1Clinical Laboratory, St. Luke′s International Hospital, 2Cardiovascular Center, St. Luke′s International Hospital, 3Department of Cardiology, Chiba Children’s Hospital, 4Department of Cardiovascular Surgery, St. Luke’s International Hospital
AAA, TAA, stiffness index, kinking, global longitudinal strain
Purpose: Dilatation of the thoracic aorta and cardiac dysfunction are long-term complications after abdominal aortic aneurysm repair. Aortic dilatation is related to hypertension, hyperlipidemia, diabetes mellitus, and smoking, which are regarded as risk factors for arteriosclerosis. Cardiac dysfunction without ischemic heart disease is also multifactorial in these patients. It remains unknown whether abdominal aortic aneurysm repair has some impact on thoracic aortic dilatation and cardiac dysfunction. Methods: A retrospective study was conducted on 50 patients who underwent abdominal aortic aneurysm repair. Fifteen age-matched individuals were also enrolled as a control group. We assessed aortic diameter, aortic stiffness, myocardial mass, and cardiac function using computed tomography and echocardiography. Results and Discussions: Ten out of 50 patients (20.0%) had thoracic aortic dilatation during a follow-up period (6.0±4.1 years). The stiffness index of the thoracic aorta increased after surgery for abdominal aortic aneurysm in the thoracic aortic dilation group (p=0.02). In addition, more patients in the aortic dilatation group showed a kinking angle over 60 degrees of the abdomen artificial vessel (p=0.03), lower global longitudinal strain (GLS), and higher cardiac mass. According to univariate logistic analysis, higher abdominal aortic kinking, blood pressure, and hyperlipidemia were important factors for dilatation of the thoracic aorta. Conclusion: Abdominal aortic aneurysmal repair may have adverse effects on thoracic aortic dilatation and cardiac function. Artificial vessel kinking, stiffness index of the thoracic aorta, GLS, and cardiac mass may be useful parameters for assessing thoracic aortic dilatation and cardiac dysfunction. In addition, well-controlled blood pressure and hyperlipidemia are essential in these patients.