Retrospective analysis of the prognostic effect of angiotensin receptor blocker on non-Marfan aortic dissection  

作　　者：HUANG Cheng LIN Yu-peng JIANG Zhi-sheng HUANG Wen-hui 黄澄;林宇鹏;姜志胜;黄文晖(Department of Cardiology,Guangdong Cardiovascular institute,Provincial Key Laboratory of Coronary Heart Disease Prevention,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong,China;Jieyang People's Hospital,Jieyang 522000,Guangdong,China;Institute of Cardiovascular Disease and Key Laboratory for Arteriosclerology of Hunan Province,Hengyang Medical School,University of South China,Hengyang 421000,Hunan,China)

机构地区：[1]Department of Cardiology,Guangdong Cardiovascular institute.Provincial Key Laboratory of Coronary Heart Disease Prevention,Guangdong Provincial People's Hospital,Guangdong Academy of Medical Sciences,Guangzhou 510080,Guangdong,China [2]Jieyang People's Hospital,Jieyang 522000,Guangdong,China [3]Institute of Cardiovascular Disease and Key Laboratory for Arteriosclerology of Hunan Province,Hengyang Medical School,University of South China,Hengyang 421000,Hunan,China

出　　处：《South China Journal of Cardiology》2020年第3期163-167,197,共6页岭南心血管病杂志（英文版）

摘　　要：Background Aortic dissection(AD)is a life-threatening vascular disease caused by various etiologies including Marfan’s syndrome.Angiotensin receptor blocker(ARB)drugs have been confirmed beneficial for patients with Marfanoid AD but remain unclear for non-Marfanoid case.Methods Patients with DeBakey typeⅢ,Standford A aortic dissection were consecutively recruited to Guangdong Provincial People’s Hospital and Jieyang People’s Hospital between January 2010 and January 2015,with 25 individuals in the ARB group and 32 individuals in the non-ARB group(control group),respectively.The follow-up was performed by database or telephone.The follow-up data consisted of patient’s symptoms and chief complaints,blood pressure,heart rate,and aortic computed tomography angiography(CTA)data.Endpoints and in-hospital events were recorded.Results Baseline data,including age,gender,heart rate,smoking status,and the incidence of diabetes,demonstrated no significant difference between two groups.There was neither death nor urgent surgical case in either group during the follow-up period.The aortic CTA follow-up demonstrated the absorption of the proximal inversely avulsed hematoma for both groups,whereas the reduction was more evident in the ARB group as compared with the non-ARB group[-(9.33±1.99)mm vs.-(4.08±2.35)mm,respectively,P<0.05],suggesting that hematoma absorption was more remarkable in the ARB group.The maximum vascular diameter at the dissection in both groups declined during the follow-up,whereas the reduction in the ARB group was significantly more striking relative to that in the non-ARB group[-(5.50±1.15)mm vs.-(0.31±0.69)mm,respectively,P<0.001],indicating a potential role of ARB drugs in curbing aortic enlargement and remodeling.Conclusions Independent of blood pressure(BP)reduction,ARB utilization in patients with non-Marfan’s aortic dissection may facilitate the absorption of reverse-torn hematoma at the proximal end of dissection,as well as delaying the aortic dilation and remodeling.

关 键 词：angiotensin receptor blocker non-Marfanoid aortic dissection aortic dilation proximal laceration hematoma 

分 类 号：R543.1[医药卫生—心血管疾病]