Magnetic resonance angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome
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Magnetic resonance angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome. / Weinrich, Julius Matthias; Lenz, Alexander; Schön, Gerhard; Behzadi, Cyrus; Molwitz, Isabel; Henes, Frank Oliver; Schoennagel, Bjoern Philip; Adam, Gerhard; von Kodolitsch, Yskert; Bannas, Peter.
in: PLOS ONE, Jahrgang 17, Nr. 2, e0262826, 2022.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Magnetic resonance angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome
AU - Weinrich, Julius Matthias
AU - Lenz, Alexander
AU - Schön, Gerhard
AU - Behzadi, Cyrus
AU - Molwitz, Isabel
AU - Henes, Frank Oliver
AU - Schoennagel, Bjoern Philip
AU - Adam, Gerhard
AU - von Kodolitsch, Yskert
AU - Bannas, Peter
PY - 2022
Y1 - 2022
N2 - BACKGROUND: To identify magnetic resonance (MR) angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome.MATERIAL AND METHODS: We retrospectively included 111 patients (32.7±16.5 years, range: 7-75 years) with a total of 446 MR angiographies. Aortic diameter growth rates of the entire thoracic aorta and Z-scores were estimated from annual diameter measurements. Aortic root shape was subdivided into three different types: (T0) normal; (T1) localized dilatation; (T2) generalized aortic root dilatation. Aortic diameter, Z-score, age, and aortic root shape at baseline were tested as predictors of aortic root dilatation using a multivariate logistic regression model.RESULTS: The highest aortic growth rate was observed at the level of the sinuses of Valsalva. Higher aortic root diameters and Z-scores at baseline predicted an increased growth of the aortic root (p = 0.003 and p<0.001). Young age (<30 years) was a predictor for the increase of Z-scores when compared to patients ≥30 years (p = 0.019). 25/111 patients (22.5%) had a T0 aortic root shape, 59/111 patients (53.2%) had a T1 aortic root shape, and 27/111 patients (24.3%) had a T2 aortic root shape. Aortic root shape did not predict further aortic growth (p>0.05). However, significantly more patients undergoing surgery had a generalized aortic dilatation (19/28, 76.9%) than a localized aortic root dilatation (9/28, 32.1%) (p = 0.001).CONCLUSION: Larger baseline aortic root diameter and Z-score as well as young age predict solely progressive aortic root dilatation in Marfan patients. MR angiography derived type of aortic root shape does not predict aortic growth, but patients with generalized aortic root dilatation are referred more frequently for aortic surgery.
AB - BACKGROUND: To identify magnetic resonance (MR) angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome.MATERIAL AND METHODS: We retrospectively included 111 patients (32.7±16.5 years, range: 7-75 years) with a total of 446 MR angiographies. Aortic diameter growth rates of the entire thoracic aorta and Z-scores were estimated from annual diameter measurements. Aortic root shape was subdivided into three different types: (T0) normal; (T1) localized dilatation; (T2) generalized aortic root dilatation. Aortic diameter, Z-score, age, and aortic root shape at baseline were tested as predictors of aortic root dilatation using a multivariate logistic regression model.RESULTS: The highest aortic growth rate was observed at the level of the sinuses of Valsalva. Higher aortic root diameters and Z-scores at baseline predicted an increased growth of the aortic root (p = 0.003 and p<0.001). Young age (<30 years) was a predictor for the increase of Z-scores when compared to patients ≥30 years (p = 0.019). 25/111 patients (22.5%) had a T0 aortic root shape, 59/111 patients (53.2%) had a T1 aortic root shape, and 27/111 patients (24.3%) had a T2 aortic root shape. Aortic root shape did not predict further aortic growth (p>0.05). However, significantly more patients undergoing surgery had a generalized aortic dilatation (19/28, 76.9%) than a localized aortic root dilatation (9/28, 32.1%) (p = 0.001).CONCLUSION: Larger baseline aortic root diameter and Z-score as well as young age predict solely progressive aortic root dilatation in Marfan patients. MR angiography derived type of aortic root shape does not predict aortic growth, but patients with generalized aortic root dilatation are referred more frequently for aortic surgery.
U2 - 10.1371/journal.pone.0262826
DO - 10.1371/journal.pone.0262826
M3 - SCORING: Journal article
C2 - 35113893
VL - 17
JO - PLOS ONE
JF - PLOS ONE
SN - 1932-6203
IS - 2
M1 - e0262826
ER -