Background: Aneurysms of the ascending aorta (AAo) develop due to cystic medial degeneration of the arterial wall, whereas aneurysms of the descending aorta (DAo) often are associated with arteriosclerosis. This could indicate different etiology and risk factors. In spite of this discrepancy, guidelines recommend screening of the whole aorta, if one dilatation is discovered. Purpose: To estimate the proportions of aortic dilatations elsewhere in case of detection of an thoracic aortic dilatation To compare risk factor profiles of ascending and descending aortic dilatations. Methods: Men and women aged 65-74 were selected 1:3 without exclusion criteria to participate in the randomized population-based Danish Cardiovascular Clinical Trial, DANCAVAS. The participants had electrocardiography-gated noncontrast CT-scans performed and the diameters of ascending, descending and abdominal aorta were measured. Through multivariate linear regression analyses based on age, gender and body surface area (BSA), normal diameters of AAo and DAo were estimated. By dividing the observed diameters with the predicted diameters, size indexes were created. An index <1.25 was set to be normal, an index ≥1.25 as an ectatic or aneurysmal thoracic aorta (dilatations). Associations between potential risk factors in patients with an ectatic or aneurysmal thoracic aortia were examined. The risk factors to be entered into a multivariate analysis were identified by a p-value below 10% in univariate analyses. Adjusted odds ratios (OR) were estimated by multiple logistic regression analyses.
Results:The study population consists of 8354 subjects (7613 male, 741 female) with an average of 69 years ±3 years. The prevalence of AAo and DAo ectasies and aneurysms were 4.1% (95% CI: 3.6-4.5) and 2.3% (95% CI: 2.0-2.7), respectively. In all, 15.4% (95% CI: 11.8-19.8) with AAo dilatations had similar lesions of DAo, abdominal aorta or both, while 33.0% (95% CI: 26.5-40.2) with DAo dilatations had similar lesions of AAo, abdominal aorta or both. (Figure 1 Conclusion: AAo and DAo dilatations share several risk factors, but the risk profile for AAo dilatations seems more complex than for DAo dilatations. However, the strongest risk factor for both AAo and DAo dilatations are dilatations on any segment elsewhere of the aorta. Consequently, if a dilatation is found anywhere along the aorta, it is important to screen the whole aorta. Background: Population screening for abdominal aortic aneurysm (AAA) with ultrasound has been recommended in some guidelines. Epidemiologic screening studies have demonstrated that the prevalence of AAA of Asian origin appears to be lower than other racial groups such as Caucasians and so increases uncertainty about cost-effectiveness of screening AAA in Chinese. As the costeffectiveness of screening AAA is affected by disease prevalence, we sought to evaluate a specific population with the potential for higher detection rates of AAA. Some studies have demonstrated a higher prevalence of AAA in patients with atherosclerotic risk...
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