Ascending Aortic Length and Type A Dissection: A Propensity
Score-Matched Cohort Analysis
Abstract
Background: Little information is available regarding the
relationship between ascending aortic length and acute aortic events. We
aim to evaluate whether patients with acute type A aortic dissection
(ATAAD) exhibit differential aortic measurements compared to control
patients. Methods: Data were collected on patients with ATAAD
and control patients who received imaging for unrelated conditions.
Propensity score matching was conducted using age, sex, race, body
surface area, and hypertension in the logistic model. After matching, 67
patients remained in each group. Aortic morphometry was assessed via
computed tomographic angiography. Ascending aortic length was defined as
the centerline distance between the sinotubular junction (STJ) and the
origin of the brachiocephalic trunk. Results: The mean
ascending aortic length was 76.9 ± 15.7 mm (range 36.8 to 115.0 mm) for
patients with ATAAD and was 62.0 ± 10.7 mm (range 34.0 to 87.8 mm) for
control patients, which was a significant difference (t=-6.4,
P<0.001). ATAAD patients had greater diameter at STJ (median:
41.6 vs 30.2 mm, z=7.5, P<0.001) and diameter at PAB (median:
42.3 vs 32.2 mm, z=6.8, P<0.001) compared with controls. A
maximum ascending aortic diameter >5.5 cm (at either the
PAB or STJ) was present in 12 of 67 cases (18%) and 0 of 67 controls
(P<0.001). Conclusions: Ascending aortic length is
significantly greater in patients who experienced ATAAD compared to
matched controls. Elongation of the aorta may play a role in the
pathogenesis of ATAAD, and assessment of ascending aortic length may be
valuable as a predictive marker for aortic events.