Aortic Size and Aortic Dissection: Does One Size Fit All?

Boudoulas, Konstantinos Dean; Triposkiadis, Filippos; Stefanadis, Christodoulos; Boudoulas, Harisios

doi:10.1159/000484040

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…34 Excessive dilation of the AoR may be associated with aneurysm formation and risk of rupture. 35 However, the impact of a smaller AoR on CPP has been debated. 36 It is well known that characteristic impedance (Zc) is very sensitive to changes in the aortic diameter, being inversely related to the square root of radius raised to the fifth power per the water hammer and Moens-Korteweg equations.…”

Section: Comparison With the Published Literaturementioning

confidence: 99%

Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

et al. 2021

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Higher central pulse pressure is associated with higher carotid-femoral pulse wave velocity (CFPWV) and an increased risk of cardiovascular disease (CVD). A smaller aortic root diameter (AoR) is associated with higher central pulse pressure. We hypothesized that the combination of a smaller AoR and higher CFPWV is associated with increased CVD risk (relative to a larger AoR and lower CFPWV). We tested this hypothesis in the community-based Framingham Study (N=1970, mean age 60 years, 57% women). We created sex-specific longitudinal echocardiographic AoR trajectories over 2 decades, categorizing participants into smaller versus larger AoR groups. We cross-classified participants based on their AoR trajectory and CFPWV (dichotomized at the sex-specific median). We used Cox regression to relate the cross-classified groups to CVD incidence on follow-up (median 17 years): lower CFPWV, larger AoR (referent group; 6.4/1000 person-years); lower CFPWV, smaller AoR (6.9/1000 person-years); higher CFPWV, larger AoR (23.1/1000 person-years); and higher CFPWV, smaller AoR (21.9/1000 person-years). In sex-pooled analyses, groups with higher CFPWV were associated with a multivariable-adjusted 1.8-fold risk of CVD ( P <0.01) regardless of AoR size. We observed effect modification by sex ( P for sex×AoR-CFPWV group interaction 0.04). In men, the group with smaller AoR and higher CFPWV was associated with a 2.5- to 2.8-fold risk of CVD ( P <0.001). In women, the group with larger AoR and higher CFPWV experienced a statistically nonsignificant 70% to 80% higher CVD risk. Our observations indicate that the prognostic significance of a smaller versus larger AoR varies in men versus women. Additional studies are warranted to confirm our findings.

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Section: Comparison With the Published Literaturementioning

confidence: 99%

Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

et al. 2021

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“… 2007 ; Boudoulas et al. 2018 ). For instance, regarding aneurysmal dilatation, a fixed value of the aortic diameter of 5.5 cm is normally used for deciding on surgical intervention (Gott et al.…”

Section: Introductionmentioning

confidence: 99%

“…The value of absolute aortic dimensions for clinical prognosis or intervention has been already questioned in other aortic diseases (Pape et al 2007;Boudoulas et al 2018). For instance, regarding aneurysmal dilatation, a fixed value of the aortic diameter of 5.5 cm is normally used for deciding on surgical intervention (Gott et al 1999).…”

Section: Introductionmentioning

confidence: 99%

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

Jafarinia

Melito

Müller

et al. 2023

Biomech Model Mechanobiol

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Type B aortic dissection (TBAD) carries a high risk of complications, particularly with a partially thrombosed or patent false lumen (FL). Therefore, uncovering the risk factors leading to FL thrombosis is crucial to identify high-risk patients. Although studies have shown that morphological parameters of the dissected aorta are related to FL thrombosis, often conflicting results have been reported. We show that recent models of thrombus evolution in combination with sensitivity analysis methods can provide valuable insights into how combinations of morphological parameters affect the prospect of FL thrombosis. Based on clinical data, an idealized geometry of a TBAD is generated and parameterized. After implementing the thrombus model in computational fluid dynamics simulations, a global sensitivity analysis for selected morphological parameters is performed. We then introduce dimensionless morphological parameters to scale the results to individual patients. The sensitivity analysis demonstrates that the most sensitive parameters influencing FL thrombosis are the FL diameter and the size and location of intimal tears. A higher risk of partial thrombosis is observed when the FL diameter is larger than the true lumen diameter. Reducing the ratio of the distal to proximal tear size increases the risk of FL patency. In summary, these parameters play a dominant role in classifying morphologies into patent, partially thrombosed, and fully thrombosed FL. In this study, we point out the predictive role of morphological parameters for FL thrombosis in TBAD and show that the results are in good agreement with available clinical studies.

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Section: Introductionmentioning

confidence: 99%

“…3 Moreover, excessive dilation of the aorta was linked to aneurysm formation and dissection, both of which are potentially fatal diseases. 4 To date, however, few proven therapeutic strategies are available to alleviate or reverse this progression. Thus, the study of risk factors related to aortic dilation mayThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.…”

mentioning

confidence: 99%

The positive correlation between brachial‐ankle pulse wave velocity and aortic diameter in Chinese patients with diabetes

Xie

et al. 2022

J of Clinical Hypertension

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Aortic dilation is associated with an increased risk of cardiovascular diseases.Increased brachial-ankle pulse wave velocity (baPWV) is a hallmark of vascular aging and arterial stiffness, as well as an important risk factor for vascular disease. This study aimed to retrospectively analyze the correlation between baPWV and aortic diameter (AoD) of inpatients with diabetes. A total of 1294 diabetic patients with the detailed medical records were investigated. Arterial stiffness was assessed using baPWV and AoD using echocardiography. The results showed that baPWV and AoD increase with age (p <0.05). Based on multiple linear regression analysis, age, systolic and diastolic blood pressure, left atrial diameter, right ventricle diameter, pulmonary artery diameter, peak velocity of early transmitral blood flow/peak velocity of late transmitral blood flow, and baPWV independently correlated with AoD in patients with diabetes. Additionally, an increased risk of aortic dilation occurred in the highest baPWV quartile compared with the lowest quartile (p <0.001). In conclusion, baPWV is independently and positively associated with AoD. Hence, prospective cohorts or randomized clinical trials will be the next step to further determine whether interventions designed to improve arterial stiffness in patients with diabetes will reduce the risk of aortic dilation. K E Y W O R D Saortic diameter, arterial stiffness, brachial-ankle pulse wave velocity, diabetes BACKGROUNDCardiovascular disease is a leading cause of mortality and a threat to human health worldwide. Several studies have reported that a larger aortic diameter (AoD) is prospectively associated with cardiovascular morbidity, 1,2 and has been described as an important marker of hypertension-related organ damage. 3 Moreover, excessive dilation of the aorta was linked to aneurysm formation and dissection, both of which are potentially fatal diseases. 4 To date, however, few proven therapeutic strategies are available to alleviate or reverse this progression. Thus, the study of risk factors related to aortic dilation mayThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Aortic Size and Aortic Dissection: Does One Size Fit All?

Cited by 8 publications

References 27 publications

Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

Aortic Root Diameter and Arterial Stiffness: Conjoint Relations to the Incidence of Cardiovascular Disease in the Framingham Heart Study

Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models

The positive correlation between brachial‐ankle pulse wave velocity and aortic diameter in Chinese patients with diabetes

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