PMID- 37305473
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230613
IS  - 2405-8440 (Print)
IS  - 2405-8440 (Electronic)
IS  - 2405-8440 (Linking)
VI  - 9
IP  - 5
DP  - 2023 May
TI  - Longitudinal analysis of thoracic aortic expansion in non-syndromic real-world 
      patients.
PG  - e15823
LID - 10.1016/j.heliyon.2023.e15823 [doi]
LID - e15823
AB  - Remodeling of the thoracic aorta is commonly seen and viewed as a precursor to an 
      aortic aneurysm. However, while aneurysms have been shown to expand at a rate of 
      approximately 1 mm annually, the expansion of the pre-aneurysmal aorta is poorly 
      characterized, especially in relation to age, gender, and aortic size per se. We 
      identified patients that had undergone echocardiography at least twice at a large 
      university medical center. Diagnosis codes, medications, and blood test results 
      were obtained from hospital records. Syndromic patients were excluded (e.g., 
      Marfan's syndrome, bicuspid aortic valve). Final population comprised n = 24,928 
      patients (median age 61.2 years (inter-quartile range (IQR): 50.6-71.5); 55.8% 
      males) that had undergone a median of 3 echocardiograms (2-4; range 2-27) during 
      a median of 4.0 years (IQR: 2.3-6.2). Hypertension was present in 39.6% of 
      patients and diabetes in 20.7%, median LV ejection fraction was 56.0% (IQR: 
      41.0-62.0). Aortic size measurements were analyzed in mixed models while 
      clustering on individual patients. Mean expansion was determined for sinus of 
      Valsalva as 1.93 (95% confidence interval; CI(95): 1.87-1.99) mm per decade, and 
      for ascending aorta as 1.76 (CI(95): 1.70-1.82) mm per decade. Faster expansion 
      was found in males, with larger aortic size, and younger age (p for interaction 
      <0.05 for all). In conclusion, expansion of the thoracic aorta, in real world, 
      non-syndromic patients, is slow and averages <2 mm per decade. This will help to 
      inform management of this large patient group.
CI  - (c) 2023 The Authors.
FAU - Ng, Josiah
AU  - Ng J
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
FAU - Ewe, See Hooi
AU  - Ewe SH
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Tan, Ju Le
AU  - Tan JL
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Chao, Victor Tt
AU  - Chao VT
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Ding, Zee Pin
AU  - Ding ZP
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Ling, Lieng-Hsi
AU  - Ling LH
AD  - Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
AD  - Department of Cardiology, National University Heart Centre Singapore, Singapore.
FAU - Sin, Kenny Yk
AU  - Sin KY
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Chua, Terrance Sj
AU  - Chua TS
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
FAU - Sahlen, Anders
AU  - Sahlen A
AD  - Department of Cardiology, National Heart Centre Singapore, Singapore.
AD  - Karolinska Institutet, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20230425
PL  - England
TA  - Heliyon
JT  - Heliyon
JID - 101672560
PMC - PMC10256846
OTO - NOTNLM
OT  - Aorta
OT  - Arterial disease
OT  - Echocardiography
COIS- The authors declare the following financial interests/personal relationships 
      which may be considered as potential competing interests.
EDAT- 2023/06/12 06:42
MHDA- 2023/06/12 06:43
PMCR- 2023/04/25
CRDT- 2023/06/12 04:24
PHST- 2023/03/18 00:00 [received]
PHST- 2023/04/17 00:00 [revised]
PHST- 2023/04/24 00:00 [accepted]
PHST- 2023/06/12 06:43 [medline]
PHST- 2023/06/12 06:42 [pubmed]
PHST- 2023/06/12 04:24 [entrez]
PHST- 2023/04/25 00:00 [pmc-release]
AID - S2405-8440(23)03030-X [pii]
AID - e15823 [pii]
AID - 10.1016/j.heliyon.2023.e15823 [doi]
PST - epublish
SO  - Heliyon. 2023 Apr 25;9(5):e15823. doi: 10.1016/j.heliyon.2023.e15823. eCollection 
      2023 May.