1. Characteristics of Inter-Arm Difference in Blood Pressure in Acute Aortic Dissection
- Author
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Nozomi, Sasamoto, Koichi, Akutsu, Takeshi, Yamamoto, Toshiaki, Otsuka, Hideto, Sangen, Hiroshi, Hayashi, Hiroshige, Murata, Hideki, Miyachi, Yusuke, Hosokawa, Shuhei, Tara, Yukichi, Tokita, Satoshi, Miyata, Tetsuro, Morota, Takashi, Nitta, Wataru, Shimizu, Sasamoto, Nozomi, Akutsu, Koichi, Yamamoto, Takeshi, Otsuka, Toshiaki, Sangen, Hideto, Hayashi, Hiroshi, Murata, Hiroshige, Miyachi, Hideki, Hosokawa, Yusuke, Tara, Shuhei, Tokita, Yukichi, Miyata, Satoshi, Morota, Tetsuro, Nitta, Takashi, and Shimizu, Wataru
- Subjects
Male ,medicine.medical_specialty ,Lower blood pressure ,Blood Pressure ,03 medical and health sciences ,0302 clinical medicine ,Right Common Carotid Artery ,medicine.artery ,Internal medicine ,Back pain ,medicine ,Brachiocephalic artery ,Humans ,In patient ,Pulse ,Aged ,Retrospective Studies ,Aortic dissection ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,medicine.disease ,Acute cardiovascular disease ,Aortic Dissection ,Blood pressure ,030220 oncology & carcinogenesis ,Acute Disease ,Cardiology ,030211 gastroenterology & hepatology ,Female ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
An inter-arm difference in blood pressure (IADBP) is characteristic of acute aortic dissection (AAD), but the importance of which arm exhibits lower blood pressure (BP) and the mechanism underlying IADBP are not well understood.We identified consecutive patients with chest and/or back pain and suspected acute cardiovascular disease whose BP had been measured in both arms. We retrospectively compared the characteristics of such patients with AAD (n=93) to those without AAD (non-AAD group, n=122). Additionally, we separately compared patients with type A AAD (TAAD group, n=58) or type B AAD (TBAD group, n=35) to the non-AAD group. The characteristics analyzed were patient background and IADBP-related factors, including systolic BP (SBP) in the right arm (R) and left arm (L), and R-L or L-R as IADBP. Computed tomography (CT) findings of AD extending to the brachiocephalic artery (BCA) and/or left subclavian artery (LSCA) were examined in patients with an IADBP.In a comparison of the TAAD group and non-AAD group, the prevalences of R130 mm Hg (38% vs. 19%, p=0.009), L-R15 mm Hg (19% vs. 8%, p=0.047), L-R20 mm Hg (14% vs. 4%, p=0.029) were higher in the TAAD group. Multivariate analysis showed that L-R15 mm Hg with R130 mm Hg was independently associated with TAAD (OR 25.97, 95% CI 2.45-275.67, p=0.007). However, IADBP-related factors were not associated with TBAD. AAD patients with L-R20 mm Hg all had TAAD, and all aortic dissection extended to the BCA just before the right common carotid artery on CT.IADBP was characterized by RL with low R in TAAD but was not associated with TBAD.
- Published
- 2021