Aortic elasticity indices by magnetic resonance predict progression of ascending aorta dilation

Aquaro, Giovanni Donato; Vangosa, Alessandra Briatico; Toia, Patrizia; Barison, Andrea; Ait-Alì, Lamia; Midiri, Massimo; Cotroneo, Antonio Raffaele; Emdin, Michele; Festa, Pierluigi

doi:10.1007/s00330-016-4501-5

Cited by 16 publications

(18 citation statements)

References 17 publications

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“…Moreover, receiver operating characteristic curve analysis of MRSD distinguished BAV from controls with 100% sensitivity and 95% specificity. In a longitudinal study with a short follow-up of 17 months, the same authors showed that MRSD could predict an increase of aortic diameter with 93.7% specificity and 75.6% sensitivity, with a cut-off value of MRSD ≤ 6 (Aquaro et al, 2017).…”

Section: Stiffness Evaluation Of the Aorta Of Bav Patientsmentioning

confidence: 97%

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Aortic Wall Elastic Properties in Case of Bicuspid Aortic Valve

et al. 2019

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Purpose of the Review Bicuspid aortic valve (BAV) is associated with a significant risk of development of aneurysm and dissection of the ascending thoracic aorta. Development of what is called BAV associated aortopathy is particularly heterogeneous with an uncertain prognosis and with no prognostic biomarkers except for the aortic diameter. This situation leads to an important variability of the therapeutic strategy of this aortopathy. By reviewing the literature on aortic stiffness in the case of BAV, we aimed at evaluating its potential prognostic role in the development of aortic dilatation. Recent Findings Studies evaluating aortic stiffness, with ultrasound or magnetic resonance imaging, converge toward the description of an increased segmental aortic stiffness in BAV patients regardless of age, diameter or aortic level, from the root to the arch. Even though there is a lack of longitudinal studies evaluating the progression of aortic dilatation, new data have recently shown the potential prognostic role of the maximal rate of systolic distension of the aortic wall with magnetic resonance imaging. Summary Although the use of aortic distensibility calculation is a simple evaluation of stiffness that could be easily transposed in daily practice, its interpretation remains uncertain. New arterial stiffening indicators seem more promising but need a stronger validation.

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Section: Stiffness Evaluation Of the Aorta Of Bav Patientsmentioning

confidence: 97%

“…There is currently very limited data on this topic. Only MRSD, measured with MRI and recently validated by Aquaro et al (2017) as an aortic dilatation marker, gave a prognostic value among BAV patients (Nollen et al, 2004; Aquaro et al, 2017).…”

Section: Clinical Relevance Of Aortic Stiffness Indicatorsmentioning

confidence: 99%

Aortic Wall Elastic Properties in Case of Bicuspid Aortic Valve

et al. 2019

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“…At present, many studies focus on the noninvasive evaluation of arterial elasticity of aorta, carotid artery, and other large arteries, and the main research methods utilized are magnetic resonance imaging (MRI) and ultrasonography. [ 4 , 6 , 7 , 11 , 12 ] Some studies concentrate on PA elasticity using ultrasound and MR, [ 4 , 6 , 7 ] but the use of computed tomography (CT) on PA elasticity is rarely reported. In our study, retrospective electrocardiograph (ECG)-gated coronary computed tomographic angiography (CCTA) was used to evaluate the functional change of large artery, not just the aorta, but also the PA.…”

Section: Introductionmentioning

confidence: 99%

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

et al. 2018

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As the prevalence of coronary computed tomographic angiography (CCTA), it is meaningful that CCTA can provide not only the structural details of artery, but also functional information of vessel elasticity. Our aim was to explore the elasticity characteristics of ascending aorta (AA), descending aorta (DA), main pulmonary artery (MPA), left pulmonary artery (LPA), right pulmonary artery (RPA), and their relationship between each other using 640 slice-volume computed tomography (CT). Furthermore, this study will also observe their relations with age.A total of 42 subjects that were free of cardiovascular disease, high blood pressure, diabetes, and hyperlipidemia underwent CCTA on 640 slice-volume CT and were enrolled in this study. The subjects were divided into 2 groups: Group 1, age <46; Group 2, age ≥46. The aortic distensibility (AD) and aortic compliance (AC) of aorta and pulmonary artery (PA) of each group were compared.The AD and AC of PA decreased in the following order: MPA, RPA, and LPA. The correlation coefficients of different elastic parameters between different vessels were found to be different. The correlation coefficient of AD between AA and DA, AA and MPA, DA and MPA, RPA and MPA, LPA and MPA, and RPA and LPA were 0.689 (P = .000), 0.520 (P = .000), 0.393 (P = .010), 0.329 (P = .033), 0.579 (P = .000), and 0.534 (P = .000), respectively. The correlation coefficients of AC for the 6 groups mentioned above were 0.351 (P = .023), 0.470 (P = .002), 0.249 (P = .112), 0.190 (P = .228), 0.441 (P = .005), and 0.409 (P = .010), respectively. There was an age-dependent decrease of AD and AC in AA, DA, MPA, LPA (P < .05), but no difference in RPA (P > .05).The elasticity characteristics of AA, DA, MPA, LPA, and RPA could be well shown by 640 slice-volume CT. The elasticity relativity was observed and was different between AA and DA, AA and MPA, LPA and MPA, LPA and RPA. An obvious age-related decrease in vascular elasticity was found in AA, DA, MPA, and LPA, which should be taken into consideration in clinical trials and treatments for the elasticity-related cardiovascular diseases.

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“…Severe aortic dilation would lead to some aortic diseases, such as aortic aneurysm and dissection, which seriously affect patients' living quality and even cause patients' death. Conventional clinical guidelines of aortic dilation only rely on the aortic diameter and ignore the tissue properties of the aorta which have been proved to own better abilities in prediction of aortic dilation progression especially in patients with small-to-moderate size ascending aortas [ 24 ]. Considering the good performances of computational biomechanical modeling in the investigations of cardiovascular diseases, we proposed image-based computational models in this study to simulate the movement of the ascending aorta and blood inside to obtain a better understanding of ascending aortic mechanics.…”

Section: Discussionmentioning

confidence: 99%

“…Geisbusch et al proposed computed tomography volume measurements which provide an objective method for ascertaining aortic size and monitoring expansion [ 23 ]. Donato Aquaro et al used the maximum rate of systolic distension (MRSD) as an index of aortic wall properties and found MRSD was a valuable predictor for progression in ascending aortic dilation [ 24 ]. Alreshidan et al used speckle tracking echocardiography to estimate aortic stiffness in vivo and proved that the stiffness was helpful to determinate the risk of complications in patients with aortic diseases [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Patient-Specific CT-Based Fluid-Structure-Interaction Aorta Model to Quantify Mechanical Conditions for the Investigation of Ascending Aortic Dilation in TOF Patients

Zuo

et al. 2020

Computational and Mathematical Methods in Medicine

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Background. Some adult patients with Tetralogy of Fallot (TOF) were found to simultaneously develop ascending aortic dilation. Severe aortic dilation would lead to several aortic diseases, including aortic aneurysm and dissection, which seriously affect patients’ living quality and even cause patients’ death. Current practice guidelines of aortic-dilation-related diseases mainly focus on aortic diameter, which has been found not always a good indicator. Therefore, it may be clinically useful to identify some other factors that can potentially better predict aortic response to dilation. Methods. 20 TOF patients scheduled for TOF repair surgery were recruited in this study and were divided into dilated and nondilated groups according to the Z scores of ascending aorta diameters. Patient-specific aortic CT images, pressure, and flow rates were used in the construction of computational biomechanical models. Results. Simulation results demonstrated a good coincidence between numerical mean flow rate at inlet and the one obtained from color Doppler ultrasonography, which implied that computational models were able to simulate the movement of the aorta and blood inside accurately. Our results indicated that aortic stress can effectively differentiate patients of the dilated group from the ones of the nondilated group. Mean ascending aortic stress-P1 (maximal principal stress) from the dilated group was 54% higher than that from the nondilated group (97.97 kPa vs. 63.47 kPa, p value = 0.044) under systolic pressure. Velocity magnitude in the aorta and aortic wall displacement of the dilated group were also greater than those of the nondilated group with p value < 0.1. Conclusion. Computational modeling and ascending aortic biomechanical factors may be used as a potential tool to identify and analyze aortic response to dilation. Large-scale clinical studies are needed to validate these preliminary findings.

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Aortic elasticity indices by magnetic resonance predict progression of ascending aorta dilation

Cited by 16 publications

References 17 publications

Aortic Wall Elastic Properties in Case of Bicuspid Aortic Valve

Aortic Wall Elastic Properties in Case of Bicuspid Aortic Valve

Analysis of elasticity characteristics of ascending aorta, descending aorta and pulmonary artery using 640 slice-volume CT

Patient-Specific CT-Based Fluid-Structure-Interaction Aorta Model to Quantify Mechanical Conditions for the Investigation of Ascending Aortic Dilation in TOF Patients

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