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Abstract：
UNASSIGNED: Thoracic ascending aortic (TAA) aneurysms are an important cause of disability and death and require early detection for effective management. Currently, there is a paucity of data from Africa pertaining to TAA aneurysms. This study describes the spectrum of TAA aneurysms at a peri-urban tertiary hospital.
UNASSIGNED: A descriptive retrospective study based on clinical and echocardiographic imaging data of patients with TAA aneurysms from October 2017-October 2022. Advanced strain imaging was performed to measure left ventricular (LV) basal, apical, and global longitudinal strain as well as circumferential strain (CS) of the ascending aorta as a proxy measurement of aortic compliance.
UNASSIGNED: The study comprised 139 cases of TAA aneurysms (52.5% females) with a mean age of 50 ± 14.8 years with 45 age and gender matched controls. Most cases (95%) were of African ethnicity. The main etiologies were hypertension (41.7%), HIV (36.6%), connective tissue disease (10.7%), congenital (2.2%) and mixed pathologies (8.6%). Two-thirds of patients (69.7%) presented in heart failure, 10% presented with aortic dissection. Thirty percent of the patients were classified as New York Heart Association (NYHA) class I, 59.7% NYHA II, 8.6% NYHA III and two patients NYHA class IV. Echocardiography revealed enlarged aortic dimensions compared to controls (P < 0.001). TAA aneurysms were complicated by severe aortic regurgitation (AR) in half (50.3%) of patients, moderate AR in 25.8%, and mild AR in 14.3%. The mean LV ejection fraction (46.9 ± 12.7%) was reduced compared to controls (P < 0.001). Aortic CS was reduced compared to controls [4.4 (3.2-6.2) % vs. 9.0 (7.1-13.4) %, P < 0.001]. Aortic stiffness was higher in the aortic aneurysm group compared to controls (15.39 ± 20.65 vs. 5.04 ± 2.09, P = 0.001). LV longitudinal strain (-13.9 ± 3.9% vs. 18.1 ± 6.7%), basal CS (-13.9 ± 5.6% vs. -17.9 ± 5.8%) and apical CS (-8.7 ± 8.5% vs. -30.6 ± 3.8%) were reduced compared to controls (P < 0.001). Most patients were on diuretic and anti-remodeling therapy. Surgery was performed in 29.4% and overall mortality was 7.9%. Mortality for acute aortic dissection was 40%.
UNASSIGNED: TAA aneurysms associated with hypertension and HIV are common in this predominantly African female population and are associated with considerable morbidity and mortality. Two-dimensional echocardiography and advanced strain imaging are potential tools for detecting and risk stratifying TAA aneurysms.
UNASSIGNED: A descriptive retrospective study based on clinical and echocardiographic imaging data of patients with TAA aneurysms from October 2017-October 2022. Advanced strain imaging was performed to measure left ventricular (LV) basal, apical, and global longitudinal strain as well as circumferential strain (CS) of the ascending aorta as a proxy measurement of aortic compliance.
UNASSIGNED: The study comprised 139 cases of TAA aneurysms (52.5% females) with a mean age of 50 ± 14.8 years with 45 age and gender matched controls. Most cases (95%) were of African ethnicity. The main etiologies were hypertension (41.7%), HIV (36.6%), connective tissue disease (10.7%), congenital (2.2%) and mixed pathologies (8.6%). Two-thirds of patients (69.7%) presented in heart failure, 10% presented with aortic dissection. Thirty percent of the patients were classified as New York Heart Association (NYHA) class I, 59.7% NYHA II, 8.6% NYHA III and two patients NYHA class IV. Echocardiography revealed enlarged aortic dimensions compared to controls (P < 0.001). TAA aneurysms were complicated by severe aortic regurgitation (AR) in half (50.3%) of patients, moderate AR in 25.8%, and mild AR in 14.3%. The mean LV ejection fraction (46.9 ± 12.7%) was reduced compared to controls (P < 0.001). Aortic CS was reduced compared to controls [4.4 (3.2-6.2) % vs. 9.0 (7.1-13.4) %, P < 0.001]. Aortic stiffness was higher in the aortic aneurysm group compared to controls (15.39 ± 20.65 vs. 5.04 ± 2.09, P = 0.001). LV longitudinal strain (-13.9 ± 3.9% vs. 18.1 ± 6.7%), basal CS (-13.9 ± 5.6% vs. -17.9 ± 5.8%) and apical CS (-8.7 ± 8.5% vs. -30.6 ± 3.8%) were reduced compared to controls (P < 0.001). Most patients were on diuretic and anti-remodeling therapy. Surgery was performed in 29.4% and overall mortality was 7.9%. Mortality for acute aortic dissection was 40%.
UNASSIGNED: TAA aneurysms associated with hypertension and HIV are common in this predominantly African female population and are associated with considerable morbidity and mortality. Two-dimensional echocardiography and advanced strain imaging are potential tools for detecting and risk stratifying TAA aneurysms.
摘要：
■胸段升主动脉（TAA）动脉瘤是导致残疾和死亡的重要原因，需要早期发现以进行有效管理。目前,非洲缺乏与TAA动脉瘤相关的数据。这项研究描述了城市周边三级医院的TAA动脉瘤的范围。
■一项基于2017年10月-2022年10月TAA动脉瘤患者临床和超声心动图影像学数据的描述性回顾性研究。进行高级应变成像以测量左心室（LV）基底，顶端,和升主动脉的整体纵向应变以及周向应变（CS）作为主动脉顺应性的替代测量。
■该研究包括139例TAA动脉瘤（52.5%为女性），平均年龄为50±14.8岁，45例年龄和性别匹配的对照。大多数病例（95％）是非洲种族。主要病因为高血压（41.7%），艾滋病毒（36.6%），结缔组织病（10.7%），先天性（2.2％）和混合性病理（8.6％）。三分之二的患者（69.7％）出现心力衰竭，10%表现为主动脉夹层。30%的患者被归类为纽约心脏协会（NYHA）一级，59.7%NYHAII，8.6%的NYHAⅢ级患者和两名NYHAⅣ级患者。与对照组相比，超声心动图显示主动脉尺寸增大（P<0.001）。TAA动脉瘤并发严重主动脉瓣反流(AR)的患者占一半(50.3%),中度AR为25.8%，轻度AR为14.3%。与对照组相比,平均LV射血分数(46.9±12.7%)降低(P<0.001)。与对照组相比，主动脉CS降低[4.4（3.2-6.2）％vs.9.0（7.1-13.4）%，P<0.001]。与对照组相比，主动脉瘤组的主动脉硬度更高（15.39±20.65vs.5.04±2.09，P=0.001）。LV纵向应变(-13.9±3.9%vs.18.1±6.7%)，基础CS（-13.9±5.6%vs.-17.9±5.8%）和根尖CS（-8.7±8.5%vs.与对照组相比，-30.6±3.8％）降低（P<0.001）。大多数患者接受利尿剂和抗重塑治疗。手术率为29.4%，总死亡率为7.9%。急性主动脉夹层的死亡率为40％。
■与高血压和HIV相关的TAA动脉瘤在非洲女性人群中很常见，并与相当高的发病率和死亡率相关。二维超声心动图和高级应变成像是检测和分层TAA动脉瘤的潜在工具。
■一项基于2017年10月-2022年10月TAA动脉瘤患者临床和超声心动图影像学数据的描述性回顾性研究。进行高级应变成像以测量左心室（LV）基底，顶端,和升主动脉的整体纵向应变以及周向应变（CS）作为主动脉顺应性的替代测量。
■该研究包括139例TAA动脉瘤（52.5%为女性），平均年龄为50±14.8岁，45例年龄和性别匹配的对照。大多数病例（95％）是非洲种族。主要病因为高血压（41.7%），艾滋病毒（36.6%），结缔组织病（10.7%），先天性（2.2％）和混合性病理（8.6％）。三分之二的患者（69.7％）出现心力衰竭，10%表现为主动脉夹层。30%的患者被归类为纽约心脏协会（NYHA）一级，59.7%NYHAII，8.6%的NYHAⅢ级患者和两名NYHAⅣ级患者。与对照组相比，超声心动图显示主动脉尺寸增大（P<0.001）。TAA动脉瘤并发严重主动脉瓣反流(AR)的患者占一半(50.3%),中度AR为25.8%，轻度AR为14.3%。与对照组相比,平均LV射血分数(46.9±12.7%)降低(P<0.001)。与对照组相比，主动脉CS降低[4.4（3.2-6.2）％vs.9.0（7.1-13.4）%，P<0.001]。与对照组相比，主动脉瘤组的主动脉硬度更高（15.39±20.65vs.5.04±2.09，P=0.001）。LV纵向应变(-13.9±3.9%vs.18.1±6.7%)，基础CS（-13.9±5.6%vs.-17.9±5.8%）和根尖CS（-8.7±8.5%vs.与对照组相比，-30.6±3.8％）降低（P<0.001）。大多数患者接受利尿剂和抗重塑治疗。手术率为29.4%，总死亡率为7.9%。急性主动脉夹层的死亡率为40％。
■与高血压和HIV相关的TAA动脉瘤在非洲女性人群中很常见，并与相当高的发病率和死亡率相关。二维超声心动图和高级应变成像是检测和分层TAA动脉瘤的潜在工具。
