Research progress on risk factors for acute aortic dissection complicated with acute lung injury_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Wenjun ¹ , CHI Wencui ² , LI Wanshun ¹ , SONG Bing ¹ ,  LI Yuanmin ¹

1. Department of Cardiovascular Surgery, The First Hospital of Lanzhou University, Lanzhou, 730000, P.R.China;
2. Department of ICU, The People's Hospital of Hui County, Longnan, 742300, Gansu, P.R.China;

Corresponding author：

LI Yuanmin, Email: ldyylym@163.com

Keywords：

Acute aortic dissection; acute lung injury; risk factors; prediction model; prevention and treatment

DOI：

10.7507/1007-4848.202008033

Video：

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Acute lung injury is one of the common and serious complications of acute aortic dissection, and it greatly affects the recovery of patients. Old age, overweight, hypoxemia, smoking history, hypotension, extensive involvement of dissection and pleural effusion are possible risk factors for the acute lung injury before operation. In addition, deep hypothermia circulatory arrest and blood product infusion can further aggravate the acute lung injury during operation. In this paper, researches on risk factors, prediction model, prevention and treatment of acute aortic dissection with acute lung injury were reviewed, in order to provide assistance for clinical diagnosis and treatment.

Citation： ZHOU Wenjun, CHI Wencui, LI Wanshun, SONG Bing, LI Yuanmin. Research progress on risk factors for acute aortic dissection complicated with acute lung injury. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(12): 1503-1507. doi: 10.7507/1007-4848.202008033 Copy

1.	中国医师协会心血管外科分会大血管外科专业委员会. 主动脉夹层诊断与治疗规范中国专家共识. 中华胸心血管外科杂志, 2017, 33(11): 641-654.
2.	Ren W, Wang ZW, Wu ZY, et al. Corrigendum to "JAK2/STAT3 pathway was associated with the protective effects of IL-22 on aortic dissection with acute lung injury". Dis Markers, 2019, 2019: 1901626.
3.	Pan X, Lu J, Cheng W, et al. Independent factors related to preoperative acute lung injury in 130 adults undergoing Stanford type-A acute aortic dissection surgery: A single-center cross-sectional clinical study. J Thorac Dis, 2018, 10(7): 4413-4423.
4.	Guo Z, Yang Y, Zhao M, et al. Preoperative hypoxemia in patients with type A acute aortic dissection: A retrospective study on incidence, related factors and clinical significance. J Thorac Dis, 2019, 11(12): 5390-5397.
5.	Ge HQ, Jiang Y, Jin QJ, et al. Nomogram for the prediction of postoperative hypoxemia in patients with acute aortic dissection. BMC Anesthesiol, 2018, 18(1): 146.
6.	Hiraoka A, Suzuki K, Chikazawa G, et al. Adaptive servo-ventilation suppresses elevation of C-reactive protein and sympathetic activity in acute uncomplicated type B aortic dissection. Interact Cardiovasc Thorac Surg, 2017, 24(1): 27-33.
7.	Kashiwagi Y, Komukai K, Suzuki K, et al. Predictors of oxygenation impairment in medical treatment for type B acute aortic dissection. Heart Vessels, 2018, 33(12): 1463-1470.
8.	Gong M, Wu ZN, Xu SJ, et al. Increased risk for the development of postoperative severe hypoxemia in obese women with acute type A aortic dissection. J Cardiothorac Surg, 2019, 14(1): 81.
9.	张欢欢, 杨玉金, 张加乐, 等. 急性主动脉夹层发生低氧血症患者危险因素的 Meta 分析. 中国现代医学杂志, 2018, 28(19): 67-74.
10.	Wu ZY, Wang ZW, Wu HB, et al. Obesity is a risk factor for preoperative hypoxemia in Stanford A acute aortic dissection. Medicine (Baltimore), 2020, 99(11): e19186.
11.	张明萌, 张斌, 饶敏腊, 等. 肥胖相关的部分脂肪因子研究进展. 中国医药, 2019, 14(6): 952-956.
12.	何诚, 陶宁, 赵利. 老年急性主动脉夹层合并急性肺损伤的临床特征及其影响因素. 中国老年学杂志, 2019, 39(20): 4889-4891.
13.	Liu N, Zhang W, Ma W, et al. Risk factors for hypoxemia following surgical repair of acute type A aortic dissection. Interact Cardiovasc Thorac Surg, 2017, 24(2): 251-256.
14.	Gao Z, Pei X, He C, et al. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: A prospective observational study. J Thorac Dis, 2019, 11(4): 1190-1201.
15.	Yamada Y, Tanno J, Nakano S, et al. Clinical implications of pleural effusion in patients with acute type B aortic dissection. Eur Heart J Acute Cardiovasc Care, 2016, 5(7): 72-81.
16.	周楚芝, 王湘, 姜妮, 等. 急性 A 型主动脉夹层孙氏术后低氧血症的危险因素分析. 岭南心血管病杂志, 2017, 23(2): 165-170.
17.	刘明娟, 刘婷珊, 邓康, 等. Stanford A 型急性主动脉夹层支架植入术后低氧血症的危险因素. 中华麻醉学杂志, 2019, 39(1): 121-122.
18.	Wang XH, Zhang HP, Cao L, et al. The role of macrophages in aortic dissection. Front Physiol, 2020, 11: 54.
19.	Wu Z, Ruan Y, Chang J, et al. AngiotensinⅡ is related to the acute aortic dissection complicated with lung injury through mediating the release of MMP9 from macrophages. Am J Transl Res, 2016, 8(3): 1426-1436.
20.	Mori K, Tamune H, Tanaka H, et al. Admission values of D-dimer and C-reactive protein (CRP) predict the long-term outcomes in acute aortic dissection. Intern Med, 2016, 55(14): 1837-1843.
21.	张鹏, 王永才, 张喜报, 等. 血清降钙素原、炎症细胞因子及超敏C−反应蛋白联合检测放射性肺炎合并肺部感染的诊断价值. 中华医院感染学杂志, 2017, 27(23): 5322-5324.
22.	Lv H, Yu Z, Zheng Y, et al. Isovitexin exerts anti-inflammatory and anti-oxidant activities on lipopolysaccharide-induced acute lung injury by inhibiting MAPK and NF-κB and activating HO-1/Nrf2 pathways. Int J Biol Sci, 2016, 12(1): 72-86.
23.	Cheng L, Zhao Y, Qi D, et al. Wnt/β-catenin pathway promotes acute lung injury induced by LPS through driving the Th17 response in mice. Biochem Biophys Res Commun, 2018, 495(2): 1890-1895.
24.	贺宝臣. 外周血 Th17 细胞、降钙素原在急性 A 型主动脉夹层病人中的表达与急性肺损伤的关系. 实用老年医学, 2019, 33(4): 346-350.
25.	Yuan SM, Yan SL, Wu N. Unusual aspects of cardiac myxoma. Anatol J Cardiol, 2017, 17(3): 241-247.
26.	Yuan SM. Profiles and predictive values of interleukin-6 in aortic dissection: A review. Braz J Cardiovasc Surg, 2019, 34(5): 596-604.
27.	黄相, 何黎, 王科科. 急性 A 型主动脉夹层血清白细胞介素-6、8 的变化及其与急性肺损伤的相关性. 中华胸心血管外科杂志, 2016, 32(11): 665-668.
28.	成泽怡, 杨梦阳, 李雅茹, 等. 主动脉夹层生物标志物的研究进展. 心血管病学进展, 2019, 40(1): 49-53.
29.	张丹, 申昌军. 急性 A 型主动脉夹层患者血清 D-二聚体、MMP-9 水平与急性肺损伤的相关性. 标记免疫分析与临床, 2019, 26(10): 1688-1691.
30.	Poole LG, Massey VL, Siow DL, et al. Plasminogen activator inhibitor-1 is critical in alcohol-enhanced acute lung injury in mice. Am J Respir Cell Mol Biol, 2017, 57(3): 315-323.
31.	Siti DL, Ma X. Predictors of acute lung injury in acute aortic dissection patients: A hospital-based retrospective study. J Am Coll Cardiol, 2018, 72(16): C185-C186.
32.	石烽, 王志维, 吴红兵, 等. 杂交手术治疗 Stanford A 型主动脉夹层. 实用医学杂志, 2019, 35(13): 2175-2179.
33.	Gao F, Zeng Q, Lin F, et al. Sandwich technique for endovascular repair of acute type A aortic dissection. J Endovasc Ther, 2017, 24(5): 647-653.
34.	Luo Y, Che W, Zhao M. Ulinastatin post-treatment attenuates lipopolysaccharide-induced acute lung injury in rats and human alveolar epithelial cells. Int J Mol Med, 2017, 39(2): 297-306.
35.	Duan XZ, Xu ZY, Lu FL, et al. Inflammation is related to preoperative hypoxemia in patients with acute Stanford type A aortic dissection. J Thorac Dis, 2018, 10(3): 1628-1634.
36.	Pan X, Lu J, Cheng W, et al. Pulmonary static inflation with 50% xenon attenuates decline in tissue factor in patients undergoing Stanford type A acute aortic dissection repair. J Thorac Dis, 2018, 10(7): 4368-4376.
37.	Jin M, Yang YW, Pan XD, et al. Effects of pulmonary static inflation with 50% xenon on oxygen impairment during cardiopulmonary bypass for Stanford type A acute aortic dissection. Medicine (Baltimore), 2017, 96(10): e6253.
38.	Wu Z, Chang J, Ren W, et al. Bindarit reduces the incidence of acute aortic dissection complicated lung injury via modulating NF-κB pathway. Exp Ther Med, 2017, 14(3): 2613-2618.
39.	Sadikot RT, Kolanjiyil AV, Kleinstreuer C, et al. Nanomedicine for treatment of acute lung injury and acute respiratory distress syndrome. Biomed Hub, 2017, 2(2): 1-12.

1. 中国医师协会心血管外科分会大血管外科专业委员会. 主动脉夹层诊断与治疗规范中国专家共识. 中华胸心血管外科杂志, 2017, 33(11): 641-654.
2. Ren W, Wang ZW, Wu ZY, et al. Corrigendum to "JAK2/STAT3 pathway was associated with the protective effects of IL-22 on aortic dissection with acute lung injury". Dis Markers, 2019, 2019: 1901626.
3. Pan X, Lu J, Cheng W, et al. Independent factors related to preoperative acute lung injury in 130 adults undergoing Stanford type-A acute aortic dissection surgery: A single-center cross-sectional clinical study. J Thorac Dis, 2018, 10(7): 4413-4423.
4. Guo Z, Yang Y, Zhao M, et al. Preoperative hypoxemia in patients with type A acute aortic dissection: A retrospective study on incidence, related factors and clinical significance. J Thorac Dis, 2019, 11(12): 5390-5397.
5. Ge HQ, Jiang Y, Jin QJ, et al. Nomogram for the prediction of postoperative hypoxemia in patients with acute aortic dissection. BMC Anesthesiol, 2018, 18(1): 146.
6. Hiraoka A, Suzuki K, Chikazawa G, et al. Adaptive servo-ventilation suppresses elevation of C-reactive protein and sympathetic activity in acute uncomplicated type B aortic dissection. Interact Cardiovasc Thorac Surg, 2017, 24(1): 27-33.
7. Kashiwagi Y, Komukai K, Suzuki K, et al. Predictors of oxygenation impairment in medical treatment for type B acute aortic dissection. Heart Vessels, 2018, 33(12): 1463-1470.
8. Gong M, Wu ZN, Xu SJ, et al. Increased risk for the development of postoperative severe hypoxemia in obese women with acute type A aortic dissection. J Cardiothorac Surg, 2019, 14(1): 81.
9. 张欢欢, 杨玉金, 张加乐, 等. 急性主动脉夹层发生低氧血症患者危险因素的 Meta 分析. 中国现代医学杂志, 2018, 28(19): 67-74.
10. Wu ZY, Wang ZW, Wu HB, et al. Obesity is a risk factor for preoperative hypoxemia in Stanford A acute aortic dissection. Medicine (Baltimore), 2020, 99(11): e19186.
11. 张明萌, 张斌, 饶敏腊, 等. 肥胖相关的部分脂肪因子研究进展. 中国医药, 2019, 14(6): 952-956.
12. 何诚, 陶宁, 赵利. 老年急性主动脉夹层合并急性肺损伤的临床特征及其影响因素. 中国老年学杂志, 2019, 39(20): 4889-4891.
13. Liu N, Zhang W, Ma W, et al. Risk factors for hypoxemia following surgical repair of acute type A aortic dissection. Interact Cardiovasc Thorac Surg, 2017, 24(2): 251-256.
14. Gao Z, Pei X, He C, et al. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: A prospective observational study. J Thorac Dis, 2019, 11(4): 1190-1201.
15. Yamada Y, Tanno J, Nakano S, et al. Clinical implications of pleural effusion in patients with acute type B aortic dissection. Eur Heart J Acute Cardiovasc Care, 2016, 5(7): 72-81.
16. 周楚芝, 王湘, 姜妮, 等. 急性 A 型主动脉夹层孙氏术后低氧血症的危险因素分析. 岭南心血管病杂志, 2017, 23(2): 165-170.
17. 刘明娟, 刘婷珊, 邓康, 等. Stanford A 型急性主动脉夹层支架植入术后低氧血症的危险因素. 中华麻醉学杂志, 2019, 39(1): 121-122.
18. Wang XH, Zhang HP, Cao L, et al. The role of macrophages in aortic dissection. Front Physiol, 2020, 11: 54.
19. Wu Z, Ruan Y, Chang J, et al. AngiotensinⅡ is related to the acute aortic dissection complicated with lung injury through mediating the release of MMP9 from macrophages. Am J Transl Res, 2016, 8(3): 1426-1436.
20. Mori K, Tamune H, Tanaka H, et al. Admission values of D-dimer and C-reactive protein (CRP) predict the long-term outcomes in acute aortic dissection. Intern Med, 2016, 55(14): 1837-1843.
21. 张鹏, 王永才, 张喜报, 等. 血清降钙素原、炎症细胞因子及超敏C−反应蛋白联合检测放射性肺炎合并肺部感染的诊断价值. 中华医院感染学杂志, 2017, 27(23): 5322-5324.
22. Lv H, Yu Z, Zheng Y, et al. Isovitexin exerts anti-inflammatory and anti-oxidant activities on lipopolysaccharide-induced acute lung injury by inhibiting MAPK and NF-κB and activating HO-1/Nrf2 pathways. Int J Biol Sci, 2016, 12(1): 72-86.
23. Cheng L, Zhao Y, Qi D, et al. Wnt/β-catenin pathway promotes acute lung injury induced by LPS through driving the Th17 response in mice. Biochem Biophys Res Commun, 2018, 495(2): 1890-1895.
24. 贺宝臣. 外周血 Th17 细胞、降钙素原在急性 A 型主动脉夹层病人中的表达与急性肺损伤的关系. 实用老年医学, 2019, 33(4): 346-350.
25. Yuan SM, Yan SL, Wu N. Unusual aspects of cardiac myxoma. Anatol J Cardiol, 2017, 17(3): 241-247.
26. Yuan SM. Profiles and predictive values of interleukin-6 in aortic dissection: A review. Braz J Cardiovasc Surg, 2019, 34(5): 596-604.
27. 黄相, 何黎, 王科科. 急性 A 型主动脉夹层血清白细胞介素-6、8 的变化及其与急性肺损伤的相关性. 中华胸心血管外科杂志, 2016, 32(11): 665-668.
28. 成泽怡, 杨梦阳, 李雅茹, 等. 主动脉夹层生物标志物的研究进展. 心血管病学进展, 2019, 40(1): 49-53.
29. 张丹, 申昌军. 急性 A 型主动脉夹层患者血清 D-二聚体、MMP-9 水平与急性肺损伤的相关性. 标记免疫分析与临床, 2019, 26(10): 1688-1691.
30. Poole LG, Massey VL, Siow DL, et al. Plasminogen activator inhibitor-1 is critical in alcohol-enhanced acute lung injury in mice. Am J Respir Cell Mol Biol, 2017, 57(3): 315-323.
31. Siti DL, Ma X. Predictors of acute lung injury in acute aortic dissection patients: A hospital-based retrospective study. J Am Coll Cardiol, 2018, 72(16): C185-C186.
32. 石烽, 王志维, 吴红兵, 等. 杂交手术治疗 Stanford A 型主动脉夹层. 实用医学杂志, 2019, 35(13): 2175-2179.
33. Gao F, Zeng Q, Lin F, et al. Sandwich technique for endovascular repair of acute type A aortic dissection. J Endovasc Ther, 2017, 24(5): 647-653.
34. Luo Y, Che W, Zhao M. Ulinastatin post-treatment attenuates lipopolysaccharide-induced acute lung injury in rats and human alveolar epithelial cells. Int J Mol Med, 2017, 39(2): 297-306.
35. Duan XZ, Xu ZY, Lu FL, et al. Inflammation is related to preoperative hypoxemia in patients with acute Stanford type A aortic dissection. J Thorac Dis, 2018, 10(3): 1628-1634.
36. Pan X, Lu J, Cheng W, et al. Pulmonary static inflation with 50% xenon attenuates decline in tissue factor in patients undergoing Stanford type A acute aortic dissection repair. J Thorac Dis, 2018, 10(7): 4368-4376.
37. Jin M, Yang YW, Pan XD, et al. Effects of pulmonary static inflation with 50% xenon on oxygen impairment during cardiopulmonary bypass for Stanford type A acute aortic dissection. Medicine (Baltimore), 2017, 96(10): e6253.
38. Wu Z, Chang J, Ren W, et al. Bindarit reduces the incidence of acute aortic dissection complicated lung injury via modulating NF-κB pathway. Exp Ther Med, 2017, 14(3): 2613-2618.
39. Sadikot RT, Kolanjiyil AV, Kleinstreuer C, et al. Nanomedicine for treatment of acute lung injury and acute respiratory distress syndrome. Biomed Hub, 2017, 2(2): 1-12.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Research progress on risk factors for acute aortic dissection complicated with acute lung injury

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