PURPOSE: Progressive aortic dilatation is a major complication noted in patients with aortic dissection. Although optimal blood pressure control is the cornerstone of therapy, its impact on aortic dilatation is uncertain. We sought to evaluate the relationship between baseline left ventricular (LV) mass and computerized tomography (CT) determined aortic dilatation on follow up.
METHODS: 48 patients with Stanford B classification aortic dissection who underwent baseline transthoracic echocardiography (TTE) were included in the study. Patients had CT performed with serial measurements of aortic dimensions at 0, 6 and 12 months. LV mass was calculated according to the validated Penn convention using parameters obtained by TTE.
RESULTS: Average age was 63.5 years (30 - 84 years) and 64% of the population were male. Only 3 patients had diabetes mellitus and 47% had a diagnosis of coronary artery disease. The average LV mass was 261.34 g (121.93 - 447.98 g) and none of the patients had more than mild aortic valve regurgitation by TTE. CT at baseline and at 6 months was performed in 43 patients with no evidence of correlation between TTE data (LV mass) and CT diameters (r= −0.06, p=0.7, Figure 1). Similarly, LV mass did not correlate with aortic dilation at 12 months (n= 25, r=0.18, p=0.4, Figure 2). The only significant aortic dimension that changed over time was the proximal descending aortic (PDA) diameter (average of 42.66± 11.1 mm at baseline to 42.83 ± 11.2 mm at follow up, p=0.02) which was taken as the principal diameter to calculate the entire study.
CONCLUSION: LV mass at baseline does not predict future aortic dilation in patients with Stanford B aortic dissections.
CLINICAL IMPLICATIONS: Estimation of LV mass by echocardiography does not help in the management of Stanford B aortic dissections.
DISCLOSURE: Samuel Unzek, No Financial Disclosure Information; No Product/Research Disclosure Information