{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T07:17:46Z","timestamp":1780730266037,"version":"3.54.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Ascending aortic dilation is monitored with serial imaging, yet event rates are low, with type A dissections often occurring at nonsurgical sizes. We aimed to characterize ascending aortic growth trajectories in a real\u2010world population to understand their clinical consequences and better inform surveillance strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We conducted a retrospective, single\u2010center study of adults with \u22652 thoracic computed tomography angiography\/magnetic resonance angiography examinations. Midascending diameters from clinical reports were used to analyze real\u2010world surveillance effectiveness. Growth trajectories were clustered using latent profile analysis. Early (first 3 scans; n=1997) and extended (first 5 scans; n=757) latent profile analysis models each yielded 4 classes: Stable, Growth, Dramatic Growth, and Fluctuation (an unstable trajectory attributed to measurement noise).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We studied 3363 adults (median age 62\u2009years; 68% men). Stable class was most common (74% Early; 70 % Extended); Growth and Dramatic Growth classes comprised 23% and 2% respectively. Only 1.1% met guideline growth\u2010based criteria for repair, and this subgroup had smaller baseline diameters (37.0 versus 40.3\u2009mm,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.009). At Extended follow\u2010up, 80% of those initially Stable remained Stable. Reclassification into a Growth class was associated with younger age and Marfan syndrome (50.0% versus 3.0%,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006). Acute type A dissection was rare (0.45%) and not clearly linked to any trajectory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Most patients with a dilated ascending aorta show negligible growth and low complication rates during routine surveillance. Repeated imaging beyond 3 scans may amplify uncertainty without clear improvements in risk stratification, suggesting that imaging surveillance may be safely deescalated for stable patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046358","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:01:15Z","timestamp":1762182075000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Growth Trajectories in Ascending Thoracic Aortic Dilation: Classification and Implications for the Effectiveness of Real\u2010World Imaging Surveillance"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5768-4859","authenticated-orcid":false,"given":"Prabhvir S.","family":"Marway","sequence":"first","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]},{"name":"University of Wisconsin\u2010Madison","place":["Madison, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5290-7294","authenticated-orcid":false,"given":"Carlos A.","family":"Campello Jorge","sequence":"additional","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]},{"name":"University of Wisconsin\u2010Madison","place":["Madison, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1118-1994","authenticated-orcid":false,"given":"Gregory","family":"Spahlinger","sequence":"additional","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]},{"name":"University of Wisconsin\u2010Madison","place":["Madison, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5529-6000","authenticated-orcid":false,"given":"Marion","family":"Hofmann Bowman","sequence":"additional","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7943-7851","authenticated-orcid":false,"given":"Matthew S.","family":"Davenport","sequence":"additional","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]},{"name":"Michigan Medicine","place":["Ann Arbor, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5198-4383","authenticated-orcid":false,"given":"Nicholas S.","family":"Burris","sequence":"additional","affiliation":[{"name":"University of Michigan","place":["Ann Arbor, USA"]},{"name":"University of Wisconsin\u2010Madison","place":["Madison, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001106"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/rct.0000000000000167"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2019.03.023"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjopen\/oead085"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2022.3305"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad148"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.06.025"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2014.05.050"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.12.028"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.038821"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.124.036896"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-012-0102-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-021-01564-9"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2022.06.021"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2021-320574"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.25.32808"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41568-019-0142-8"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204227"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.031264"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2016.00123"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0022-5347(17)38267-8"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2024.09.025"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2023-323042"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1117\/1.jmi.10.5.051810"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-018-5931-z"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2023.111067"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021210658"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15496"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.08.017"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezy110"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.3390\/biom10020182"}],"container-title":["Journal 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