Abstract:
BACKGROUND:We aimed to characterize the clinical and pathologic findings of aortic dissection (AD) over a nearly 60-year period. METHODS:The Jesse E. Edwards Registry of Cardiovascular Disease database was queried for cardiac specimens from autopsies with AD as a diagnosis and compared 2 cohorts: early (1956-1992) and current (1993-2015). RESULTS:From 1956 to 2015, 338 cases (166 early, 170 current) with AD were included (mean age: 60; 62% male). The AD was 86% type A and 14% type B. Sixty-two percent of cases were under medical care at time of death (61% early, 62% current, P = not significant). Of those under medical care, 63% were not diagnosed prior to death (64% early, 62% current, P = not significant). Risks for dissection did not differ between time intervals and include left ventricular hypertrophy, suggestive of hypertension (84%), prior cardiovascular surgery (38%), bicuspid valve (14%), and connective tissue disease (9%). An intimal tear was identified in the ascending aorta in the majority (68%), followed by descending (14%), root (9.5%), and arch (7%). Aortic rupture occurred in 58%, most frequently in the ascending aorta (41%). CONCLUSIONS:In a large cardiovascular registry, >60% of cases of AD were not detected clinically and first identified at autopsy. Although diagnostic techniques have significantly improved over the time interval, the percentage of AD discovered at autopsy did not differ from the early to the current era. The most prevalent risk factors for dissection including hypertension and prior cardiovascular surgery remain similar in both time periods. AD death is related to rupture of the aorta in the majority of cases.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Huynh N,Thordsen S,Thomas T,Mackey-Bojack SM,Duncanson ER,Nwuado D,Garberich RF,Harris KMdoi
10.1016/j.ahj.2018.11.006subject
Has Abstractpub_date
2019-03-01 00:00:00pages
108-115eissn
0002-8703issn
1097-6744pii
S0002-8703(18)30322-3journal_volume
209pub_type
杂志文章abstract:OBJECTIVES:To define the incidence and cumulative risk of atrial fibrillation (AF) in a population-based cohort of whites and African Americans. BACKGROUND:African-Americans reportedly have a lower risk of AF than whites despite their higher exposure to AF risk factors. However, precise estimates of AF incidence in Af...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2009.05.010
更新日期:2009-07-01 00:00:00
abstract::An expression representative of the rate of change of ventricular power during ejection was derived. The primary advantages of the expression are its theoretical value and its ability to characterize ventricular performance. The rate of change of ventricular power, measured during ejection, is virtually free of assump...
journal_title:American heart journal
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1053/hj.1999.v137.92521
更新日期:1999-02-01 00:00:00
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更新日期:1980-10-01 00:00:00
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abstract::Thirty cases of paradoxical embolism are reviewed to consolidate clinical presentations and common predisposing factors. The presence of patent foramen ovale in the great majority of these patients in association with maneuvers that transiently elevate right atrial pressure is emphasized in relation to the pathophysio...
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pub_type: 杂志文章
doi:10.1016/0002-8703(86)90692-7
更新日期:1986-07-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(07)80024-x
更新日期:1993-07-01 00:00:00
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更新日期:1998-08-01 00:00:00
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pub_type: 杂志文章
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doi:10.1016/s0002-8703(99)70463-1
更新日期:1999-01-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(94)90632-7
更新日期:1994-09-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1997-10-01 00:00:00
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doi:10.1016/0002-8703(92)90646-d
更新日期:1992-02-01 00:00:00
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doi:10.1016/j.ahj.2015.03.013
更新日期:2015-07-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/0002-8703(93)90053-c
更新日期:1993-01-01 00:00:00
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journal_title:American heart journal
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更新日期:2010-07-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:1993-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ahj.2007.01.027
更新日期:2007-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ahj.2020.06.005
更新日期:2020-09-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
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更新日期:2012-11-01 00:00:00
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journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2003-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1989-02-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/j.ahj.2007.07.035
更新日期:2007-12-01 00:00:00
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journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(92)90992-5
更新日期:1992-10-01 00:00:00