{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T01:49:22Z","timestamp":1789264162222,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Shandong Municipal Health Commission","award":["ZR2021MB036"],"award-info":[{"award-number":["ZR2021MB036"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aimed to analyse and determine the role of aortic length and curvature in the pathogenesis of acute type A aortic dissection (ATAAD) with ascending aortic diameters (AADs) &amp;lt;5\u2009cm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>We reviewed the clinical and imaging data of patients with ATAAD (n\u2009=\u2009201) and ascending aortic dilation (n\u2009=\u200983). Thoracic aortic bending index (TABI) was used to quantify aortic curvature and analyse its role in ATAAD below the diameter risk threshold.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The AAD was &amp;lt;5.0 and &amp;lt;4.0\u2009cm in 78% and 37% of patients with ATAAD, respectively. The median ascending aortic length (AAL) was 104.6\u2009mm (Q1\u2013Q3, 96.5\u2013113.6\u2009mm), and in 62.7% of patients, it was &amp;lt;11\u2009cm. The median TABI was 14.99\u2009mm\/cm (Q1\u2013Q3, 14.18\u201315.86\u2009mm\/cm). Patients with ATAAD and those with aortic dilation were matched for AAD, age, sex, height and other clinical factors. After matched, the dissection group had higher AALs (median, 102.9\u2009mm; Q1\u2013Q3, 96.0\u2013112.5\u2009mm vs median, 88.2\u2009mm; Q1\u2013Q3, 83.7\u201395.9\u2009mm; P\u2009&amp;lt;\u20090.001) and TABI (median, 14.84\u2009mm\/cm; Q1\u2013Q3, 14.06\u201315.83\u2009mm\/cm vs median, 13.55\u2009mm\/cm; Q1\u2013Q3, 13.03\u201314.28\u2009mm\/cm; P\u2009&amp;lt;\u20090.001). According to the regression analysis, the area under the curve required to distinguish patients with ATAAD from those with aortic dilation was 0.831 in AAL, 0.837 in TABI and 0.907 when AAL was combined with TABI.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>The patients with ATAAD had higher AAL and TABI than those with aortic dilation. The combination of TABI and AAL might be a potential morphological marker for determining ATAAD risk below the current aortic diameter risk threshold.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezae016","type":"journal-article","created":{"date-parts":[[2024,1,14]],"date-time":"2024-01-14T03:12:26Z","timestamp":1705201946000},"source":"Crossref","is-referenced-by-count":6,"title":["Morphological risk of acute type A aortic dissection in the mildly to moderately dilated aorta"],"prefix":"10.1093","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-8209","authenticated-orcid":false,"given":"Lianjie","family":"Sun","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Surgery, Qingdao Municipal Hospital , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyou","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Qingdao Municipal Hospital , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiangzhen","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Institute of Ultrasound in Medicine and Engineering, Zhongshan Hospital, Fudan University , Shanghai, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianchao","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenfeng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Qingdao Municipal Hospital , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianxun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaozhuo","family":"Niu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Qingdao Municipal Hospital , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1607-1108","authenticated-orcid":false,"given":"Gaoli","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, The Affiliated Hospital of Qingdao University , Qingdao, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,13]]},"reference":[{"key":"2024012615220786400_ezae016-B1","doi-asserted-by":"crossref","first-page":"2611","DOI":"10.1161\/CIRCULATIONAHA.106.630400","article-title":"Thoracic aortic aneurysm and dissection: increasing prevalence and improved outcomes reported in a nationwide population-based study of more than 14,000 cases from 1987 to 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