Aortic Dissection
Conditions
Brief summary
Acute type A aortic dissection is often accompanied by postoperative hypoxemia, the cause of which is not fully understood. Angiotensin II is an important component of the renin-angiotensin system (RAS), which has been suggested to be involved in the development of aortic dissection and pulmonary inflammation.The purpose of this study was to investigate the role and mechanism of angiotensin II pathway in postoperative hypoxemia after acute type A aortic dissection, and to provide reference for clinical application
Interventions
OTHERNo intervention
No intervention
Sponsors
Beijing Anzhen Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing surgery for acute type A aortic dissection * age between 18 to 80
Exclusion criteria
* perioperative severe cardiac insufficiency * rejection of consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The Difference Concentrations of ANG II in Serum Between Patients With and Without Postoperative Hypoxemia. | Within 24 hours after surgery | Blood samples were taken within 24 hours after operation to detect the contents of ANG II in serum. Postoperative hypoxemia is defined by the oxygenation index (OI), which is the ratio of arterial partial pressure of oxygen to fraction inspired oxygen (PaO2 / FiO2), of less than or equal to 200 for two consecutive times within the first 24 h after operation |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The Risk Factors for Postoperative Hypoxemia in Stanford Type A Acute Aortic Dissection Patients. | up to 60 days | Basic characteristics, intraoperative details, biochemical parameters and outcome results were obtained, and blood was collected within 24 hours after surgery for the measurement of ANG II, sACE2 and mir-145 concentrations. Univariate analysis was first performed to identify the potential risk factors for postoperative hypoxemia. Multivariate logistic regression analysis was performed for factors with P \< 0.05 or that were considered clinically important. |
| Duration of Stay in the Intensive Care Unit | up to 60 days | Duration of Stay in the intensive care unit after surgery |
Countries
China
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Hypoxemia Group oxygenation index (OI)≤200
No intervention: No intervention | 25 |
| Non-hypoxemia Group oxygenation index (OI)\>200
No intervention: No intervention | 63 |
| Total | 88 |
Baseline characteristics
| Characteristic | Hypoxemia Group | Non-hypoxemia Group | Total |
|---|---|---|---|
| Age, Continuous | 52.1 years STANDARD_DEVIATION 10.6 | 50.4 years STANDARD_DEVIATION 10.5 | 50.9 years STANDARD_DEVIATION 10.5 |
| BMI | 29.0 kg / m2 STANDARD_DEVIATION 3.7 | 25.2 kg / m2 STANDARD_DEVIATION 3.4 | 26.3 kg / m2 STANDARD_DEVIATION 3.9 |
| Hight | 169.7 cm STANDARD_DEVIATION 7.6 | 171.6 cm STANDARD_DEVIATION 8.9 | 171.1 cm STANDARD_DEVIATION 8.6 |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 25 Participants | 63 Participants | 88 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 0 Participants | 0 Participants | 0 Participants |
| Sex: Female, Male Female | 8 Participants | 19 Participants | 27 Participants |
| Sex: Female, Male Male | 17 Participants | 44 Participants | 61 Participants |
| Weight | 83.9 Kg STANDARD_DEVIATION 14.9 | 74.4 Kg STANDARD_DEVIATION 12.8 | 77.1 Kg STANDARD_DEVIATION 14 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 1 / 25 | 0 / 63 |
| other Total, other adverse events | 0 / 25 | 0 / 63 |
| serious Total, serious adverse events | 0 / 25 | 0 / 63 |
Outcome results
Primary
The Difference Concentrations of ANG II in Serum Between Patients With and Without Postoperative Hypoxemia.
Blood samples were taken within 24 hours after operation to detect the contents of ANG II in serum. Postoperative hypoxemia is defined by the oxygenation index (OI), which is the ratio of arterial partial pressure of oxygen to fraction inspired oxygen (PaO2 / FiO2), of less than or equal to 200 for two consecutive times within the first 24 h after operation
Time frame: Within 24 hours after surgery
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Hypoxemia Group | The Difference Concentrations of ANG II in Serum Between Patients With and Without Postoperative Hypoxemia. | 100 pg / mL |
| Non-hypoxemia Group | The Difference Concentrations of ANG II in Serum Between Patients With and Without Postoperative Hypoxemia. | 78.5 pg / mL |
Secondary
Duration of Stay in the Intensive Care Unit
Duration of Stay in the intensive care unit after surgery
Time frame: up to 60 days
Secondary
The Risk Factors for Postoperative Hypoxemia in Stanford Type A Acute Aortic Dissection Patients.
Basic characteristics, intraoperative details, biochemical parameters and outcome results were obtained, and blood was collected within 24 hours after surgery for the measurement of ANG II, sACE2 and mir-145 concentrations. Univariate analysis was first performed to identify the potential risk factors for postoperative hypoxemia. Multivariate logistic regression analysis was performed for factors with P \< 0.05 or that were considered clinically important.
Time frame: up to 60 days