Search

Background: The erythroblast transformation-specific related gene (ERG) is expressed in hematopoietic stem and progenitor cells and endothelial cells. This study aimed to investigate if ERG rs2836411 is a novel genetic locus associated with anemia and aortic dissection (AD)., Method: A case-control trial was conducted to evaluate the association between ERG rs2836411 polymorphism, anemia, and AD risk. The ERG rs2836411 polymorphism was analyzed using Sanger dideoxy chain termination sequencing on genomic DNA extracted from whole blood. Serum erythropoietin (EPO) and interleukin-6 (IL-6) concentrations were measured by enzyme-linked immunosorbent assay (ELISA)., Results: 119 preoperative AD patients and 119 healthy controls were enrolled, with age and sex matched. Anemia was found independently associated with AD presence (Odds ratio (OR) 20.82, p < 0.001). Remarkably, T carriers (CT + TT) of ERG rs2836411 were associated with anemia in AD patients (OR 2.81, p = 0.013) but not in controls. After adjusting for conventional risk factors including age, sex, smoking and hypertension status, T carriers (CT + TT) were independently associated with AD presence (OR 2.20, p = 0.015), but were not associated if anemia was further adjusted. While EPO concentration was higher in AD patients and was associated with AD presence (OR 1.09, p = 0.006), no difference in EPO levels was observed between the ERG genotypes of AD patients., Conclusions: T carriers (CT + TT) of ERG rs2836411 are independently associated with anemia and AD presence. The association between ERG rs2836411 polymorphism and susceptibility to AD may be mediated by anemia. Further studies are warranted to validate whether this association is causal., Competing Interests: Declarations. Ethics approval and consent to participate: The study was approved by the Ethics Committee of Xinqiao Hospital, Army Medical University (2022-059-03). All eligible patients supplied written informed consent, and the study was performed in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

There is scarce information about the risk factors for incomplete false lumen thrombosis (FLT) among type B aortic dissection (AD) patients, particularly in the sub-acute phase following thoracic endovascular aortic repair (TEVAR). We enrolled consecutive sub-acute type B AD patients at Xinqiao Hospital (Chongqing, China) from May 2010 to December 2019. Patients with severe heart failure, cancer, and myocardial infarction were excluded. The postoperative computed tomography angiography (CTA) data were extracted from the most recent follow-up aortic CTA. Multivariate logistic regressions were applied to identify the association between FLT and clinical or imaging factors. Fifty-five subjects were enrolled in our study. Twelve participants showed complete FLT, and 2 of these died during the follow-up, while 8 patients died in incomplete FLT group. In the multivariate analysis, maximum abdominal aorta diameter (OR 1.20, 95% CI 1.016-1.417 p = 0.032) and the number of branches arising from the false lumen (FL) (OR 15.062, 95% 1.681-134.982 p = 0.015) were significantly associated with incomplete FLT. The C-statistics was 0.873 (95% CI 0.773-0.972) for the model. The FL diameter (p < 0.001) was significantly shorter following TEVAR, while the true lumen diameter (p < 0.001) and maximum abdominal aorta diameter (p = 0.011) were larger after the aortic repair. There were 21.8% of sub-acute type B AD patients presented complete FLT post-TEVAR. Maximum abdominal aorta diameter and the number of branches arising from the FL were independent risk factors for incomplete FLT. The true lumen diameter, maximum abdominal aorta diameter, and FL diameter changed notably following TEVAR., (© 2021. Springer Japan KK, part of Springer Nature.)

Objective To investigate the risk factors associated with post-implantation syndrome (PIS) in Stanford type B aortic dissection (TBAD) patients undergoing thoracic endovascular aortic repair (TEVAR) and the relationship of PIS with short-term outcomes. Methods A case-control trial was conducted on the clinical data of patients undergoing TEVAR treatment for TBAD in our department from December 2013 to December 2022. They were divided into 2 groups based on the occurrence of PIS. Independent risk factors were analyzed according to the different clinical characteristics between the 2 groups. The overall 30-day mortality following TEVAR was assessed in both groups. Kaplan-Meier survival curves were utilized to evaluate the 30-day postoperative survival. Logistic regression models were constructed to investigate the relationship between PIS and overall mortality occurring within 30 d after TEVAR. Results A total of 373 TBAD patients, with an average age of 57.9±12.1 years and a male ratio of 77.5% (289 cases), were enrolled in this study. There were 106 cases (28.4%) experiencing PIS following TEVAR. Significantly larger proportions of implanted stents ≥2, operation duration ≥2 h and implantation of polyethylene terephthalate (PET)-coverted stents were observed in the PIS group than the non-PIS group (P < 0.05). Multivariate logistic regression analysis suggested that implanted stents ≥2 (OR=1.886, 95%CI: 1.049~3.389, P=0.034), operation duration ≥2 h (OR=1.938, 95%CI: 1.147~3.275, P=0.013) and implantation of PET-coverted stents (OR=2.131, 95%CI: 1.263~3.597, P=0.005) were independent risk factors for PIS after TEVAR. Within 30 d after TEVAR, 15 (4.0%) cases dead, including 10 (9.4%) from the PIS group and 5 (1.9%) from the non-PIS group. Kaplan-Meier survival curve indicated a significantly lower survival in the PIS group (Log-rank P=0.000 7). The results of multivariate logistic regression model indicated that cystatin C (OR=1.486, 95%CI: 1.053~2.097, P=0.024) and PIS (OR=5.628, 95%CI: 1.836~17.248, P=0.002) were independent risk factors for 30-day mortality after TEVAR in TBAD patients. Conclusion Implanted stents ≥2, operation duration ≥2 h and implantation of PET-coverted stents are closely associated with the occurrence PIS in TBAD patients after TEVAR. Cystatin C level and PIS are primary risk factors for poor 30-day prognosis after TEVAR.