1. The Short-term Predictive Value of Vessel Wall Stiffness on Abdominal Aortic Aneurysm Growth
- Author
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Marcus Langenskiöld, Ulver S Lorenzen, Kim K. Bredahl, Henrik Sillesen, Jonas Eiberg, Rebecka Hultgren, and Anders Wanhainen
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Denmark ,Diastole ,macromolecular substances ,Risk Assessment ,Vascular Stiffness ,Aneurysm ,Wall stiffness ,Predictive Value of Tests ,Risk Factors ,medicine.artery ,Internal medicine ,medicine ,Humans ,Prospective Studies ,cardiovascular diseases ,Watchful Waiting ,Aorta ,Aged ,Randomized Controlled Trials as Topic ,Ultrasonography ,Sweden ,business.industry ,Ultrasound ,General Medicine ,Prognosis ,medicine.disease ,Predictive value ,United Kingdom ,Abdominal aortic aneurysm ,Biomechanical Phenomena ,Ecg gating ,Disease Progression ,cardiovascular system ,Cardiology ,Female ,Surgery ,Cardiology and Cardiovascular Medicine ,business ,Aortic Aneurysm, Abdominal - Abstract
Background Abdominal aortic aneurysm (AAA) surveillance programs are currently based solely on AAA diameter. The diameter criterion alone, however, seems inadequate as small AAAs comprise 5–10 % of ruptured AAAs as well as some large AAAs never rupture. Aneurysm wall stiffness has been suggested to predict rupture and growth; this study aimed to investigate the prognostic value of AAA vessel wall stiffness for growth on prospectively collected data. Methods Analysis was based on data from a randomised, placebo-controlled, multicentre trial investigating mast-cell-inhibitors to halt aneurysm growth (the AORTA trial). Systolic and diastolic AAA diameter was determined in 326 patients using electrocardiogram-gated ultrasound (US). Stiffness was calculated at baseline and after 1 year. Results Maximum AAA diameter increased from 44.1 mm to 46.5 mm during the study period. Aneurysm growth after 1 year was not predicted by baseline stiffness (-0.003 mm/U; 95 % CI: -0.007 to 0.001 mm/U; P = 0.15). Throughout the study period, stiffness remained unchanged (8.3 U; 95 % CI: -2.5 to 19.1 U; P = 0.13) and without significant correlation to aneurysm growth (R: 0.053; P = 0.38). Conclusions Following a rigorous US protocol, this study could not confirm AAA vessel wall stiffness as a predictor of aneurysm growth in a 1-year follow-up design. The need for new and subtle methods to complement diameter for improved AAA risk assessment is warranted.
- Published
- 2021