Atherosclerosis of the aorta in patients with acute thoracic aortic dissection.
BACKGROUND
The role of atherosclerosis in thoracic aortic dissection has not been established yet. Transesophageal echocardiography (TEE) is an imaging modality widely used in the diagnostic evaluation of thoracic aortic dissection, and it can detect aortic atherosclerotic plaques and assess their size and specific characteristics.


RESULTS
One hundred consecutive patients with thoracic aortic dissection and adequate imaging of the thoracic aorta by TEE were studied. The type of dissection (proximal or distal) and the presence and the degree of aortic atherosclerosis were defined. Proximal aortic dissection (Stanford type A) was found in 64 patients. Patients with proximal dissection were younger than those with distal (type B; 58+/-13 vs 67+/-11 years, p<0.001). The prevalence of arterial hypertension was higher in patients with distal dissection compared with those with proximal. Aortic atherosclerosis was present in less patients with proximal than with distal dissection (67% vs 94%, p<0.002). Logistic regression analysis revealed that patients with severe atherosclerosis were 7.6-fold more probable to have type B than type A dissection (p<0.001).


CONCLUSIONS
Aortic atherosclerosis is more associated with distal than with proximal aortic dissection.
Barbetseas
John
J
First Cardiology Department, Athens Medical School, Hippokration Hospital, Athens, Greece.
Alexopoulos
Nikolaos
N
Brili
Stella
S
Aggeli
Constadina
C
Chrysohoou
Christina
C
Frogoudaki
Alexandra
A
Vyssoulis
Gregory
G
Pitsavos
Christos
C
Stefanadis
Christodoulos
C
D000208:Acute Disease; D000368:Aged; D001019:Aortic Rupture / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence