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False lumen rotational flow and aortic stiffness are associated with aortic growth rate in patients with chronic aortic dissection of the descending aorta : a 4D flow cardiovascular magnetic resonance study
Ruiz-Muñoz, Aroa (Universitat Autònoma de Barcelona. Departament de Medicina)
Guala, Andrea (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Dux-Santoy, Lydia (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Teixido-Tura, Gisela (Hospital Universitari Vall d'Hebron)
Servato, Maria Luz (Hospital Universitari Vall d'Hebron)
Valente, Filipa (Hospital Universitari Vall d'Hebron)
Garrido-Oliver, Juan (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Galian-Gay, Laura (Hospital Universitari Vall d'Hebron)
Gutiérrez García-Moreno, Laura (Hospital Universitari Vall d'Hebron)
Fernandez-Galera, Rubén (Hospital Universitari Vall d'Hebron)
Casas, Guillem (Hospital Universitari Vall d'Hebron)
González-Alujas, Teresa (Hospital Universitari Vall d'Hebron)
Cuellar-Calabria, Hug (Universitat Autònoma de Barcelona. Departament de Medicina)
Johnson, Kevin M. (University of Wisconsin. Departments of Medical Physics & Radiology)
Wieben, Oliver (University of Wisconsin. Departments of Medical Physics & Radiology)
Ferreira-Gonzalez, Ignacio (Universitat Autònoma de Barcelona. Departament de Medicina)
Evangelista Masip, Arturo (Universitat Autònoma de Barcelona. Departament de Medicina)
Rodriguez-Palomares, Jose F (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data: 2022
Resum: Patency of the false lumen in chronic aortic dissection (AD) is associated with aortic dilation and long-term aortic events. However, predictors of adverse outcomes in this population are limited. The aim of this study was to evaluate the relationship between aortic growth rate and false lumen flow dynamics and biomechanics in patients with chronic, patent AD. Patients with a chronic AD with patent false lumen in the descending aorta and no genetic connective tissue disorder underwent an imaging follow-up including a contrast-enhanced 4D flow cardiovascular magnetic resonance (CMR) protocol and two consecutive computed tomography angiograms (CTA) acquired at least 1 year apart. A comprehensive analysis of anatomical features (including thrombus quantification), and false lumen flow dynamics and biomechanics (pulse wave velocity) was performed. Fifty-four consecutive patients with a chronic, patent false lumen in the descending aorta were included (35 surgically-treated type A AD with residual tear and 19 medically-treated type B AD). Median follow-up was 40 months. The in-plane rotational flow, pulse wave velocity and the percentage of thrombus in the false lumen were positively related to aortic growth rate (p = 0. 006, 0. 017, and 0. 037, respectively), whereas wall shear stress showed a trend for a positive association (p = 0. 060). These results were found irrespectively of the type of AD. In patients with chronic AD and patent false lumen of the descending aorta, rotational flow, pulse wave velocity and wall shear stress are positively related to aortic growth rate, and should be implemented in the follow-up algorithm of these patients. Further prospective studies are needed to confirm if the assessment of these parameters helps to identify patients at higher risk of adverse clinical events. The online version contains supplementary material available at 10. 1186/s12968-022-00852-6.
Ajuts: Instituto de Salud Carlos III PI17/00381
Instituto de Salud Carlos III PI20/01727
Ministerio de Ciencia e Innovación RTC2019-007280-1
Ministerio de Ciencia e Innovación IJC2018-037349-I
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Matèria: Aortic dissection ; 4D flow CMR ; Magnetic resonance imaging ; Aortic stiffness
Publicat a: Journal of Cardiovascular Magnetic Resonance, Vol. 24 (march 2022) , ISSN 1532-429X

DOI: 10.1186/s12968-022-00852-6
PMID: 35346239


13 p, 1.7 MB

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 Registre creat el 2022-04-26, darrera modificació el 2023-08-29



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