{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T13:20:55Z","timestamp":1761312055772,"version":"3.41.2"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","funder":[{"name":"American Association for Thoracic Surgery Summer Intern Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>Diameter-based risk stratification for elective repair of ascending aortic aneurysm fails to prevent type A dissection in many patients. Aneurysm wall stresses may contribute to risk prediction; however, rates of wall stress change over time are poorly understood. Our objective was to examine aneurysm wall stress changes over 3\u20135 years and subsequent all-cause mortality.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Male veterans with &amp;lt;5.5 cm ascending aortic aneurysms and computed tomography at baseline and 3- to 5-year follow-up underwent three-dimensional aneurysm model construction. Peak circumferential and longitudinal wall stresses at systole were calculated using finite element analysis. Temporal trends were assessed by mixed-effects modelling. Changes in aortic wall stresses, diameter and length over time were evaluated as predictors of subsequent 3-year all-cause mortality by Cox proportional hazards modelling.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Sixty-two male veterans were included in the study. Yearly changes in geometric and biomechanical measures were 0.12\u2009mm\/year (95% confidence interval, 0.04\u20130.20) for aortic diameter, 0.41\u2009mm\/year (0.12\u20130.71) for aortic length, 1.19\u2009kPa\/year \u22125.94 to 8.33) for peak circumferential stress, and 0.48\u2009kPa\/year (\u22123.89 to 4.84) for peak longitudinal stress. Yearly change in peak circumferential stress was significantly associated with hazard of death\u2014hazard ratio for peak circumferential stress growth per 10\u2009kPa\/year, 1.27 (95% CI, 1.02\u20131.60; P\u2009=\u20090.037); hazard ratio for peak circumferential stress growth \u2265 32\u2009kPa\/year, 8.47 (95% CI, 2.42\u201330; P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In this population of nonsurgical aneurysm patients, large temporal changes in peak circumferential stress, but not aortic diameter or length, was associated with all-cause mortality. Biomechanical stress and stress changes over time may be beneficial as additional risk factors for elective surgery in small aneurysms.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/icvts\/ivae116","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T18:52:39Z","timestamp":1719255159000},"source":"Crossref","is-referenced-by-count":1,"title":["Temporal evolution of ascending aortic aneurysm wall stress predicts all-cause mortality"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3742-4320","authenticated-orcid":false,"given":"Siavash","family":"Zamirpour","sequence":"first","affiliation":[{"name":"Department of Surgery, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, 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Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6989-8547","authenticated-orcid":false,"given":"David A","family":"Saloner","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9505-564X","authenticated-orcid":false,"given":"Julius M","family":"Guccione","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3158-3144","authenticated-orcid":false,"given":"Marko T","family":"Boskovski","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5519-6747","authenticated-orcid":false,"given":"Elaine E","family":"Tseng","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of California San Francisco and San Francisco VA Healthcare System , San Francisco, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"2024070813563904200_ivae116-B1","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.xjon.2022.06.013","article-title":"Age, sex, and contemporary 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