2±11.3 and 54.2±24.5 years, respectively. Mean baseline TAA size and follow-up time were 45.9±4.0 mm and 4.5±1.9 years, respectively. Median (interquartile range) TAA growth was 0.31 (0.14-0.52) mm/year. Older arterial age (ß±SE for 1 year: 0.004±0.001, P <0.0001) was independently associated with faster TAA growth, while chronological age was not ( P =0.083). In logistic regression, each 5-year increase in arterial age was associated with a 23% increase in the odds of accelerated TAA growth (95% CI, 1.085-1.394; P =0.001). Conclusions Arterial age is independently associated with accelerated aneurysm expansion, while chronological age is not. Our results highlight that a noninvasive and inexpensive assessment of arterial age can potentially be useful for TAA risk stratification and disease monitoring as compared with the current clinical standard (chronological age).