Interdisciplinary cardiovascular and thoracic surgery · 2026
Haemodynamic Predictors of Early Aortic Growth in Uncomplicated Type B Dissection: A Cohort Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Takei Yusuke, Miyazaki Shohei, Watanabe Kai, Suzuki Kohei, Ogasawara Takeshi, Shibasaki Ikuko, Tezuka Masahiro, Hirota Shotaro, Ohashi Hirotaka, Matsuoka Taiki, Kawamura Masashi, Fukuda Hirotsugu
Аннотация
OBJECTIVES: We investigated whether systolic flow-based indices derived from four-dimensional flow magnetic resonance imaging (4D flow MRI) can predict early aortic enlargement in patients with uncomplicated type B aortic dissection.
METHODS: This single-centre observational cohort study included 36 patients with uncomplicated type B aortic dissection between 2015 and 2025 who underwent 4D flow MRI a median of 42 days after onset with serial computed tomography (CT) follow-up. Aortic growth rates were calculated using ordinary least squares regression over the first year. False lumen (FL) flow index, FL gross flow, true lumen gross flow, and FL flow range were analysed. Correlations with aortic growth rate and group comparisons between patients with and without CT-defined aortic progression were assessed using Spearman's rank correlation and the Mann-Whitney U test. Exploratory multivariable logistic regression adjusted for baseline maximum aortic diameter was also performed.
RESULTS: Sixteen patients (44%) met CT-based aortic progression criteria; 15 (42%) underwent thoracic endovascular aortic repair within 1 year. Conventional CT-derived anatomical predictors were similar between the progression and stable groups. The FL flow index (ρ = 0.44; 95% CI, 0.11-0.70) and FL gross flow (ρ = 0.46; 95% CI, 0.13-0.69) showed moderate positive correlations with aortic growth rate. On multivariable analysis, the FL flow index remained associated with progression (odds ratio, 2.31; 95% CI, 1.04-5.13) after adjustment for baseline maximum aortic diameter.
CONCLUSIONS: These hypothesis-generating findings suggest that systolic FL-dominant flow may complement CT morphology in identifying patients at risk of early aortic progression.
METHODS: This single-centre observational cohort study included 36 patients with uncomplicated type B aortic dissection between 2015 and 2025 who underwent 4D flow MRI a median of 42 days after onset with serial computed tomography (CT) follow-up. Aortic growth rates were calculated using ordinary least squares regression over the first year. False lumen (FL) flow index, FL gross flow, true lumen gross flow, and FL flow range were analysed. Correlations with aortic growth rate and group comparisons between patients with and without CT-defined aortic progression were assessed using Spearman's rank correlation and the Mann-Whitney U test. Exploratory multivariable logistic regression adjusted for baseline maximum aortic diameter was also performed.
RESULTS: Sixteen patients (44%) met CT-based aortic progression criteria; 15 (42%) underwent thoracic endovascular aortic repair within 1 year. Conventional CT-derived anatomical predictors were similar between the progression and stable groups. The FL flow index (ρ = 0.44; 95% CI, 0.11-0.70) and FL gross flow (ρ = 0.46; 95% CI, 0.13-0.69) showed moderate positive correlations with aortic growth rate. On multivariable analysis, the FL flow index remained associated with progression (odds ratio, 2.31; 95% CI, 1.04-5.13) after adjustment for baseline maximum aortic diameter.
CONCLUSIONS: These hypothesis-generating findings suggest that systolic FL-dominant flow may complement CT morphology in identifying patients at risk of early aortic progression.