{"id":"01335be7a0bb","type":"article","url":"https://hartvaat.nl/2026/03/25/vrouwen-krijgen-een-type-a-aortadissectie-bij-een-kleinere-aortadiameter-door-hu/","title":"Vrouwen krijgen een type A-aortadissectie bij een kleinere aortadiameter — door hun kleinere lichaamsbouw","title_en":"Sex differences in ascending aortic diameter at the time of acute type A aortic dissection","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["aortadissectie","aortainsufficiëntie","perifeer-vaatlijden"],"journal":"Heart","doi":"http://heart.bmj.com/cgi/content/short/112/8/462?rss=1","source_url":"https://doi.org/http://heart.bmj.com/cgi/content/short/112/8/462?rss=1","authors":["Wagner","C. M.","Marway","P. S.","Ferrel","M. N.","Campello Jorge","C. A.","Fukuhara","S.","Hawkins","R. B.","Deeb","G. M.","Patel","H. J.","Ailawadi","G.","Yang","B.","Burris","N. S.","Hamilton","B. C. S."],"significance":6,"published":"2026-03-25","source_date":"2026-03-25","image":"https://hartvaat.nl/global/img/2ea89016db5e.webp","kennis":["https://hartvaat.nl/kennis/cardiometabool/diabetes-type-1-en-hart/","https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"Guideline size criteria for prophylactic ascending aortic aneurysm repair do not account for sex, although women may experience acute type A aortic dissection (ATAAD) at smaller diameters. In this single-centre retrospective study (413 patients with ATAAD, 35% female), aortic diameter at dissection was smaller in women, who were also older (65 vs 58 years). Female sex was associated with dissection at a smaller absolute diameter, but this association disappeared when accounting for women's smaller body size (diameter indexed to height or body surface area). Guidelines that account for sex or body size could thus reduce preventable complications in women.","created":"2026-07-03T10:32:21Z","updated":"2026-07-03T13:31:18Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De richtlijncriteria voor preventieve operatie van een aneurysma van de aorta ascendens houden geen rekening met geslacht, terwijl vrouwen mogelijk al bij een kleinere diameter een acute type A-aortadissectie (ATAAD) krijgen. In deze retrospectieve single-centerstudie (413 patiënten met ATAAD, 35% vrouw) was de aortadiameter op het moment van dissectie bij vrouwen kleiner; vrouwen waren ook ouder (65 vs. 58 jaar). Het vrouwelijke geslacht was geassocieerd met dissectie bij een kleinere absolute diameter, maar dit verband verdween wanneer werd gecorrigeerd voor de kleinere lichaamsbouw van vrouwen (diameter geïndexeerd naar lengte of lichaamsoppervlak). Richtlijnen die rekening houden met geslacht of lichaamsgrootte zouden dus vermijdbare complicaties bij vrouwen kunnen verminderen.","abstract_original":"Background\n

Guideline size criteria for prophylactic repair of ascending aortic aneurysm do not account for sex, although some evidence suggests women may experience acute type A aortic dissection (ATAAD) at smaller diameters. We examined sex differences in ascending aortic diameter among patients with ATAAD.

\n\nMethods\n

We performed a single-centre, retrospective study including consecutive adult patients undergoing repair of spontaneous ATAAD (2011–2023). Maximal ascending aortic diameter was measured on index CT. Maximum diameter and diameter indexed to height and body surface area (BSA) were compared by sex. Multivariable linear regression, accounting for sex, age and comorbidities, predicted aortic diameter at time of ATAAD. Height and BSA were separately added to the model to evaluate how associations changed with body size.

\n\nResults\n

Among 413 included patients, 146 (35.4%) were female. Women were older (65 "}