{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:19:26Z","timestamp":1791389966331,"version":"4.3.3"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Imaging"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>Risk stratification is highly desirable in patients with uncomplicated Stanford type B aortic dissection but inadequately supported by evidence. We sought to validate externally a published prediction model for late adverse events (LAEs), consisting of 1 clinical (connective tissue disease) and 4 imaging variables: maximum aortic diameter, false lumen circumferential angle, false lumen outflow, and number of identifiable intercostal arteries.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>We assembled a retrospective multicenter cohort (ROADMAP [Registry of Aortic Diseases to Model Adverse Events and Progression]) of 401 patients with uncomplicated Stanford type B aortic dissection presenting to 1 of 8 aortic centers between 2001 and 2013, followed until 2020. LAEs were defined as fatal or nonfatal aortic rupture, new refractory hypertension or pain, organ or limb ischemia, aortic aneurysm formation (\u22656 cm), or rapid growth (\u22651 cm per year). We applied the original model parameters to the validation cohort and examined the effect on risk categorization using LAE end points.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>\n              One hundred and seventy-six patients (44%) with incomplete imaging or clinical data were excluded. Of 225 patients in the final cohort, 90 (40%) developed LAEs, predominantly driven by aneurysm formation. Baseline maximum aortic diameter was significantly larger in patients with (42.6 [95% CI, 39.1\u201345.8] mm) compared with patients without LAEs (39.9 [95% CI, 36.3\u201344.2] mm;\n              <jats:italic>P<\/jats:italic>\n              =0.001). A multivariable Cox regression model indicated that only maximum diameter was associated with LAEs (hazard ratio, 1.07 [95% CI, 1.03\u20131.11] per mm;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), while the other parameters were not (\n              <jats:italic>P<\/jats:italic>\n              &gt;0.05). Applying the original prediction model to the validation cohort resulted in a poor 5-year sensitivity (38%) and specificity (69%).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>A clinical and imaging-based prediction model performed poorly in the ROADMAP cohort. Maximum aortic diameter remains the strongest predictor of LAEs in uncomplicated Stanford type B aortic dissection.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circimaging.124.016766","type":"journal-article","created":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T19:00:32Z","timestamp":1739905232000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Predicting Late Adverse Events in Uncomplicated Stanford Type B Aortic Dissection: Results From the ROADMAP Validation Study"],"prefix":"10.1161","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0715-0952","authenticated-orcid":true,"given":"Dominik","family":"Fleischmann","sequence":"first","affiliation":[{"name":"Department of Radiology (D.F., D.M., M.J.W., V.L.T., V.H., M.C., A.M.S., G.M., M.H.M., K.B., J.S., K.M.L.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8227-0757","authenticated-orcid":true,"given":"Domenico","family":"Mastrodicasa","sequence":"additional","affiliation":[{"name":"Department of Radiology (D.F., D.M., M.J.W., V.L.T., V.H., M.C., A.M.S., G.M., M.H.M., K.B., J.S., K.M.L.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6991-6557","authenticated-orcid":true,"given":"Martin J.","family":"Willemink","sequence":"additional","affiliation":[{"name":"Department of Radiology (D.F., D.M., M.J.W., V.L.T., V.H., M.C., A.M.S., G.M., M.H.M., K.B., J.S., K.M.L.), Stanford University School of Medicine, CA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2195-5725","authenticated-orcid":true,"given":"Valery L.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Radiology 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