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Aortic dissection is determined by specific shape and hemodynamic interactions

Williams, J. G ; Sharif University of Technology | 2022

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  1. Type of Document: Article
  2. DOI: 10.1007/s10439-022-02979-0
  3. Publisher: Springer , 2022
  4. Abstract:
  5. The aim of this study was to determine whether specific three-dimensional aortic shape features, extracted via statistical shape analysis (SSA), correlate with the development of thoracic ascending aortic dissection (TAAD) risk and associated aortic hemodynamics. Thirty-one patients followed prospectively with ascending thoracic aortic aneurysm (ATAA), who either did (12 patients) or did not (19 patients) develop TAAD, were included in the study, with aortic arch geometries extracted from computed tomographic angiography (CTA) imaging. Arch geometries were analyzed with SSA, and unsupervised and supervised (linked to dissection outcome) shape features were extracted with principal component analysis (PCA) and partial least squares discriminant analysis (PLS-DA), respectively. We determined PLS-DA to be effective at separating dissection and no-dissection patients (p= 0.0010), with decreased tortuosity and more equal ascending and descending aortic diameters associated with higher dissection risk. In contrast, neither PCA nor traditional morphometric parameters (maximum diameter, tortuosity, or arch volume) were effective at separating dissection and no-dissection patients. The arch shapes associated with higher dissection probability were supported with hemodynamic insight. Computational fluid dynamics (CFD) simulations revealed a correlation between the PLS-DA shape features and wall shear stress (WSS), with higher maximum WSS in the ascending aorta associated with increased risk of dissection occurrence. Our work highlights the potential importance of incorporating higher dimensional geometric assessment of aortic arch anatomy in TAAD risk assessment, and in considering the interdependent influences of arch shape and hemodynamics as mechanistic contributors to TAAD occurrence. © 2022, The Author(s) under exclusive licence to Biomedical Engineering Society
  6. Keywords:
  7. Aortic aneurysm ; Statistical shape analysis ; Type A aortic dissection ; Blood vessels ; Computational fluid dynamics ; Discriminant analysis ; Dissection ; Geometry ; Hemodynamics ; Least squares approximations ; Principal component analysis ; Risk assessment ; Shear stress ; Aortic aneurysms ; Aortic arch ; Aortic dissections ; Haemodynamics ; Partial least squares discriminant analyses (PLSDA) ; Principal-component analysis ; Shape features ; Wall-shear stress ; Arches ; 1,3,4,6-tetra-O-acetyl-2-azido-2-deoxyglucopyranose ; Aorta ; Diagnostic imaging ; Human ; Thoracic aorta ; Aorta, Thoracic ; Aortic Dissection ; Humans
  8. Source: Annals of Biomedical Engineering ; Volume 50, Issue 12 , 2022 , Pages 1771-1786 ; 00906964 (ISSN)
  9. URL: https://pubmed.ncbi.nlm.nih.gov/35943618