PMID- 37492155
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230727
IS  - 2297-055X (Print)
IS  - 2297-055X (Electronic)
IS  - 2297-055X (Linking)
VI  - 10
DP  - 2023
TI  - Spectrum of ascending aortic aneurysms at a peri-urban tertiary hospital: an 
      echocardiography-based study.
PG  - 1209969
LID - 10.3389/fcvm.2023.1209969 [doi]
LID - 1209969
AB  - INTRODUCTION: Thoracic ascending aortic (TAA) aneurysms are an important cause of 
      disability and death and require early detection for effective management. 
      Currently, there is a paucity of data from Africa pertaining to TAA aneurysms. 
      This study describes the spectrum of TAA aneurysms at a peri-urban tertiary 
      hospital. METHODS: A descriptive retrospective study based on clinical and 
      echocardiographic imaging data of patients with TAA aneurysms from October 
      2017-October 2022. Advanced strain imaging was performed to measure left 
      ventricular (LV) basal, apical, and global longitudinal strain as well as 
      circumferential strain (CS) of the ascending aorta as a proxy measurement of 
      aortic compliance. RESULTS: The study comprised 139 cases of TAA aneurysms (52.5% 
      females) with a mean age of 50 +/- 14.8 years with 45 age and gender matched 
      controls. Most cases (95%) were of African ethnicity. The main etiologies were 
      hypertension (41.7%), HIV (36.6%), connective tissue disease (10.7%), congenital 
      (2.2%) and mixed pathologies (8.6%). Two-thirds of patients (69.7%) presented in 
      heart failure, 10% presented with aortic dissection. Thirty percent of the 
      patients were classified as New York Heart Association (NYHA) class I, 59.7% NYHA 
      II, 8.6% NYHA III and two patients NYHA class IV. Echocardiography revealed 
      enlarged aortic dimensions compared to controls (P < 0.001). TAA aneurysms were 
      complicated by severe aortic regurgitation (AR) in half (50.3%) of patients, 
      moderate AR in 25.8%, and mild AR in 14.3%. The mean LV ejection fraction 
      (46.9 +/- 12.7%) was reduced compared to controls (P < 0.001). Aortic CS was 
      reduced compared to controls [4.4 (3.2-6.2) % vs. 9.0 (7.1-13.4) %, P < 0.001]. 
      Aortic stiffness was higher in the aortic aneurysm group compared to controls 
      (15.39 +/- 20.65 vs. 5.04 +/- 2.09, P = 0.001). LV longitudinal strain (-13.9 +/- 3.9% 
      vs. 18.1 +/- 6.7%), basal CS (-13.9 +/- 5.6% vs. -17.9 +/- 5.8%) and apical CS 
      (-8.7 +/- 8.5% vs. -30.6 +/- 3.8%) were reduced compared to controls (P < 0.001). 
      Most patients were on diuretic and anti-remodeling therapy. Surgery was performed 
      in 29.4% and overall mortality was 7.9%. Mortality for acute aortic dissection 
      was 40%. CONCLUSION: TAA aneurysms associated with hypertension and HIV are 
      common in this predominantly African female population and are associated with 
      considerable morbidity and mortality. Two-dimensional echocardiography and 
      advanced strain imaging are potential tools for detecting and risk stratifying 
      TAA aneurysms.
CI  - (c) 2023 Meel, Hasenkam, Goncalves, Blair and Mogaladi.
FAU - Meel, Ruchika
AU  - Meel R
AD  - Division of Cardiothoracic Surgery, Faculty of Health Sciences, University of the 
      Witwatersrand, Johannesburg, South Africa.
FAU - Hasenkam, Michael
AU  - Hasenkam M
AD  - Aarhus University Hospital, Aarhus, Denmark.
FAU - Goncalves, Ricardo
AU  - Goncalves R
AD  - Life The Glynnwood Hospital, Johannesburg, South Africa.
FAU - Blair, Kelly
AU  - Blair K
AD  - Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa.
FAU - Mogaladi, Shungu
AU  - Mogaladi S
AD  - Division of Cardiothoracic Surgery, Department of General Surgery, Charlotte 
      Maxeke Hospital and University of the Witwatersrand, Johannesburg, South Africa.
LA  - eng
PT  - Journal Article
DEP - 20230710
PL  - Switzerland
TA  - Front Cardiovasc Med
JT  - Frontiers in cardiovascular medicine
JID - 101653388
PMC - PMC10363745
OTO - NOTNLM
OT  - Africa
OT  - aneurysms
OT  - aortic regurgitation 2
OT  - ascending aorta
OT  - echocardiography
OT  - strain imaging
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/07/26 06:42
MHDA- 2023/07/26 06:43
PMCR- 2023/01/01
CRDT- 2023/07/26 03:46
PHST- 2023/04/21 00:00 [received]
PHST- 2023/06/21 00:00 [accepted]
PHST- 2023/07/26 06:43 [medline]
PHST- 2023/07/26 06:42 [pubmed]
PHST- 2023/07/26 03:46 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fcvm.2023.1209969 [doi]
PST - epublish
SO  - Front Cardiovasc Med. 2023 Jul 10;10:1209969. doi: 10.3389/fcvm.2023.1209969. 
      eCollection 2023.