title: Prognostic Impact of Blood Pressure Variability on Aortic Dissection Patients After Endovascular Therapy.
abstract: Hypertension has been deemed as a pivotal risk factor for the development of aortic dissection; however, the importance and prognostic significance of blood pressure variability (BPV) in aortic dissection are always ignored. A total of 173 acute type B aortic dissection patients were enrolled in and retrospectively reviewed between January 2009 and November 2013. There were 74 patients with high BPV and 99 with low BPV stratified by preoperative mean BPV. Technical success was achieved in all patients. The proportions of hypertension and general anesthesia were significantly higher in the high BPV group (70.3% vs 55.6% and 77% vs 62.6%, P = 0.049 and 0.043, respectively). The risk of aorta-related death in the high BPV group was apparently higher than the low BPV group (28.4% vs 9.1%, P = 0.001). By performing multivariable logistic regression, we found history of hypertension was likely to be a risk factor of BPV (95% confidence interval [CI]: 1.010-3.911), and high BPV was an independent predictor of aorta-related death (95% CI: 1.671-9.587). The difference of aorta-related mortality was pronounced between high and low BPV subgroups regardless of the refractory hypertension (41.4% vs 14.3% and 20.0% vs 7.0%, P = 0.023 and 0.037, respectively). The thrombosis ratio of false lumen was significantly higher in the low BPV group at 3-month (72.4 ± 17.5% vs 51.8 ± 11.6%, P < 0.001) and 6-month (86.4 ± 9.1% vs 69.7 ± 7.9%, P < 0.001). High BPV is an independent risk factor for the prognosis of aortic dissection. Further studies on BPV might provide new preventive and therapeutic strategies for aortic dissection.
authors.affiliation: From the Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China (LZ, WT, RF, CS, ZZ, JB, ZJ); Department of Pharmacology, Second Military Medical University, Shanghai, China (AL, DS); and Department of Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China (JZ).
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Wen
authors.initials: W
authors.lastname: Tian
authors.forename: Rui
authors.initials: R
authors.lastname: Feng
authors.forename: Chao
authors.initials: C
authors.lastname: Song
authors.forename: Zhiqing
authors.initials: Z
authors.lastname: Zhao
authors.forename: Junmin
authors.initials: J
authors.lastname: Bao
authors.forename: Aijun
authors.initials: A
authors.lastname: Liu
authors.forename: Dingfeng
authors.initials: D
authors.lastname: Su
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.forename: Zaiping
authors.initials: Z
authors.lastname: Jing
mesh_terms: D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000209:etiology* / Q000601:surgery; D017130:Angioplasty / Q000009:adverse effects*; D001011:Aorta / Q000601:surgery; D001018:Aortic Diseases / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies