Introduction
Aortopathies are a predominantly asymptomatic disease with life threatening consequences, such as aortic dissections and rupture. Aortopathy refers to aortic dilation produced by acquired or genetic pathophysiological changes disrupting the integrity of the aortic wall. Consequently, they can be sporadic, familial, syndromic, or non-syndromic in origin. To be classed as an aortopathy the aortic diameter needs to be 50% larger than the same aortic segment in a patient of the same age and sex. Irrespective of size, aortopathies are divided into 2 subgroups based on location in reference to the diaphragm: thoracic aortic aneurysm (TAA) or abdominal aortic aneurysm (AAA), both with their own unique pathophysiological processes and risk factors.
Currently no screening protocol exists in Australia for TAAs given the low prevalence rate (4.5-5.9 per/ 100,000 persons) and uncertainty regarding risk factors. Majority of patients will be diagnosed incidentally or at the time of rupture given only 5% are symptomatic.
Mortality rates for ruptured aneurysms stand at 80%, yet there are still large gaps in literature. Recent studies have demonstrated the correlation between aortopathies and multiple inherited disorder along with lifestyle factors. Unfortunately, aortopathies among rural populations have not been adequately investigated. Current data shows a dramatically higher rate of cardiovascular disease (CVD) and aortopathy risk factors among rural populations. Rural Australians are 1.2-1.5 times more likely to die of cardiovascular disease than metropolitan residents, this is attributed to increased co-morbidities and reduced access to health care. Clear links have been drawn between CVD and aortopathy formation, thus it is hypothesised that aortopathy prevalence would follow a similar trajectory.
Therefore, it is essential that rurality be assessed as a risk factor and predictor of aortopathy formation, principally given the already drastic disadvantage rural population face when accessing healthcare services and treatment.
Aim
It is the goal of this study to firstly fill gaps in the current literature, not only on aortopathies in a rural population, but aortopathies factors in general. Additionally, we plan to evaluate the presence of any at-risk populations and effectiveness of current protocol. With the hope that one day results may help alter guidelines and screening recommendations.
Method/Description
The following report will be conducted as a cross-sectional study, reporting on patient demographics along with thoracic aortic diameter. The patients included in this study have undergone a CTCA in the Riverina from 2012-2021. Aortic measurements will be collected using patient CTCA images via the Inteleviewer software. In total, 4 aortic measurements will be made on each patient:
- Aortic annulus
- Sinotubular junction
- Ascending aorta, at the level of the main pulmonary arteries
- Descending aorta, at the level of the main pulmonary arteries
Collection of co-morbidities and patient demographics will be achieved through analysis and collation of patient files.