INFLUENCE OF CARDIOVASCULAR RISK FACTORS ON AORTIC WALL MOTION AFTER REPAIR OF TYPE A AORTIC DISSECTION: AN ECG-GATED CT STUDY

OBJECTIVES: To evaluate aortic shape changes during cardiac cycle with dynamic computed tomographic angiography at important thoracic aorta anatomic landmarks in patients who previously underwent ascending aorta repair because of type A dissection, and correlate aortic wall motion with several cardiovascular risk factors. METHODS: From December 2009 to December 2011, 18 patients (14 men and 4 women, mean age 64 ± 12 y.o.) with previous aortic repair, underwent ECG-gated-CT follow-up. Aortic systolic and diastolic diameter and cross-sectional area were measured at 4 levels: 1 cm proximal (level A) and 1 (B), 3 (C) and 10 cm (D) distal to the origin of left subclavian artery. Results were assessed according to presence of diabetes, hypertension, smoking and age (2 groups: ≤ 55 and ≥56 years). RESULTS: This morpho-functional evaluation of aortic distensibility demonstrated a significant influence (p<0,05) on aortic wall-motion of hypertension at level A and diabetes at level D. Smoke has a borderline significance at level C and D. No significant correlation between aortic wall motion and age was evident, being results not significantly different in two age groups. CONCLUSIONS: Smoking, diabetes and hypertension play a role in impairing aortic distensibility and previous surgical repair does not interfere with vessel wall motion. Aortic distensibility might predict wall structural alteration due to cardiovascular risk factors before they become morphologically evident. This might influence timing of surveillance, making this specifically tailored for any single subject.