International Heterogeneity in Diagnostic Frequency and Clinical Outcomes of Ascending Aortic Intramural Hematoma
Background Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. Methods All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strat...
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| Veröffentlicht in: | Journal of the American Society of Echocardiography 2007-11, Vol.20 (11), p.1260-1268 |
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| creator | Pelzel, Jamie M., MD Braverman, Alan C., MD Hirsch, Alan T., MD Harris, Kevin M., MD |
| description | Background Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. Methods All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). Results IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). Conclusion There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea. |
| doi_str_mv | 10.1016/j.echo.2007.03.018 |
| format | Article |
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Methods All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). Results IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). Conclusion There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea.</description><identifier>ISSN: 0894-7317</identifier><identifier>EISSN: 1097-6795</identifier><identifier>DOI: 10.1016/j.echo.2007.03.018</identifier><identifier>PMID: 17614252</identifier><language>eng</language><publisher>United States: Mosby, Inc</publisher><subject>Aorta - diagnostic imaging ; Aortic Diseases - diagnostic imaging ; Aortic Diseases - mortality ; Aortic Diseases - therapy ; Cardiovascular ; Echocardiography, Transesophageal - utilization ; Europe - epidemiology ; Hematoma - diagnostic imaging ; Hematoma - mortality ; Hematoma - therapy ; Incidence ; Internationality ; Japan - epidemiology ; Korea - epidemiology ; North America - epidemiology ; Practice Patterns, Physicians' - statistics & numerical data ; Prevalence ; Risk Assessment - methods ; Risk Factors ; Survival Analysis ; Survival Rate ; Treatment Outcome</subject><ispartof>Journal of the American Society of Echocardiography, 2007-11, Vol.20 (11), p.1260-1268</ispartof><rights>American Society of Echocardiography</rights><rights>2007 American Society of Echocardiography</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c409t-75bef522c6928dddf1f798450db60846c9add98543dc9599d179d505be67a0f43</citedby><cites>FETCH-LOGICAL-c409t-75bef522c6928dddf1f798450db60846c9add98543dc9599d179d505be67a0f43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0894731707002143$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17614252$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pelzel, Jamie M., MD</creatorcontrib><creatorcontrib>Braverman, Alan C., MD</creatorcontrib><creatorcontrib>Hirsch, Alan T., MD</creatorcontrib><creatorcontrib>Harris, Kevin M., MD</creatorcontrib><title>International Heterogeneity in Diagnostic Frequency and Clinical Outcomes of Ascending Aortic Intramural Hematoma</title><title>Journal of the American Society of Echocardiography</title><addtitle>J Am Soc Echocardiogr</addtitle><description>Background Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. Methods All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). Results IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). Conclusion There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea.</description><subject>Aorta - diagnostic imaging</subject><subject>Aortic Diseases - diagnostic imaging</subject><subject>Aortic Diseases - mortality</subject><subject>Aortic Diseases - therapy</subject><subject>Cardiovascular</subject><subject>Echocardiography, Transesophageal - utilization</subject><subject>Europe - epidemiology</subject><subject>Hematoma - diagnostic imaging</subject><subject>Hematoma - mortality</subject><subject>Hematoma - therapy</subject><subject>Incidence</subject><subject>Internationality</subject><subject>Japan - epidemiology</subject><subject>Korea - epidemiology</subject><subject>North America - epidemiology</subject><subject>Practice Patterns, Physicians' - statistics & numerical data</subject><subject>Prevalence</subject><subject>Risk Assessment - methods</subject><subject>Risk Factors</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0894-7317</issn><issn>1097-6795</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1r3DAQhkVpaLZp_0APxafe7I5k2bKgFJZt8wGBHJKehVYab7W1pUSyA_vvI3cXCjn0JAbe52X0DCGfKFQUaPt1X6H5HSoGICqoK6DdG7KiIEXZCtm8JSvoJC9FTcU5eZ_SHgCaDuAdOaeipZw1bEWebvyE0evJBa-H4hrzFHbo0U2Hwvnih9M7H9LkTHEZ8WlGbw6F9rbYDM47k5G7eTJhxFSEvlgng946vyvWIS5Mbo96nOPf6lFPYdQfyFmvh4QfT-8F-XX582FzXd7eXd1s1rel4SCnUjRb7BvGTCtZZ63taS9kxxuw2xY63hqprZVdw2trZCOlpULaBjLVCg09ry_Il2PvYwx57zSp0eX1hkF7DHNSbcc7KhjkIDsGTQwpRezVY3SjjgdFQS2i1V4totUiWkGtsugMfT61z9sR7T_kZDYHvh0DmP_47DCqZFy2h9ZFNJOywf2___sr3JyE_8EDpn2Y89GGpKhKTIG6X069XBoEAKO8rl8AY3ilbA</recordid><startdate>20071101</startdate><enddate>20071101</enddate><creator>Pelzel, Jamie M., MD</creator><creator>Braverman, Alan C., MD</creator><creator>Hirsch, Alan T., MD</creator><creator>Harris, Kevin M., MD</creator><general>Mosby, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20071101</creationdate><title>International Heterogeneity in Diagnostic Frequency and Clinical Outcomes of Ascending Aortic Intramural Hematoma</title><author>Pelzel, Jamie M., MD ; Braverman, Alan C., MD ; Hirsch, Alan T., MD ; Harris, Kevin M., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c409t-75bef522c6928dddf1f798450db60846c9add98543dc9599d179d505be67a0f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aorta - diagnostic imaging</topic><topic>Aortic Diseases - diagnostic imaging</topic><topic>Aortic Diseases - mortality</topic><topic>Aortic Diseases - therapy</topic><topic>Cardiovascular</topic><topic>Echocardiography, Transesophageal - utilization</topic><topic>Europe - epidemiology</topic><topic>Hematoma - diagnostic imaging</topic><topic>Hematoma - mortality</topic><topic>Hematoma - therapy</topic><topic>Incidence</topic><topic>Internationality</topic><topic>Japan - epidemiology</topic><topic>Korea - epidemiology</topic><topic>North America - epidemiology</topic><topic>Practice Patterns, Physicians' - statistics & numerical data</topic><topic>Prevalence</topic><topic>Risk Assessment - methods</topic><topic>Risk Factors</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pelzel, Jamie M., MD</creatorcontrib><creatorcontrib>Braverman, Alan C., MD</creatorcontrib><creatorcontrib>Hirsch, Alan T., MD</creatorcontrib><creatorcontrib>Harris, Kevin M., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American Society of Echocardiography</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pelzel, Jamie M., MD</au><au>Braverman, Alan C., MD</au><au>Hirsch, Alan T., MD</au><au>Harris, Kevin M., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>International Heterogeneity in Diagnostic Frequency and Clinical Outcomes of Ascending Aortic Intramural Hematoma</atitle><jtitle>Journal of the American Society of Echocardiography</jtitle><addtitle>J Am Soc Echocardiogr</addtitle><date>2007-11-01</date><risdate>2007</risdate><volume>20</volume><issue>11</issue><spage>1260</spage><epage>1268</epage><pages>1260-1268</pages><issn>0894-7317</issn><eissn>1097-6795</eissn><abstract>Background Differing diagnostic frequencies and management strategies for intramural hematoma (IMH) have been described in North American (NA)/European and Japanese/Korean studies. Methods All publications including type-A aortic IMH were reviewed for details on patient demographics, treatment strategy, and clinical outcomes. Publications were stratified by the geographic region (NA/Europe or Japan/Korea). Results IMH, as a percentage of aortic dissection, occurs more frequently in Japan/Korea versus NA/Europe (31.7% vs 10.9%, P < .0001). The proportion of patients treated with early medical therapy is greater in Japanese/Korean studies (77.9% vs 48.8% in NA/Europe, P < .0001). However, the overall mortality is significantly lower in Japan/Korea compared with NA/Europe (9.4% vs 20.6%, odds ratio = 2.80, P = .003) in part because of the lower mortality with early medical therapy (7.8% vs 33.3%, P < .0001). Conclusion There is significant international heterogeneity in the diagnosis and clinical outcomes of ascending IMH. IMH is diagnosed more frequently and has better overall outcomes in Japan/Korea.</abstract><cop>United States</cop><pub>Mosby, Inc</pub><pmid>17614252</pmid><doi>10.1016/j.echo.2007.03.018</doi><tpages>9</tpages></addata></record> |
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| subjects | Aorta - diagnostic imaging Aortic Diseases - diagnostic imaging Aortic Diseases - mortality Aortic Diseases - therapy Cardiovascular Echocardiography, Transesophageal - utilization Europe - epidemiology Hematoma - diagnostic imaging Hematoma - mortality Hematoma - therapy Incidence Internationality Japan - epidemiology Korea - epidemiology North America - epidemiology Practice Patterns, Physicians' - statistics & numerical data Prevalence Risk Assessment - methods Risk Factors Survival Analysis Survival Rate Treatment Outcome |
| title | International Heterogeneity in Diagnostic Frequency and Clinical Outcomes of Ascending Aortic Intramural Hematoma |
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