Academic Journal

Aortic morphology post type a acute aortic syndrome: prognosis significance and association with 24-hour blood pressure-monitoring parameters

Bibliographic Details
Title: Aortic morphology post type a acute aortic syndrome: prognosis significance and association with 24-hour blood pressure-monitoring parameters
Authors: Delsart, Pascal, Soquet, Jerome, Ramdane, Nassima, Ramond, Charline, Mugnier, Agnes, Rousse, Natacha, Ledieu, Guillaume, Bical, Antoine, Loobuyck, Valentin, Jegou, Bruno, Modine, Thomas, Hysi, Ilir, Fabre, Olivier, Juthier, Francis, Vincentelli, Andre, Mounier-Vehier, Claire
Contributors: CHU Lille, Inserm, Institut Pasteur de Lille, Université de Lille, Institut Coeur Poumon CHU Lille, Centre Hospitalier Régional Universitaire CHU Lille CHRU Lille, Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 RNMCD, METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694, Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011, Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (EGID) - U1011, Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 RNMCD, Lille Neurosciences & Cognition (LilNCog) - U 1172
Publication Year: 2025
Collection: LillOA (Lille Open Archive - Université de Lille)
Subject Terms: blood pressure monitoring, aortic dissection, prognosis, false lumen
Description: Background After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome. Methods The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis. Results The population included 79 males, with an overall mean age of 60 ± 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg ± 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P < .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24). Conclusion The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
Document Type: article in journal/newspaper
Language: English
Relation: Journal of Cardiac Surgery; J Card Surg; http://hdl.handle.net/20.500.12210/40229
Availability: https://hdl.handle.net/20.500.12210/40229
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.A0AFB48
Database: BASE
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  – Url: https://hdl.handle.net/20.500.12210/40229#
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  Data: Aortic morphology post type a acute aortic syndrome: prognosis significance and association with 24-hour blood pressure-monitoring parameters
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Delsart%2C+Pascal%22&quot;&gt;Delsart, Pascal&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Soquet%2C+Jerome%22&quot;&gt;Soquet, Jerome&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ramdane%2C+Nassima%22&quot;&gt;Ramdane, Nassima&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ramond%2C+Charline%22&quot;&gt;Ramond, Charline&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mugnier%2C+Agnes%22&quot;&gt;Mugnier, Agnes&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Rousse%2C+Natacha%22&quot;&gt;Rousse, Natacha&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ledieu%2C+Guillaume%22&quot;&gt;Ledieu, Guillaume&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bical%2C+Antoine%22&quot;&gt;Bical, Antoine&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Loobuyck%2C+Valentin%22&quot;&gt;Loobuyck, Valentin&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Jegou%2C+Bruno%22&quot;&gt;Jegou, Bruno&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Modine%2C+Thomas%22&quot;&gt;Modine, Thomas&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Hysi%2C+Ilir%22&quot;&gt;Hysi, Ilir&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Fabre%2C+Olivier%22&quot;&gt;Fabre, Olivier&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Juthier%2C+Francis%22&quot;&gt;Juthier, Francis&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Vincentelli%2C+Andre%22&quot;&gt;Vincentelli, Andre&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mounier-Vehier%2C+Claire%22&quot;&gt;Mounier-Vehier, Claire&lt;/searchLink&gt;
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  Data: CHU Lille&lt;br /&gt;Inserm&lt;br /&gt;Institut Pasteur de Lille&lt;br /&gt;Universit&#233; de Lille&lt;br /&gt;Institut Coeur Poumon CHU Lille&lt;br /&gt;Centre Hospitalier R&#233;gional Universitaire CHU Lille CHRU Lille&lt;br /&gt;R&#233;cepteurs Nucl&#233;aires, Maladies M&#233;taboliques et Cardiovasculaires - U 1011 RNMCD&lt;br /&gt;METRICS : Evaluation des technologies de sant&#233; et des pratiques m&#233;dicales - ULR 2694&lt;br /&gt;R&#233;cepteurs nucl&#233;aires, Maladies Cardiovasculaires et Diab&#232;te (RNMCD) - U1011&lt;br /&gt;R&#233;cepteurs nucl&#233;aires, Maladies Cardiovasculaires et Diab&#232;te (EGID) - U1011&lt;br /&gt;R&#233;cepteurs nucl&#233;aires, maladies cardiovasculaires et diab&#232;te - U 1011 RNMCD&lt;br /&gt;Lille Neurosciences &amp; Cognition (LilNCog) - U 1172
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  Data: 2025
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  Data: LillOA (Lille Open Archive - Universit&#233; de Lille)
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  Data: Background After an emergent surgery for type A acute aortic syndrome, medical management is based on optimal blood pressure (BP) control. We assessed the prognostic significance of BP monitoring and its relationship with aortic morphology following type A acute aortic syndrome. Methods The data of 120 patients who underwent BP monitoring after a type A acute aortic syndrome from January 2005 to June 2016 were retrospectively collected. The first CT angiogram performed after surgery was used for the morphological analysis. Results The population included 79 males, with an overall mean age of 60 &#177; 12 years. Seven patients (5.8%) died during a median follow-up of 5.5 years. The median delay between BP monitoring and discharge was 3 (1-5) months. The mean 24-hour BP of the cohort was 127/73 mm Hg &#177; 10/17. During follow-up, different parameters of BP monitoring were not associated with the risk of aortic events. However, the diameter of the false lumen of the descending thoracic aorta was the best predictor associated with the risk of new aortic events during follow-up, particularly for the threshold of 28 mm or more (P &lt; .001; Hazard ratio 4.7[2.7-8.2]). The diameter of the false lumen was associated with night-time systolic BP (P = .025; r = .2), 24-hour pulse pressure (P = .002; r = .28), and night-time pulse pressure (P = .008; r = .24). Conclusion The risk of new aortic events following type A acute aortic syndrome is associated with the size of the residual false lumen, but not directly with BP parameters. Night-time BP parameters are associated with the size of the residual false lumen.
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