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Left ventricular remodeling in patients with acute type B aortic dissection after thoracic endovascular aortic repair: Short- and mid-term outcomes

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机构: [a]Center of Vascular Surgery, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Chinese Academy ofMedical Sciences and Peking Union Medical College, Beijing, China [b]Department of Cardiac Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China [c]No. 2 Department of Respiratory Internal Medicine, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China [d]Department of Ultrasound, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China [e]Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
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关键词: Ventricular remodeling Aortic dissection Thoracic endovascular aortic repair Aortic remodeling

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Background: Left ventricular (LV) remodeling remains unknown in patients with acute Type B aortic dissection (aTBAD) after thoracic endovascular aortic repair (TEVAR) during follow-up. Methods: Between May 2004 and January 2016, 163 consecutive patients (136 males, mean preoperative age: 51.06 +/- 10.79 years) with aTBAD underwent TEVAR. A linear mixed model was used to evaluate risk factor influencing on LV remodeling and investigate longitudinal changes in LV thickness, diameter, volume, function and mass at preoperation, postoperation, short-and mid-term follow-up. Results: Median follow-up time was 48.0 months (quartiles 1-3, 31-84 months, maximum 147 months). LV thickness and mass followed a continuous downward trend over time. Interventricular septal thickness at end-diastole significantly decreased at mid-term follow-up (time, p < 0.001: preoperative 11.59 +/- 0.14 mm vs mid-term 10.82 +/- 0.15 mm, p < 0.001; postoperative 11.40 +/- 0.14 mm vs mid-term 10.82 +/- 0.15 mm, p = 0.006). LV posterior wall thickness at end-diastole was markedly reduced at mid-term follow-up (time, p < 0.001: preoperative 10.89 +/- 0.11 mm vs mid-term 10.02 +/- 0.11 mm, p < 0.001; postoperative 10.78 +/- 0.13 mm vs mid-term 10.02 +/- 0.11 mm, p < 0.001; short-term 10.56 +/- 0.15 mm vs mid-term 10.02 +/- 0.11 mm, p = 0.021). LV mass index markedly decreased during follow-up (time, p = 0.001: preoperative 129.60 +/- 3.55 g/m(2) vs short-term 119.26 +/- 3.19 g/m(2), p = 0.009; preoperative 129.60 +/- 3.55 g/m(2) vs mid-term 115.79 +/- 3.62 g/m(2), p = 0.003). LV function was improved, but not significantly so, during follow-up. Strict blood pressure control had no influence on LV remodeling. True lumen followed a continuous enlargement trend in terms of proximal thoracic aorta and celiac trunk level during follow-up. Conclusions: TEVAR can reverse LV remodeling and LV hypertrophy in patients with aTBAD during follow-up. (c) 2018 Elsevier B.V. All rights reserved.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 2 区 心脏和心血管系统
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
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出版当年[2017]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

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第一作者机构: [a]Center of Vascular Surgery, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Disease, Chinese Academy ofMedical Sciences and Peking Union Medical College, Beijing, China
通讯作者:
通讯机构: [e]Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing, China [*1]Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Disease, 100029 Beijing, China.
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