Male-female differences in thoracic aortic diameters at presentation of acute type A aortic dissection

• Published in: International journal of cardiology. Heart & vasculature 2023-12, Vol.49, p.101290-101290, Article 101290
• Main Authors: Meccanici, F., Bom, A.W., Knol, W.G., Gökalp, A.L., Thijssen, C.G.E., Bekkers, J.A., Geuzebroek, G.S.C., Mokhles, M.M., van Kimmenade, R.R.J., Budde, R.P.J., Takkenberg, J.J.M., Roos-Hesselink, J.W.
• Format: Article
• Language: English
• Subjects: Aortic dimensions; Gender; Original Paper; Sex; Stanford type A dissection; Thoracic aortic dissection
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2023.101290

Acute type A aortic dissection (ATAAD) is a highly lethal event, associated with aortic dilatation. It is not well known if patient height, weight or sex impact the thoracic aortic diameter (TAA) at ATAAD. The study aim was to identify male–female differences in TAA at ATAAD presentation. This retrospective cross-sectional study analysed all adult patients who presented with ATAAD between 2007 and 2017 in two tertiary care centres and underwent contrast enhanced computed tomography (CTA) before surgery. Absolute aortic diameters were measured at the sinus of Valsalva (SoV), ascending (AA) and descending thoracic aorta (DA) using double oblique reconstruction, and indexed for body surface area (ASI) and height (AHI). Z-scores were calculated using the Campens formula. In total, 59 % (181/308) of ATAAD patients had CT-scans eligible for measurements, with 82 female and 99 male patients. Females were significantly older than males (65.5 ± 12.4 years versus 60.3 ± 2.3, p = 0.024). Female patients had larger absolute AA diameters than male patients (51.0 mm [47.0–57.0] versus 49.0 mm [45.0–53.0], p = 0.023), and larger ASI and AHI at all three levels. Z-scores for the SoV and AA were significantly higher for female patients (2.99 ± 1.66 versus 1.34 ± 1.77, p