Influence of Cardiovascular Risk Factors on Aortic Wall Motion After Repair of Type A Aortic Dissection: An Electrocar- diography-Gated Computed Tomography Study

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 under- went ascending aorta repair because of type A dissec- tion, 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 fol- low-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 hy- pertension 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 hyper- tension play a role in impairing aortic size variations. These variations might predict wall structural altera- tions due to cardiovascular risk factors before they become morphologically evident. This might influence timing of surveillance following repair of acute dissec- tion, allowing it to be specifically tailored for any single subject.