{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T02:03:00Z","timestamp":1793152980711,"version":"4.5.0"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,7,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Data from the International Registry of Acute Aortic Dissection indicate that the guideline criterion of 5.5\u00a0cm for ascending aortic intervention misses many dissections occurring at smaller dimensions. Furthermore, studies of natural behavior have generally treated the aortic root and the ascending aorta as 1 unit despite embryological, anatomical, and functional differences. This study aims to disentangle the natural histories of the aforementioned aortic segments, allowing natural behavior to define specific intervention criteria for root and ascending segments of the aorta.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Diameters of the aortic root and mid\u2010ascending segment were measured separately. Long\u2010term complications (dissection, rupture, and death) were analyzed retrospectively for 1162 patients with ascending thoracic aortic aneurysm. Cox regression analysis suggested that aortic root dilatation (\n                      <jats:italic>P<\/jats:italic>\n                      =0.017) is more significant in predicting adverse events than mid\u2010ascending aortic dilatation (\n                      <jats:italic>P<\/jats:italic>\n                      =0.087). Short stature posed as a serious risk factor. The dedicated risk curves for the aortic root and the mid\u2010ascending aorta revealed hinge points at 5.0 and 5.25\u00a0cm, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The natural histories of the aortic root and mid\u2010ascending aorta are uniquely different. Dilation of the aortic root imparts a significant higher risk of adverse events. A diameter shift for intervention to 5.0\u00a0cm for the aortic root and to 5.25\u00a0cm for the mid\u2010ascending aorta should be considered at expert centers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.020645","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T04:56:25Z","timestamp":1625806585000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":42,"title":["Root Dilatation Is More Malignant Than Ascending Aortic Dilation"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0313-9641","authenticated-orcid":false,"given":"Paris D.","family":"Kalogerakos","sequence":"first","affiliation":[{"name":"Aortic Institute at Yale\u2010New Haven Hospital Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1666-199X","authenticated-orcid":false,"given":"Mohammad A.","family":"Zafar","sequence":"additional","affiliation":[{"name":"Aortic Institute at Yale\u2010New Haven Hospital Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2063-1067","authenticated-orcid":false,"given":"Yupeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Political Science and Economics Rowan University Glassboro NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip K.","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Aortic Institute at Yale\u2010New Haven Hospital Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bulat A.","family":"Ziganshin","sequence":"additional","affiliation":[{"name":"Aortic Institute at Yale\u2010New Haven Hospital Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Department of Economics and Department of Preventive Medicine Stony Brook University Stony Brook NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6255-8139","authenticated-orcid":false,"given":"John A.","family":"Elefteriades","sequence":"additional","affiliation":[{"name":"Aortic Institute at Yale\u2010New Haven Hospital Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e3181d4739e"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu281"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2018.02.115"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.630400"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031264"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000381281"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000481930"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.19.7.1589"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/nbt.2107"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1242\/dev.127.8.1607"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.09.014"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2014.11.015"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.03.084"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.12.028"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.05.050"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/0267659119858848"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1916.00080130010002"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.1281"},{"key":"e_1_3_1_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.049124"},{"key":"e_1_3_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.10.140"},{"key":"e_1_3_1_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2017.12.031"},{"key":"e_1_3_1_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0142697"},{"key":"e_1_3_1_25_2","doi-asserted-by":"publisher","DOI":"10.1159\/000490373"},{"key":"e_1_3_1_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.08.084"},{"key":"e_1_3_1_27_2","doi-asserted-by":"publisher","DOI":"10.21037\/acs.2016.05.13"},{"key":"e_1_3_1_28_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-3400233"},{"key":"e_1_3_1_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8651(05)70118-1"},{"key":"e_1_3_1_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70360-X"},{"key":"e_1_3_1_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(02)04147-4"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.020645","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:22:32Z","timestamp":1715584952000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.020645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,20]]},"references-count":30,"journal-issue":{"issue":"14","published-print":{"date-parts":[[2021,7,20]]}},"alternative-id":["10.1161\/JAHA.120.020645"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.020645","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.740449703.793588679","asserted-by":"object"}]},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,20]]},"assertion":[{"value":"2020-12-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-05-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-09","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e020645"}}