{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:38Z","timestamp":1791355778026,"version":"4.3.1"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the prognostic value of computed tomography angiography (CTA)-based morphological parameters for adverse aortic events in patients with acute Stanford type B aortic dissection (TBAD) and to develop an internally validated prediction model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 292 consecutive patients with CTA-confirmed acute TBAD. Baseline clinical and CTA-derived morphological variables were collected, and the primary endpoint was a composite of adverse aortic events. Candidate predictors were evaluated using least absolute shrinkage and selection operator (LASSO) logistic regression with 10-fold cross-validation, followed by multivariable logistic regression. Model performance was assessed using discrimination, calibration, precision-recall analysis, and decision curve analysis, with internal validation based on 1,000 bootstrap resamples.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 13.20 months (interquartile range, 8.15\u201319.52 months), 78 patients (26.7%) experienced adverse aortic events. The final LASSO-selected model included age, symptom onset-to-admission time, white blood cell count, D-dimer, maximum aortic diameter, TL\/FL ratio, and false lumen status. In multivariable analysis, older age (adjusted OR\u2009=\u20091.043), higher white blood cell count (OR\u2009=\u20091.164), higher D-dimer (OR\u2009=\u20091.056), and larger maximum aortic diameter (OR\u2009=\u20091.110) were associated with higher odds of adverse events, whereas a higher TL\/FL ratio was inversely associated with the outcome (OR\u2009=\u20090.060). Compared with partial false-lumen thrombosis, patent false lumen was associated with higher odds (OR\u2009=\u20093.718), whereas complete thrombosis was associated with lower odds (OR\u2009=\u20090.253). The apparent AUC was 0.849 (95% CI: 0.800\u20130.898), and the optimism-corrected AUC was 0.828 after 1,000 bootstrap resamples. The optimism-corrected calibration slope and Brier score were 0.893 and 0.143, respectively. The AUPRC was 0.708 vs. a no-skill baseline of 0.267, and decision curve analysis showed positive net benefit across a broad range of threshold probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A model integrating baseline clinical and CTA-derived morphological characteristics demonstrated good internally validated discrimination and reasonable calibration for short- to medium-term adverse aortic events in acute TBAD. Independent external validation is required before broader clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1892266","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:56Z","timestamp":1791352256000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["CTA-based morphological parameters predict adverse prognosis in stanford type B aortic dissection: a single-center retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaolong","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Radiology, Yichang Central People\u2019s Hospital, The First College of Clinical Medical Science, China Three Gorges University","place":["Yichang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengli","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yichang Central People\u2019s Hospital, The First College of Clinical Medical Science, China Three Gorges University","place":["Yichang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yichang Central People\u2019s Hospital, The First College of Clinical Medical Science, China Three Gorges University","place":["Yichang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingting","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Yichang Central People\u2019s Hospital, The First College of Clinical Medical Science, China Three Gorges University","place":["Yichang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2024.1442800","article-title":"Safe and favorable prognosis of thoracic endovascular aortic repair for the low-risk patients with non-acute type B aortic dissection","volume":"11","author":"Nakamura","year":"2024","journal-title":"Front Cardiovasc Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"793","DOI":"10.21037\/acs-2021-taes-26","article-title":"Endovascular repair of acute type B thoracic aortic dissection","volume":"10","author":"Le Huu","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"key":"B3","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1186\/s12893-024-02555-4","article-title":"Efficacy of thoracic endovascular aortic repair versus medical therapy for treatment of type B aortic dissection","volume":"24","author":"Motawea","year":"2024","journal-title":"BMC Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"723","DOI":"10.21037\/acs-2021-taes-17","article-title":"Endovascular repair of acute complicated type B aortic dissection-systematic review and meta-analysis of long-term survival and reintervention","volume":"10","author":"Wilson-Smith","year":"2021","journal-title":"Ann Cardiothorac Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e182","DOI":"10.1016\/j.jtcvs.2023.04.023","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"166","author":"Isselbacher","year":"2023","journal-title":"J Thorac Cardiovasc Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1186\/s13019-025-03600-w","article-title":"aCTA structured reporting of aortic dissection and updated knowledge required by radiologists","volume":"20","author":"Li","year":"2025","journal-title":"J Cardiothorac Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"20251179","DOI":"10.1515\/med-2025-1179","article-title":"Influencing factors of false lumen thrombosis in type B aortic dissection: a single-center retrospective study","volume":"20","author":"Tang","year":"2025","journal-title":"Open Med (Wars)"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.788541","article-title":"Is partially thrombosed false lumen really a predictor for adverse events in uncomplicated type B aortic dissection: a systematic review and meta-analysis?","volume":"8","author":"Wu","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"B9","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1007\/s10237-023-01687-5","article-title":"Morphological parameters affecting false lumen thrombosis following type B aortic dissection: a systematic study based on simulations of idealized models","volume":"22","author":"Jafarinia","year":"2023","journal-title":"Biomech Model Mechanobiol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1080\/14017431.2022.2127873","article-title":"13-year single-center experience with the treatment of acute type B aortic dissection","volume":"56","author":"Heraj\u00e4rvi","year":"2022","journal-title":"Scand Cardiovasc J"},{"key":"B11","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.xjon.2023.01.005","article-title":"Impact of high-risk features on outcome of acute type B aortic dissection","volume":"13","author":"Heraj\u00e4rvi","year":"2023","journal-title":"JTCVS Open"},{"key":"B12","doi-asserted-by":"publisher","first-page":"767","DOI":"10.1111\/2041-210X.13177","article-title":"Incorporating fine-scale environmental heterogeneity into broad-extent models","volume":"10","author":"Graham","year":"2019","journal-title":"Methods Ecol Evol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1186\/s12874-023-02008-1","article-title":"Sample size requirements are not being considered in studies developing prediction models for binary outcomes: a systematic review","volume":"23","author":"Dhiman","year":"2023","journal-title":"BMC Med Res Methodol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1186\/s12874-024-02268-5","article-title":"An evaluation of sample size requirements for developing risk prediction models with binary outcomes","volume":"24","author":"Pavlou","year":"2024","journal-title":"BMC Med Res Methodol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","article-title":"2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American Heart Association\/American College of Cardiology joint committee on clinical practice guidelines","volume":"146","author":"Isselbacher","year":"2022","journal-title":"Circulation"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2106","DOI":"10.1016\/j.jacc.2021.09.022","article-title":"Acute aortic syndrome revisited: JACC state-of-the-art review","volume":"78","author":"Vilacosta","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2761","DOI":"10.1111\/jocs.16728","article-title":"The misnomer of uncomplicated type B aortic dissection","volume":"37","author":"Bashir","year":"2022","journal-title":"J Card Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"416","DOI":"10.23736\/S0392-9590.21.04687-3","article-title":"Predictors of adverse events in uncomplicated type B aortic dissection: a systematic review with meta-analysis","volume":"40","author":"Romeiro","year":"2021","journal-title":"Int Angiol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e016766","DOI":"10.1161\/CIRCIMAGING.124.016766","article-title":"Predicting late adverse events in uncomplicated stanford type B aortic dissection: results from the ROADMAP validation study","volume":"18","author":"Fleischmann","year":"2025","journal-title":"Circ Cardiovasc Imaging"},{"key":"B20","doi-asserted-by":"publisher","first-page":"6357","DOI":"10.21037\/jtd-24-864","article-title":"Narrow true lumen favors future complication even in small diameter of type B aortic dissection","volume":"16","author":"Nakamura","year":"2024","journal-title":"J Thorac Dis"},{"key":"B21","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1093\/ehjci\/jeae030","article-title":"Radiographic complicated and uncomplicated descending aortic dissections: aortic morphological differences by CT angiography and risk factor analysis","volume":"25","author":"Berger","year":"2024","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"B22","doi-asserted-by":"publisher","first-page":"E628","DOI":"10.59958\/hsf.5739","article-title":"Does false lumen thrombosis lead to better outcomes in patients with aortic dissection: a meta-analysis and systematic review","volume":"26","author":"Zhang","year":"2023","journal-title":"Heart Surg Forum"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2811","DOI":"10.1111\/jocs.16655","article-title":"Risk profile analysis of uncomplicated type B aortic dissection patients undergoing thoracic endovascular aortic repair: laboratory and radiographic predictors","volume":"37","author":"Geragotellis","year":"2022","journal-title":"J Card Surg"},{"key":"B24","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1016\/j.avsg.2019.01.030","article-title":"Malperfusions in acute type B aortic dissection-predictors of outcomes","volume":"59","author":"Sobocinski","year":"2019","journal-title":"Ann Vasc Surg"},{"key":"B25","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1016\/j.ejvs.2019.08.003","article-title":"Endovascular vs. medical management for uncomplicated acute and sub-acute type B aortic dissection: a meta-analysis","volume":"59","author":"Hossack","year":"2020","journal-title":"Eur J Vasc Endovasc Surg"},{"key":"B26","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1016\/j.avsg.2025.06.020","article-title":"TEVAR versus optimal medical therapy for uncomplicated type B aortic dissection: a systematic review & meta-analysis","volume":"120","author":"Jubouri","year":"2025","journal-title":"Ann Vasc Surg"},{"key":"B27","doi-asserted-by":"publisher","first-page":"311","DOI":"10.5114\/aic.2023.133256","article-title":"Endovascular repair versus best medical treatment for uncomplicated acute type B acute aorta dissection: a meta-analysis","volume":"19","author":"Ma","year":"2023","journal-title":"Postepy Kardiol Interwencyjnej"}],"container-title":["Frontiers in Cardiovascular Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1892266\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:57Z","timestamp":1791352257000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fcvm.2026.1892266\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,7]]},"references-count":27,"alternative-id":["10.3389\/fcvm.2026.1892266"],"URL":"https:\/\/doi.org\/10.3389\/fcvm.2026.1892266","relation":{},"ISSN":["2297-055X"],"issn-type":[{"value":"2297-055X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,7]]},"article-number":"1892266"}}