{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T05:27:34Z","timestamp":1782451654147,"version":"3.54.5"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["THC"],"published-print":{"date-parts":[[2024,3,14]]},"abstract":"<jats:p>BACKGROUND: Acute type B aortic dissection (ATBAD) is a life-threatening aortic disease. However, little information is available on predicting and understanding of ATBAD. OBJECTIVE: The study sought to explore the underlying mechanism of ATBAD by analyzing the morphological and hemodynamic characteristics related to aortic length. METHODS: The length and tortuosity of the segment and the whole aorta in the ATBAD group (n= 163) and control group (n= 120) were measured. A fixed anatomic landmark from the distal of left subclavian artery (LSA) to the superior border of sixth thoracic vertebra was proposed as the proximal descending thoracic aorta (PDTA), and the dimensionless parameter, length ratio, was introduced to eliminate the individual differences. The significant morphological parameters were filtrated and the associations between parameters were investigated using statistical approaches. Furthermore, how aortic morphology influenced ATBAD was explored based on idealized aortic models and hemodynamic-related metrics. RESULTS: The PDTA length was significantly increased in the ATBAD group compared with the control group and had a strong positive correlation with the whole aortic length (r= 0.89). The length ratio (LR2) and tortuosity (T2) of PDTA in the ATBAD group were significantly increased (0.15 \u00b1 0.02 vs 0.12 \u00b1 0.02 and 1.73 \u00b1 0.48 vs 1.50 \u00b1 0.36; P&lt; 0.001), and LR2 was positive correlation with T2 (r= 0.73). In receiver-operating curve analysis, the area under the curve was 0.835 for LR2 and 0.641 for T2. Low and oscillatory shear (LOS) was positive correlation with LR2, and the elevated LOS occurred in the distal of LSA. CONCLUSION: Elongation of PDTA is associated with ATBAD, and the length ratio is a novel predictor. Elongated PDTA induced more aggressive hemodynamic forces, and high LOS regions may correspond to the entry tear location. The synergy of the morphological variation and aggressive hemodynamics creates contributory conditions for ATBAD.<\/jats:p>","DOI":"10.3233\/thc-230194","type":"journal-article","created":{"date-parts":[[2023,8,4]],"date-time":"2023-08-04T12:46:52Z","timestamp":1691153212000},"page":"765-777","source":"Crossref","is-referenced-by-count":5,"title":["Elongation of the proximal descending thoracic aorta and associated hemodynamics increase the risk of acute type B aortic dissection"],"prefix":"10.1177","volume":"32","author":[{"given":"Xuelan","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China"},{"name":"School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaoyang","family":"Li","sequence":"additional","affiliation":[{"name":"Institute of Fluid Science, Tohoku University, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiehua","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingyao","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Che","sequence":"additional","affiliation":[{"name":"School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liancun","family":"Zheng","sequence":"additional","affiliation":[{"name":"School of Mathematics and Physics, University of Science and Technology Beijing, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Anzai","sequence":"additional","affiliation":[{"name":"Institute of Fluid Science, Tohoku University, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Ohta","sequence":"additional","affiliation":[{"name":"Institute of Fluid Science, Tohoku University, Sendai, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Second Xiangya Hospital, Central South University, Changsha, Hunan, China"},{"name":"Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/THC-230194_ref1","first-page":"1","article-title":"Aortic dissection","volume":"2","author":"Nienaber","year":"2016","journal-title":"Nat Rev Dis primers."},{"key":"10.3233\/THC-230194_ref2","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1161\/CIRCRESAHA.114.304936","article-title":"Role of mechanotransduction in vascular biology: Focus on thoracic aortic aneurysms and dissections","volume":"116","author":"Humphrey","year":"2015","journal-title":"Circ Res."},{"key":"10.3233\/THC-230194_ref3","first-page":"e266","article-title":"2010 ACCF\/AHA\/ AATS\/ACR\/ASA\/SCA\/SCAI\/SIR\/STS\/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease","volume":"121","author":"Hiratzka","year":"2010","journal-title":"Circulation."},{"key":"10.3233\/THC-230194_ref4","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The task force for the diagnosis and treatment of aortic diseases of the european society of cardiology (ESC)","volume":"35","author":"Erbel","year":"2014","journal-title":"Eur Heart J."},{"key":"10.3233\/THC-230194_ref5","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1016\/j.jtcvs.2010.12.032","article-title":"Descending aortic diameter of 5.5 cm or greater is not an accurate predictor of acute type B aortic dissection","volume":"142","author":"Trimarchi","year":"2011","journal-title":"J Thorac Cardiov Sur."},{"key":"10.3233\/THC-230194_ref6","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.jcmg.2012.07.018","article-title":"Predicting the Risk for Acute Type B Aortic Dissection in Hypertensive Patients Using Anatomic Variables","volume":"6","author":"Shirali","year":"2013","journal-title":"JACC-Cardiovasc Imag."},{"key":"10.3233\/THC-230194_ref7","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.ejvs.2017.05.017","article-title":"Aortic elongation and Stanford B dissection: The T\u00fcbingen Aortic Pathoanatomy (TAIPAN) project","volume":"54","author":"Lescan","year":"2017","journal-title":"Eur J Vasc Endovasc."},{"key":"10.3233\/THC-230194_ref9","doi-asserted-by":"crossref","first-page":"105522","DOI":"10.1016\/j.cmpb.2020.105522","article-title":"Analysis of the formation mechanism and occurrence possibility of Post-Stenotic Dilatation of the aorta by CFD approach","volume":"194","author":"Zhang","year":"2020","journal-title":"Comput Meth Prog Bio."},{"key":"10.3233\/THC-230194_ref10","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s10439-014-1224-0","article-title":"Progression of abdominal aortic aneurysm towards rupture: Refining clinical risk assessment using a fully coupled fluid-structure interaction method","volume":"43","author":"Xenos","year":"2015","journal-title":"Ann Biomed Eng."},{"key":"10.3233\/THC-230194_ref11","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jvs.2012.02.064","article-title":"Longitudinal computational fluid dynamics study of aneurysmal dilatation in a chronic DeBakey type III aortic dissection","volume":"56","author":"Karmonik","year":"2012","journal-title":"J Vasc Surg."},{"key":"10.3233\/THC-230194_ref13","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1098\/rsif.2011.0041","article-title":"Blood flow and coherent vortices in the normal and aneurysmatic aortas: A fluid dynamical approach to intra-luminal thrombus formation","volume":"8","author":"Biasetti","year":"2011","journal-title":"J R Soc Interface."},{"key":"10.3233\/THC-230194_ref14","doi-asserted-by":"crossref","first-page":"105619","DOI":"10.1016\/j.cnsns.2020.105619","article-title":"Application of 3D curvature and torsion in evaluating aortic tortuosity","volume":"95","author":"Zhang","year":"2021","journal-title":"Commun Nonlinear Sci Numer Simul."},{"key":"10.3233\/THC-230194_ref15","doi-asserted-by":"crossref","first-page":"3115","DOI":"10.1016\/j.apm.2015.09.096","article-title":"Prediction of thrombus formation using vortical structures presentation in Stanford type B aortic dissection: A preliminary study using CFD approach","volume":"40","author":"Ab Naim","year":"2016","journal-title":"App Math Model."},{"key":"10.3233\/THC-230194_ref16","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.jbiomech.2010.12.014","article-title":"Investigation of hemodynamics in the development of dissecting aneurysm within patient-specific dissecting aneurismal aortas using computational fluid dynamics (CFD) simulations","volume":"44","author":"Tse","year":"2011","journal-title":"J Biomech."},{"key":"10.3233\/THC-230194_ref17","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1016\/j.medengphy.2013.02.006","article-title":"A longitudinal study of Type-B aortic dissection and endovascular repair scenarios: Computational analyses","volume":"35","author":"Chen","year":"2013","journal-title":"Med Eng Phys."},{"key":"10.3233\/THC-230194_ref18","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.ejrad.2008.06.024","article-title":"Motion characterization of aortic wall and intimal flap by ECG-gated CT in patients with chronic B-dissection","volume":"72","author":"Ganten","year":"2009","journal-title":"Eur J Radiol."},{"key":"10.3233\/THC-230194_ref19","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1161\/ATVBAHA.119.312687","article-title":"Morphology and hemodynamics in isolated common iliac artery aneurysms impacts proximal aortic remodeling","volume":"39","author":"Parker","year":"2019","journal-title":"Arterioscl Throm Vas."},{"key":"10.3233\/THC-230194_ref21","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1007\/s00586-018-5812-9","article-title":"The effect of patient positioning on the relative position of the aorta to the thoracic spine","volume":"28","author":"Plataniotis","year":"2019","journal-title":"Eur Spine J."},{"key":"10.3233\/THC-230194_ref22","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1136\/heartjnl-2017-312866","article-title":"Aortic elongation part I: The normal aortic ageing process","volume":"104","author":"Adriaans","year":"2018","journal-title":"Heart."},{"key":"10.3233\/THC-230194_ref23","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1016\/j.jvs.2010.07.008","article-title":"Society for Vascular Surgery Ad Hoc Committee on TRS. Reporting standards for thoracic endovascular aortic repair (TEVAR)","volume":"52","author":"Fillinger","year":"2010","journal-title":"J Vasc Surg."},{"key":"10.3233\/THC-230194_ref24","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1093\/ejcts\/ezx292","article-title":"How does descending aorta geometry change when it dissects","volume":"53","author":"Rylski","year":"2018","journal-title":"Eur J Cardiothoracic Surg."},{"issue":"12","key":"10.3233\/THC-230194_ref25","doi-asserted-by":"crossref","first-page":"6396","DOI":"10.1007\/s00330-019-06320-7","article-title":"Predictive imaging for thoracic aortic dissection and rupture: Moving beyond diameters","volume":"29","author":"Adriaans","year":"2019","journal-title":"Eur. Radiol."},{"key":"10.3233\/THC-230194_ref26","first-page":"1883","article-title":"Ascending aortic length and risk of aortic adverse events: The neglected dimension","volume":"74","author":"Adriaans","year":"2019","journal-title":"Eur Radiol."},{"key":"10.3233\/THC-230194_ref27","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.yexmp.2003.11.003","article-title":"Hemodynamic forces regulate mural macrophage infiltration in experimental aortic aneurysms","volume":"76","author":"Sho","year":"2004","journal-title":"Exp Mol Pathol."},{"key":"10.3233\/THC-230194_ref28","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.jss.2013.06.007","article-title":"Molecular mechanisms of thoracic aortic dissection","volume":"184","author":"Wu","year":"2013","journal-title":"J Surg Res."},{"key":"10.3233\/THC-230194_ref29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s12276-019-0286-3","article-title":"Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm","volume":"51","author":"Jana","year":"2019","journal-title":"Exp Mol Med."},{"key":"10.3233\/THC-230194_ref30","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1136\/jcp.39.10.1074","article-title":"Histological pattern and changes in extracellular matrix in aortic dissections","volume":"39","author":"Sariola","year":"1986","journal-title":"J Clin Pathol."}],"container-title":["Technology and Health Care"],"original-title":[],"link":[{"URL":"https:\/\/content.iospress.com\/download?id=10.3233\/THC-230194","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:57:34Z","timestamp":1777615054000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.3233\/THC-230194"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":27,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3233\/thc-230194","relation":{},"ISSN":["0928-7329","1878-7401"],"issn-type":[{"value":"0928-7329","type":"print"},{"value":"1878-7401","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,14]]}}}