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Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection

 : OBJECTIVES: Aortic arch type is a readily recognizable and obtainable morphological feature of the aorta that does not require complex measurements. The goal of this study was to evaluate whether aortic arch type is a comparable and alternative morphological parameter for predicting acute type B...

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Autores principales: Sun, Likun, Li, Jiehua, Liu, Zhenyu, Li, Quanming, He, Hao, Li, Xin, Li, Ming, Wang, Tun, Wang, Lunchang, Peng, Yuan, Wang, Hui, Shu, Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860428/
https://www.ncbi.nlm.nih.gov/pubmed/34935037
http://dx.doi.org/10.1093/icvts/ivab359
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author Sun, Likun
Li, Jiehua
Liu, Zhenyu
Li, Quanming
He, Hao
Li, Xin
Li, Ming
Wang, Tun
Wang, Lunchang
Peng, Yuan
Wang, Hui
Shu, Chang
author_facet Sun, Likun
Li, Jiehua
Liu, Zhenyu
Li, Quanming
He, Hao
Li, Xin
Li, Ming
Wang, Tun
Wang, Lunchang
Peng, Yuan
Wang, Hui
Shu, Chang
author_sort Sun, Likun
collection PubMed
description  : OBJECTIVES: Aortic arch type is a readily recognizable and obtainable morphological feature of the aorta that does not require complex measurements. The goal of this study was to evaluate whether aortic arch type is a comparable and alternative morphological parameter for predicting acute type B aortic dissection (aTBAD) by comparing the prognostic value of the aortic arch type with that of other morphological parameters such as aortic length, angulation and tortuosity index. METHODS: The patients with aTBAD (n = 216) were matched 1:1 with a control group (n = 263) by propensity score matching. The morphological data of the ascending aorta and the aortic arch, which included diameter, length, angulation and tortuosity index, were collected on a three-dimensional aortic model using 3mensio Vascular software. The aortic arch type was identified by the vertical distance from the origin of the brachiocephalic trunk to the top of the arch. The binary logistic regression models were analysed to determine the independent geometric variables related to the aTBAD. The nonparametric approach was performed to assess whether there were statistical differences between the area under the receiver operating characteristic curves (AUC) of the models. RESULTS: After propensity score matching, 151 matched pairs of patients were selected. The diameters at the sinotubular junction and the mid-ascending aorta, the ascending aorta length and the ascending aorta angulation in the aTBAD group were significantly greater than those of the controls. Compared with the control group, the diameters at the proximal aortic arch, mid-aortic arch and distal aortic arch, the angulation and the tortuosity index of the aortic arch were significantly greater in the aTBAD group. The proportion of the type III arch in the patients with aTBAD is higher than that of the type I arch and the type II arch (χ(2) = 70.187; P < 0.001). Binary logistic regression analysis showed that the diameter at the mid-aortic arch, the ascending aorta length, the aortic arch angulation and the tortuosity index were independently related to the aTBAD with an AUC value of 0.887. Another binary logistic regression analysis indicated that the diameter at the mid-aortic arch and the aortic arch type were independent correlative variables associated with the aTBAD with an AUC of 0.874. No significant difference was observed in the prognostic value of receiver operating characteristic curves between the 2 models (P = 0.716). CONCLUSIONS: The type III arch, which has the characteristics of aortic elongation, incremental angulation and tortuosity index, is a comparable and alternative identifier for patients at high risk for aTBAD.
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spelling pubmed-88604282022-02-22 Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection Sun, Likun Li, Jiehua Liu, Zhenyu Li, Quanming He, Hao Li, Xin Li, Ming Wang, Tun Wang, Lunchang Peng, Yuan Wang, Hui Shu, Chang Interact Cardiovasc Thorac Surg Vascular  : OBJECTIVES: Aortic arch type is a readily recognizable and obtainable morphological feature of the aorta that does not require complex measurements. The goal of this study was to evaluate whether aortic arch type is a comparable and alternative morphological parameter for predicting acute type B aortic dissection (aTBAD) by comparing the prognostic value of the aortic arch type with that of other morphological parameters such as aortic length, angulation and tortuosity index. METHODS: The patients with aTBAD (n = 216) were matched 1:1 with a control group (n = 263) by propensity score matching. The morphological data of the ascending aorta and the aortic arch, which included diameter, length, angulation and tortuosity index, were collected on a three-dimensional aortic model using 3mensio Vascular software. The aortic arch type was identified by the vertical distance from the origin of the brachiocephalic trunk to the top of the arch. The binary logistic regression models were analysed to determine the independent geometric variables related to the aTBAD. The nonparametric approach was performed to assess whether there were statistical differences between the area under the receiver operating characteristic curves (AUC) of the models. RESULTS: After propensity score matching, 151 matched pairs of patients were selected. The diameters at the sinotubular junction and the mid-ascending aorta, the ascending aorta length and the ascending aorta angulation in the aTBAD group were significantly greater than those of the controls. Compared with the control group, the diameters at the proximal aortic arch, mid-aortic arch and distal aortic arch, the angulation and the tortuosity index of the aortic arch were significantly greater in the aTBAD group. The proportion of the type III arch in the patients with aTBAD is higher than that of the type I arch and the type II arch (χ(2) = 70.187; P < 0.001). Binary logistic regression analysis showed that the diameter at the mid-aortic arch, the ascending aorta length, the aortic arch angulation and the tortuosity index were independently related to the aTBAD with an AUC value of 0.887. Another binary logistic regression analysis indicated that the diameter at the mid-aortic arch and the aortic arch type were independent correlative variables associated with the aTBAD with an AUC of 0.874. No significant difference was observed in the prognostic value of receiver operating characteristic curves between the 2 models (P = 0.716). CONCLUSIONS: The type III arch, which has the characteristics of aortic elongation, incremental angulation and tortuosity index, is a comparable and alternative identifier for patients at high risk for aTBAD. Oxford University Press 2021-12-22 /pmc/articles/PMC8860428/ /pubmed/34935037 http://dx.doi.org/10.1093/icvts/ivab359 Text en © The Author(s) 2021. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Vascular
Sun, Likun
Li, Jiehua
Liu, Zhenyu
Li, Quanming
He, Hao
Li, Xin
Li, Ming
Wang, Tun
Wang, Lunchang
Peng, Yuan
Wang, Hui
Shu, Chang
Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title_full Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title_fullStr Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title_full_unstemmed Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title_short Aortic arch type, a novel morphological indicator and the risk for acute type B aortic dissection
title_sort aortic arch type, a novel morphological indicator and the risk for acute type b aortic dissection
topic Vascular
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860428/
https://www.ncbi.nlm.nih.gov/pubmed/34935037
http://dx.doi.org/10.1093/icvts/ivab359
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