title: Using The Descending Aortic Wall Thickness Measured In Transesophageal Echocardiography As A Risk Marker For Aortic Dissection.
abstract: OBJECTIVE
  The aim of this study is to estimate whether aortic wall thickness is increased in patients with Aortic dissection (AD) compared to low risk control group and can be used in addition to aortic diameter as a risk marker of AD.
  
  
  BACKGROUND
  AD occurs due to pathologies that may increase thickness of the aortic wall. Transesophageal echocardiography (TEE) has the ability to visualize both the thoracic aortic wall and lumen. Aortic diameter has been used to predict aortic dissection and timing of surgery, but it is not always predictive of that risk.
  
  
  METHODS
  In 48 patients with AD who underwent TEE were examined retrospectively and compared to 48 control patients with patent foramen ovale (PFO). We measured aortic diameter at different levels, intimal/medial thickness (IMT) and complete wall thickness (CMT). Demographic data and cardiovascular risk factors were reviewed. The data was analyzed using ANOVA and student t test.
  
  
  RESULTS
  (AD) patients were older [mean age 66 AD vs. 51 PFO], had more hypertension, diabetes, hyperlipidemia and Coronary artery disease. Both IMT and CMT in the descending aorta were increased in AD group [(1.85 vs. 1.43 mm; P=0.03 and 2.93 vs. 2.46 mm; p=0.01). As expected the diameter of ascending aorta was also greater in AD (4.61 vs. 2.92 cm; P=0.004).
  
  
  CONCLUSIONS
  CMT and IMT in the descending aorta detected by TEE is greater in patients with AD when compared to control and may add prognostic data to that of aortic diameter.
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Zaher
authors.initials: Z
authors.lastname: Fanari
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Sumaya
authors.initials: S
authors.lastname: Hammami
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Muhammad Baraa
authors.initials: MB
authors.lastname: Hammami
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Safa
authors.initials: S
authors.lastname: Hammami
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: Chete
authors.initials: C
authors.lastname: Eze-Nliam
authors.affiliation: Section of Cardiology, Christiana Care Health System, Newark, DE.
authors.forename: William S
authors.initials: WS
authors.lastname: Weintraub
keywords: Aortic diameter; Aortic dissection; Intimal/medial thickness.; Transesophageal echocardiography