Analysis of aortic area/height ratio in patients with thoracic aortic aneurysm and Type A dissection†

Acharya, Metesh; Youssefi, Pouya; Soppa, Gopal; Valencia, Oswaldo; Nowell, Justin; Kanagasabay, Robin; Edsell, Mark; Morgan, Robert; Tomé, Maite; Jahangiri, Marjan

doi:10.1093/ejcts/ezy110

Cited by 21 publications

(14 citation statements)

References 11 publications

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“…Among patients with moderately dilated aorta, 44% had abnormal DHI, and this population accounted for 78% of long-term deaths (47). Among patients with a BAV as well as a moderately dilated aorta, patients with abnormal DHI accounted for 70% of overall mortality (46). In another study, ATAA patients were further divided into 45-50 and 50-55 mm groups.…”

Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

“…Importantly, it is not reasonable to use the same risk stratification threshold in ATAA patients of different heights (38). Many studies have adopted a new predictive indicator called DHI by indexing height to diameter, which is known to be consistent in people of different heights (2,27,34,38,(45)(46)(47)(48). Abnormal DHI was highly correlated with increased long-term cardiovascular mortality, which illustrates its suitability as predictor of AAEs (34,47).…”

Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

“…Previous studies have used DHI =2.4 cm/m as the risk stratification threshold, and found that patients with DHI above this threshold have significantly higher probability of surgical intervention than those below (P<0.001) (2). Moreover, DHI can help to stratify diameter indicators in moderately dilated aorta (4.5-5.5 cm) and identify high-risk patients who may develop AAEs, which remains a grey area in the current guidelines (34,46,47). Among patients with moderately dilated aorta, 44% had abnormal DHI, and this population accounted for 78% of long-term deaths (47).…”

Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

See 2 more Smart Citations

New indicators for systematic assessment of aortic morphology: a narrative review

Luan¹,

Mao²,

Zhu³

et al. 2021

J Thorac Dis

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In order to prevent the occurrence of aortic adverse events in ascending thoracic aortic aneurysm patients, preventive surgery is the sole option in case of large aneurysm. Identifying high-risk patients timely and accurately requires effective predictive indicators of aortic adverse events and accurate risk stratification thresholds. Absolute diameter measured after a single imaging examination, which has been used as the predictive indicator for decades, has been proved to be ineffective for risk stratification in moderately dilated aorta. Previously, new indicators combining absolute diameters with personalized parameters have been reported to show better predictive power of aortic adverse events than absolute diameters by correcting the effect of these parameters on the diameters. Meanwhile, combining three-dimensional parameters to formulate risk stratification thresholds not only may characterize the aortic risk morphology more precisely, but also predict aortic adverse events more accurately. These new indicators may provide more systematic assessment methods of patients' risk, formulate more personalized intervention strategies for ascending thoracic aortic aneurysm patients, and also provide a basis for researchers to develop more accurate and effective risk thresholds. We also highlight that the algorithm obtained by combining multiple indicators may be a better choice compared with single indicator, but this still requires the support of more evidence.Due to the particularity of syndromic aortic disease, whether these new indicators can be used for its risk stratification is still uncertain. Therefore, the scope of this manuscript does not include this kind of disease.

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Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

Section: Diameter Height Index (Dhi)mentioning

confidence: 99%

See 1 more Smart Citation

New indicators for systematic assessment of aortic morphology: a narrative review

Luan¹,

Mao²,

Zhu³

et al. 2021

J Thorac Dis

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“…One of the most popular has been the height-indexing approach cited by the authors of this letter that was originally proposed by Svensson and Khitin, 4 and on which Acharya has also published. 5 I will only mention that height-indexing has not achieved a determinative role in the guidelines in the 18 years that have passed since it was proposed.…”

Section: Reply: Should Small Aortas Be Replaced?mentioning

confidence: 99%

Reply: Concomitant Aortic Replacement: How Proactive Should We Be?

Haywood

Krön

2021

The Journal of Thoracic and Cardiovascular Surgery

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“…Although studies investigating biomarkers or genetic markers and radiographic markers (such as indexed aortic areas) are very promising, current methods are imperfect predictors of acute aortic events in both TAV and BAV patients and have not yet been incorporated in current guidelines. 6,[28][29][30]…”

Section: Commentmentioning

confidence: 99%

Type A Aortic Dissection in Patients With Bicuspid Aortic Valve Aortopathy

Kreibich

Rylski

Czerny

et al. 2020

The Annals of Thoracic Surgery

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Background. The aim of this study was to evaluate clinical, aortic, and outcome characteristics of type A aortic dissection patients with bicuspid aortic valves (BAVs) and tricuspid aortic valves (TAVs).Methods. Patient characteristics and radiographic, operative, and outcome data were evaluated and compared between 1068 TAV patients and 72 BAV patients operated on for type A aortic dissection in 2 centers. Predissection aortic diameters were calculated as previously reported for TAV patients.Results. BAV patients were significantly younger (P < .001) and had a lower incidence of cardiovascular risk factors. Although the clinical presentation was similar, the dissection affected the abdominal aorta significantly more often in TAV patients (P [ .029). Aortic root replacements were performed significantly more often in BAV patients (P < .001). Postoperative outcome

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Analysis of aortic area/height ratio in patients with thoracic aortic aneurysm and Type A dissection†

Cited by 21 publications

References 11 publications

New indicators for systematic assessment of aortic morphology: a narrative review

New indicators for systematic assessment of aortic morphology: a narrative review

Reply: Concomitant Aortic Replacement: How Proactive Should We Be?

Type A Aortic Dissection in Patients With Bicuspid Aortic Valve Aortopathy

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