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Original research article
Aortic elongation part I: the normal aortic ageing process
  1. Bouke P Adriaans1,2,3,
  2. Samuel Heuts3,4,
  3. Suzanne Gerretsen1,
  4. Emile C Cheriex2,
  5. Rein Vos5,
  6. Ehsan Natour4,6,
  7. Jos G Maessen3,4,
  8. Peyman Sardari Nia3,4,
  9. Harry J G M Crijns2,3,
  10. Joachim E Wildberger1,3,
  11. Simon Schalla1,2,3
  1. 1Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
  2. 2Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
  3. 3Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
  4. 4Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
  5. 5Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands
  6. 6Department of Thoracic and Cardiovascular Surgery, Uniklinik RWTH Aachen, Aachen, Germany
  1. Correspondence to Samuel Heuts, Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht HX 6229, The Netherlands; sam.heuts{at}mumc.nl

Abstract

Objectives Differentiation between normal and abnormal features of vascular ageing is crucial, as the latter is associated with adverse outcomes. The normal aortic ageing process is accompanied by gradual luminal dilatation and reduction of vessel compliance. However, the influence of age on longitudinal aortic dimensions and geometry has not been well studied. This study aims to describe the normal evolution of aortic length and shape throughout life.

Methods A total of 210 consecutive patients were prospectively enrolled in this cross-sectional single-centre study. All subjects underwent CT on a third-generation dual-source CT scanner. Morphometric measurements, including measurements of segmental length and tortuosity, were performed on three-dimensional models of the thoracic aorta.

Results The length of the thoracic aorta was significantly related to age (r=0.54) and increased by 59 mm (males) or 66 mm (females) between the ages of 20 and 80 years. Elongation was most pronounced in the proximal descending aorta, which showed an almost 2.5-fold length increase during life. The lengthening of the thoracic aorta was accompanied by a marked change of its geometry: whereas the aortic apex was located between the branch vessels in younger patients, it shifted to a more distalward position in the elderly.

Conclusions The normal ageing process is accompanied by gradual aortic elongation and a notable change of aortic geometry. Part II of this two-part article investigates the hypothesis that excessive elongation could play a role in the occurrence of acute aortic dissection.

  • aortic elongation
  • vascular aging
  • aortic aging

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Footnotes

  • Contributors All listed author contributed in the following way to the manuscript. BPA and SH (corresponding author): conceptualisation, data acquisition, data analysis, data interpretation, drafting and writing of the manuscript, final approval and agreement to be accountable for all aspects of the work. SG: data acquisition, data interpretation, drafting and writing of the manuscript, final approval and agreement to be accountable for all aspects of the work. ECC: conceptualisation, data acquisition, manuscript review, final approval and agreement to be accountable for all aspects of the work. RV: data analysis, data interpretation, drafting and writing of the manuscript, final approval and agreement to be accountable for all aspects of the work. EN, JGM, HJGMC: conceptualisation, data interpretation, manuscript review, final approval and agreement to be accountable for all aspects of the work. PSN, JEW, SS: conceptualisation, data interpretation, drafting and writing of the manuscript, final approval and agreement to be accountable for all aspects of the work.

  • Funding This work was supported by Stichting de Weijerhorst, Maastricht, Limburg, The Netherlands.

  • Competing interests None declared.

  • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

  • Ethics approval Institutional Medical Ethics Committee Maastricht University Medical Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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