mpact of Hypertension History and Blood Pressure at Presentation on Cardiac Remodeling and Mortality in Aortic Dissectio

Autor(es):Mostrar menos -

Oliveira, Matheus F. R. A. ^[1] ; Rocha, Walter E. M. ^[1] ; Soares, Julia D. ^[2] ; L'Armee, Victor M. F. S. ^[2] ; Martins, Mayara P. G. ^[3] ; Rocha, Aloisio M. ^[3] ; Feitosa, Audes D. M. ^{[2, 4]} ; Lima, Ricardo C. ^[2] ; Oliveira, Pedro P. M. ^[5] ; Silveira-Filho, Lindemberg M. ^[5] ; Coelho-Filho, Otavio R. ^[1] ; Matos-Souza, Jose R. ^[1] ; Petrucci, Jr., Orlando ^[5] ; Sposito, Andrei C. ^[1] ; Nadruz Jr, Wilson

Afiliação do(s) autor(es)

^[1] Univ Estadual Campinas, Sch Med Sci, Dept Internal Med, Sao Paulo - Brazil

^[2] Univ Pernambuco, Pronto Socorro Cardiol Pernambuco, Recife, PE - Brazil

^[3] Pontifical Catholic Univ Campinas, Dept Cardiol, Campinas - Brazil

^[4] Univ Catolica Pernambuco, Clin Res Inst, Recife, PE - Brazil

^[5] Univ Estadual Campinas, Sch Med Sci, Dept Surg, Sao Paulo - Brazil

• Tipo de documento: Artigo Científico
• Fonte: FRONTIERS IN CARDIOVASCULAR MEDICINE; v. 8, JAN 21 2022.
• Citações Web of Science: 0

Resumo

ObjectiveThis study compared clinical, echocardiographic, and prognostic characteristics among patients with aortic dissection (AD) with (HypHist) and without (No-HypHist) hypertension history and evaluated the association of blood pressure (BP) at presentation with 1-year mortality, left ventricular (LV) remodeling and renal dysfunction. MethodsWe investigated clinical and echocardiographic characteristics and 1-year mortality among 367 patients with AD (81% HypHist, 66% Type-A) from three Brazilian centers. ResultsPatients with No-HypHist were more likely to have Marfan syndrome, bicuspid aortic valve, to undergo surgical therapy, were less likely to have LV hypertrophy and concentricity, and had similar mortality compared with HypHist patients. Adjusted restricted cubic spline analysis showed that systolic BP (SBP) and diastolic BP (DBP) at presentation had a J-curve association with mortality among patients with No-HypHist, but did not associate with death among patients with HypHist (p for interaction = 0.001 for SBP and = 0.022 for DBP). Conversely, the association between SBP at presentation and mortality was influenced by previous use of antihypertensive medications in the HypHist group (p for interaction = 0.002). Results of multivariable logistic regression analysis comprising the whole sample showed direct associations of SBP and DBP at presentation with LV hypertrophy (p = 0.009) and LV concentricity (p = 0.015), respectively, and an inverse association between pulse pressure at presentation and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) (p = 0.008). ConclusionCombined information on BP at presentation, previous diagnosis of hypertension, and use of antihypertensive medications might be useful to predict mortality risk and to estimate extra-aortic end-organ damage among patients with AD. (AU)

• Processo FAPESP: 13/07607-8 - CMPO - Centro Multidisciplinar de Pesquisa em Obesidade e Doenças Associadas
• Beneficiário: Licio Augusto Velloso
• Modalidade de apoio: Auxílio à Pesquisa - Centros de Pesquisa, Inovação e Difusão - CEPIDs