title: Aortic elasticity indices by magnetic resonance predict progression of ascending aorta dilation.
abstract: OBJECTIVE
  Aortic distensibility and pulse-wave velocity (PWV) are under investigation as parameters by which to evaluate the indication for ascending aorta (AA) replacement. The maximum rate of systolic distension (MRSD) was proposed as a new index of aortic elasticity. The aim of this study was to assess the role of aortic elasticity parameters to predict AA growth rates in patients with AA dilation (AAD).
  
  
  METHODS
  Magnetic resonance imaging (MRI) was performed annually in 65 patients with AA dilation (median follow-up 17 months; 25-75th percentile; range 12-30 months). A significant increase in AA diameter was defined as a ≥2-mm increase.
  
  
  RESULTS
  An increase in AA diameter was found in 42 (68 %) patients (AAD+ group) and absent in 20. Median increase was 0.16 (25-75th percentile; range 0.32-0.7) mm/month. The AAD+ group had a lower MRSD (4.6 ± 2.2 vs 7.4 ± 2.0, p < 0.001) but the same PWV and distensibility. MRSD showed 93.7 % specificity and 75.6 % sensitivity for prediction of increase. Patients with MRSD ≤ 6 had lower progression-free survival times (p < 0.002). After a follow-up of 4.1 years, patients who underwent surgical therapy had lower MRSD and distensibility than others.
  
  
  CONCLUSIONS
  MRSD is an index of aorta elastic properties and is a valuable predictor for progression in AAD.
  
  
  CONCLUSIONS
  • MRI-derived parameters of aortic wall elasticity predict progression of ascending aorta dilation. • Maximal rate of systolic distension (MRSD) was the best predictor of progression. • Patients with MRSD ≤ 6 had lower progression-free survival (PFS) times. • Patients who underwent surgical therapy had lower MRSD and distensibility. • MRI-derived parameters identify patients with fast progression of Ascending Aorta Dilation.
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy. aquaro@ftgm.it.
authors.forename: Giovanni Donato
authors.initials: GD
authors.lastname: Aquaro
authors.affiliation: University of Chieti, Chieti, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Briatico Vangosa
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Toia
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Barison
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy.
authors.forename: Lamia
authors.initials: L
authors.lastname: Ait-Ali
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Midiri
authors.affiliation: University of Chieti, Chieti, Italy.
authors.forename: Antonio Raffaele
authors.initials: AR
authors.lastname: Cotroneo
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Emdin
authors.affiliation: Fondazione G. Monasterio CNR-Regione Toscana, Via Giuseppe Moruzzi, 1, 56124, Pisa, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Festa
mesh_terms: D001011:Aorta / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D004548:Elasticity / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D063177:Pulse Wave Analysis; D012680:Sensitivity and Specificity; D013599:Systole
keywords: Aortic distensibility; Aortic elasticity; Ascending aorta dilation; Maximal rate of systolic distension; Pulse wave velocity