Left ventricular remodeling in patients with acute type B aortic dissection after thoracic endovascular aortic repair: Short- and mid-term outcomes

Du, Yuxuan; Maimaitiaili, Aizezi; Lin, Hao; Xie, Xiang; He, Jing; Qi, Baokun; Zhang, Weimin; Ayibieke, Naibi; Guo, Shuxiang; Guo, Yujin; Zhang, Zonggang; Tang, He-nian; Yang, Xinying

doi:10.1016/j.ijcard.2018.09.008

Cited by 8 publications

(4 citation statements)

References 29 publications

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“…[28] However, TEVAR can significantly reduce the short-term mortality rate, but not the long-term mortality rate, which is consistent with the trends in the false lumen area after TEVAR. [29] In our present study, we found that the trends in aortic reflux and LV remodeling were similar to those in the aortic false lumen, although the true lumen area did not shrink but increased progressively. Combined with previous evidence, prevention of dilation of the false lumen area may be the most important treatment for STBAD patients after TEVAR and maybe more important than enlargement of the true lumen area.…”

Section: Discussionsupporting

confidence: 71%

“…[27] The increase in pressure overload can also lead to aortic reflux, and most patients experienced mild aortic reflux because the intimal flap did not involve the aortic valve. [28,29] Both aortic reflux and LV remodeling are associated with the severity of pressure overload, namely, with the false lumen area, and an increase in the false lumen area can aggravate the pressure overload and thus aortic reflux and LV remodeling. [30] In fact, TEVAR can significantly reduce the false lumen area, but TEVAR cannot completely eliminate the false lumen in all patients.…”

Section: Discussionmentioning

confidence: 99%

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Effects of circulating levels of Th17 cells on the outcomes of acute Stanford B aortic dissection patients after thoracic endovascular aortic repair

et al. 2019

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T helper 17 (Th17) cells are related to the progression of aortic dissection. This study aimed to determine whether circulating Th17 levels are associated with the prognosis of acute Stanford type B aortic dissection (STBAD) after thoracic endovascular aortic repair (TEVAR).A cohort study was performed and STBAD patients (n = 140) received TEVAR were enrolled, the circulating Th17 levels were measured and the patients were divided into low and high Th17 groups, and 36 months of follow-up was performed. The data for mortality, survival outcomes, heart structure and function changes, aortic regurgitation prevalence, and aortic remodeling outcomes were recorded.Lower mortality and fewer complications were observed in the low Th17 group than in the high Th17 group in the third year of follow-up. In addition, the low Th17 group exhibited better cardiac remodeling and cardiac function when compared with that in the high Th17 group in the second to third year after TEVAR. Aortic reflux was improved in both groups but was more pronounced in the low Th17 group. During follow-up, the true lumen of the proximal thoracic aorta at the level of the celiac trunk in both the low and high Th17 groups continuously enlarged and was more pronounced in the low Th17 group.Circulating Th17 cells were related to cardiac and aortic remodeling and prognosis during STBAD after TEVAR. Anti-inflammatory therapy may be useful for STBAD patients who have undergone TEVAR. Abbreviations: AD = aortic dissection, CAD = coronary artery disease, CHF = chronic heart failure, CTA = computed tomography angiography, IL = interleukin, LSA = left subclavian artery, LV = left ventricular, LVEDD = LV end-diastolic diameter, LVEDV = LV end-diastolic volume, LVEF = LV ejection fraction, LVESD = LV end-systolic diameter, LVESV = LV end-systolic volume, PAD = peripheral arterial disease, PWT = posterior wall thickness, SINE = stent graft-induced new entry, STBAD = Stanford type B aortic dissection, TEVAR = thoracic endovascular aortic repair, Th17 = T helper 17, VHD = valvular heart disease, VSMCs = vascular smooth muscle cells.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Effects of circulating levels of Th17 cells on the outcomes of acute Stanford B aortic dissection patients after thoracic endovascular aortic repair

et al. 2019

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“…25 The initial MCL discretized all elements with lumped values that represented different segments of the human body ignorant to the spatial features. 26,27 To study the local hemodynamic features, human-specific models were embedded into the MCL. 15,16 As for AD studies, previous researches only applied the simplified aortic models.…”

Section: Discussionmentioning

confidence: 99%

“…Left ventricular diastolic dysfunction was often found in AD. 27,28 Clinical studies have shown that elevated afterload was the major cause. The systolic pressure in the ascending aorta and aortic branches of the AD model was higher than that in the normal aortic model, ranging from 3.95% to 11.01%.…”

Section: Discussionmentioning

confidence: 99%

A Mock Circulation Loop for In Vitro Hemodynamic Evaluation of Aorta: Application in Aortic Dissection

Chen

Liang

et al. 2021

J Endovasc Ther

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Purpose Aortic dissection (AD) is a catastrophic disease with complex hemodynamic conditions, however, understandings regarding its perfusion characteristics were not sufficient. In this study, a mock circulation loop (MCL) that integrated the Windkessel element and patient-specific silicone aortic phantoms was proposed to reproduce the aortic flow environment in vitro. Materials and Methods Patient-specific normal and dissected aortic phantoms with 12 branching vessels were established and embedded into this MCL. Velocities for aortic branches based on 20 healthy volunteers were regarded as the standardized data for flow division. By altering boundary conditions, the proposed MCL could mimic normal resting and left-sided heart failure (LHF) conditions. Flow rates and pressure status of the aortic branches could be quantified by separate sensors. Results In normal resting condition, the simulated heart rate and systemic flow rate were 60 bpm and 4.85 L/minute, respectively. For the LHF condition, the systolic and diastolic blood pressures were 75.94±0.77 mmHg and 57.65±0.35 mmHg, respectively. By tuning the vascular compliance and peripheral resistance, the flow distribution ratio (FDR) of each aortic branch was validated by the standardized data in the normal aortic phantom (mean difference 2.4%±1.70%). By comparing between the normal and dissected aortic models under resting condition, our results indicated that the AD model presented higher systolic (117.82±0.60 vs 108.75±2.26 mmHg) and diastolic (72.38±0.58 vs 70.46±2.33 mmHg) pressures, the time-average velocity in the true lumen (TL; 36.95 cm/s) was higher than that in the false lumen (FL; 22.95 cm/s), and the blood transport direction between the TL and FL varied in different re-entries. Conclusions The proposed MCL could be applied as a research tool for in vitro hemodynamic analysis of the aorta diseases under various physical conditions.

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The Effect of Ascending Aortic Repair on Left Ventricular Remodeling

Ikeno¹,

Truong²,

Tanaka³

et al. 2022

The American Journal of Cardiology

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Left ventricular remodeling in patients with acute type B aortic dissection after thoracic endovascular aortic repair: Short- and mid-term outcomes

Cited by 8 publications

References 29 publications

Effects of circulating levels of Th17 cells on the outcomes of acute Stanford B aortic dissection patients after thoracic endovascular aortic repair

Effects of circulating levels of Th17 cells on the outcomes of acute Stanford B aortic dissection patients after thoracic endovascular aortic repair

A Mock Circulation Loop for In Vitro Hemodynamic Evaluation of Aorta: Application in Aortic Dissection

The Effect of Ascending Aortic Repair on Left Ventricular Remodeling

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