Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions
Abstract 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 p...
| Main Authors: | , , , , , , , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | English |
| Published: |
Springer International Publishing
2023
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| Online Access: | https://hdl.handle.net/1721.1/146944 |
| _version_ | 1826208582448709632 |
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| author | Williams, Jessica G. Marlevi, David Bruse, Jan L. Nezami, Farhad R. Moradi, Hamed Fortunato, Ronald N. Maiti, Spandan Billaud, Marie Edelman, Elazer R. Gleason, Thomas G. |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Williams, Jessica G. Marlevi, David Bruse, Jan L. Nezami, Farhad R. Moradi, Hamed Fortunato, Ronald N. Maiti, Spandan Billaud, Marie Edelman, Elazer R. Gleason, Thomas G. |
| author_sort | Williams, Jessica G. |
| collection | MIT |
| description | Abstract
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 (
$$p = 0.0010$$
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. |
| first_indexed | 2024-09-23T14:07:55Z |
| format | Article |
| id | mit-1721.1/146944 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T14:07:55Z |
| publishDate | 2023 |
| publisher | Springer International Publishing |
| record_format | dspace |
| spelling | mit-1721.1/1469442024-03-19T14:05:21Z Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions Williams, Jessica G. Marlevi, David Bruse, Jan L. Nezami, Farhad R. Moradi, Hamed Fortunato, Ronald N. Maiti, Spandan Billaud, Marie Edelman, Elazer R. Gleason, Thomas G. Massachusetts Institute of Technology. Institute for Medical Engineering & Science Abstract 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 ( $$p = 0.0010$$ 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. 2023-01-03T13:52:03Z 2023-01-03T13:52:03Z 2022-08-09 2022-12-28T04:20:48Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/146944 Williams, Jessica G., Marlevi, David, Bruse, Jan L., Nezami, Farhad R., Moradi, Hamed et al. 2022. "Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions." en https://doi.org/10.1007/s10439-022-02979-0 Creative Commons Attribution-Noncommercial-Share Alike http://creativecommons.org/licenses/by-nc-sa/4.0/ The Author(s) under exclusive licence to Biomedical Engineering Society application/pdf Springer International Publishing Springer International Publishing |
| spellingShingle | Williams, Jessica G. Marlevi, David Bruse, Jan L. Nezami, Farhad R. Moradi, Hamed Fortunato, Ronald N. Maiti, Spandan Billaud, Marie Edelman, Elazer R. Gleason, Thomas G. Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title | Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title_full | Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title_fullStr | Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title_full_unstemmed | Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title_short | Aortic Dissection is Determined by Specific Shape and Hemodynamic Interactions |
| title_sort | aortic dissection is determined by specific shape and hemodynamic interactions |
| url | https://hdl.handle.net/1721.1/146944 |
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