title: Influence of Cardiovascular Risk Factors on Aortic Wall Motion After Repair of Type A Aortic Dissection: An Electrocardiography-Gated Computed Tomography Study.
abstract: BACKGROUND
  We aimed to evaluate size changes of the thoracic aorta during the cardiac cycle with dynamic computed tomographic angiography (CTA) at specific anatomic landmarks in patients who previously underwent ascending aorta repair because of type A dissection, and to correlate aortic wall motion with several cardiovascular risk factors.
  
  
  METHODS
  From December 2008 to December 2010, 18 patients (14 men and 4 women, mean age 64 ± 12 years) with previous aortic repair underwent electrocardiography-gated CTA follow-up. Aortic systolic and diastolic diameter and cross-sectional area were measured at 4 levels: 1 cm proximal (level A) and 1 (B), 3 (C), and 10 cm (D) distal to the origin of the left subclavian artery. RESULTS were assessed according to age and presence of diabetes, hypertension, and smoking.
  
  
  RESULTS
  This morpho-functional evaluation of aortic wall motion demonstrated a significant influence (P < 0.05) of hypertension at level A and D and diabetes at level D. Smoking had a borderline significance at level C and D. No significant correlation with age was evident, with results not significantly different in patients ≤ 55 and > 55 years.
  
  
  CONCLUSIONS
  Smoking, diabetes, and hypertension play a role in impairing aortic size variations. These variations might predict wall structural alterations due to cardiovascular risk factors before they become morphologically evident. This might influence timing of surveillance following repair of acute dissection, allowing it to be specifically tailored for any single subject.
authors.affiliation: Department of Cardiac Surgery, Heart Transplantation Division, University of Siena, Siena, Italy.
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Croccia
authors.affiliation: Section of Cardiac Surgery.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Levantino
authors.affiliation: Division of Radiology, University Hospital, Pisa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Marraccini
authors.affiliation: Department of Anesthesia and Intensive Care, University of Siena, Siena, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Franchi
authors.affiliation: Section of Cardiac Surgery.
authors.forename: Uberto
authors.initials: U
authors.lastname: Bortolotti
keywords: Aortic dissection; Computed tomography; Repair of aortic dissection