دورية أكاديمية
أعرض في EDS

The predictive capability of aortic stiffness index for aortic dissection among dilated ascending aortas.

التفاصيل البيبلوغرافية
العنوان: The predictive capability of aortic stiffness index for aortic dissection among dilated ascending aortas.
المؤلفون: Fortunato RN; Department of Mechanical Engineering and Materials Science, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa., Huckaby LV; Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa., Emerel LV; Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa., Schlosser V; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa., Yang F; Department of Statistics, University of Pittsburgh School of Public Health, Pittsburgh, Pa., Phillippi JA; Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa., Vorp DA; Department of Mechanical Engineering and Materials Science, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; McGowan Institute for Regenerative Medicine, Pittsburgh, Pa; Department of Chemical and Petroleum Engineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; Asheville Heart, Asheville, NC., Maiti S; Department of Mechanical Engineering and Materials Science, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; Department of Chemical and Petroleum Engineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa., Gleason TG; Department of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pa; Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, Pa; Asheville Heart, Asheville, NC. Electronic address: tgleason@ashevilleheart.com.
المصدر: The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2024 Jun; Vol. 167 (6), pp. 2015-2024. Date of Electronic Publication: 2022 Sep 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Mosby Country of Publication: United States NLM ID: 0376343 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-685X (Electronic) Linking ISSN: 00225223 NLM ISO Abbreviation: J Thorac Cardiovasc Surg Subsets: MEDLINE
أسماء مطبوعة: Publication: St. Louis, MO : Mosby
Original Publication: St. Louis.
مواضيع طبية MeSH: Aortic Dissection*/physiopathology , Aortic Dissection*/diagnostic imaging , Vascular Stiffness* , Finite Element Analysis* , Aortic Aneurysm*/physiopathology , Aortic Aneurysm*/diagnostic imaging , Echocardiography*, Humans ; Male ; Female ; Middle Aged ; Models, Cardiovascular ; Aged ; Predictive Value of Tests ; Aorta/physiopathology ; Aorta/diagnostic imaging ; Stress, Mechanical ; Dilatation, Pathologic
مستخلص: Objective: We created a finite element model to predict the probability of dissection based on imaging-derived aortic stiffness and investigated the link between stiffness and wall tensile stress using our model.
Methods: Transthoracic echocardiogram measurements were used to calculate aortic diameter change over the cardiac cycle. Aortic stiffness index was subsequently calculated based on diameter change and blood pressure. A series of logistic models were developed to predict the binary outcome of aortic dissection using 1 or more series of predictor parameters such as aortic stiffness index or patient characteristics. Finite element analysis was performed on a subset of diameter-matched patients exhibiting patient-specific material properties.
Results: Transthoracic echocardiogram scans of patients with type A aortic dissection (n = 22) exhibited elevated baseline aortic stiffness index when compared with aneurysmal patients' scans with tricuspid aortic valve (n = 83, P < .001) and bicuspid aortic valve (n = 80, P < .001). Aortic stiffness index proved an excellent discriminator for a future dissection event (area under the curve, 0.9337, odds ratio, 2.896). From the parametric finite element study, we found a correlation between peak longitudinal wall tensile stress and stiffness index (ρ = .6268, P < .001, n = 28 pooled).
Conclusions: Noninvasive transthoracic echocardiogram-derived aortic stiffness measurements may serve as an impactful metric toward predicting aortic dissection or quantifying dissection risk. A correlation between longitudinal stress and stiffness establishes an evidence-based link between a noninvasive stiffness parameter and stress state of the aorta with clinically apparent dissection events.
(Copyright © 2022 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: R01 HL109132 United States HL NHLBI NIH HHS; R01 HL131632 United States HL NHLBI NIH HHS; T32 HL076124 United States HL NHLBI NIH HHS; T32 HL098036 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: aneurysm pathophysiology; aortic dissection; aortic wall stiffness; aortic wall tensile stress; computational modeling; dissection risk prediction; stress analysis
تواريخ الأحداث: Date Created: 20221007 Date Completed: 20240515 Latest Revision: 20240517
رمز التحديث: 20240517
مُعرف محوري في PubMed: PMC10225159
DOI: 10.1016/j.jtcvs.2022.09.003
PMID: 36207164
قاعدة البيانات: MEDLINE
الوصف
تدمد:1097-685X
DOI:10.1016/j.jtcvs.2022.09.003