ArticlePloS one2020
Prosthetic aortic graft replacement of the ascending thoracic aorta alters biomechanics of the native descending aorta as assessed by transthoracic echocardiography.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Effects of resveratrol on aortic growth in patients with Marfan syndrome: a single-arm open-label multicentre trial.Heart (British Cardiac Society) · 2024Trial
- Outcomes of Type B Dissection in Marfan Syndrome: The Cornell Aortic Aneurysm Registry.Journal of the American Heart Association · 2026Article
- Tortuous Descending Thoracic Aorta in a Patient with a History of Ascending Aorta Replacement as a Confounder in Transesophageal Echocardiographic Evaluation of the Left Atrium: A Procedural Challenge.Research in heart yield and translational medicine · 2026Article
- Exaggerated Pressure Recovery during Pregnancy: A Multimodal Approach to Assessment of Prosthetic Aortic Stenosis Severity.CASE (Philadelphia, Pa.) · 2024Article
- TheFrontiers in cardiovascular medicine · 2024Article
- Distal aortic biomechanics after transcatheter versus surgical aortic valve replacement: a hypothesis generating study.Journal of cardiothoracic surgery · 2023Article
- FN (Fibronectin)-Integrin α5 Signaling Promotes Thoracic Aortic Aneurysm in a Mouse Model of Marfan Syndrome.Arteriosclerosis, thrombosis, and vascular biology · 2023Article
- Myocardial Contractile Mechanics in Ischemic Mitral Regurgitation: Multicenter Data Using Stress Perfusion Cardiovascular Magnetic Resonance.JACC. Cardiovascular imaging · 2022Article
- Impact of ascending aortic prosthetic grafts on early postoperative descending aortic biomechanics on cardiac magnetic resonance imaging.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2022Article
- Clinical implications of the biomechanics of bicuspid aortic valve and bicuspid aortopathy.Frontiers in cardiovascular medicine · 2022Review
- Progressive Microstructural Deterioration Dictates Evolving Biomechanical Dysfunction in the Marfan Aorta.Frontiers in cardiovascular medicine · 2021Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
introductionIn patients with ascending aortic (AA) aneurysms, prosthetic graft replacement yields benefit but risk for complications in the descending aorta persists. Longitudinal impact of AA grafts on native descending aortic physiology is poorly understood.
methodsTransthoracic echocardiograms (echo) in patients undergoing AA elective surgical grafting were analyzed: Descending aortic deformation indices included global circumferential strain (GCS), time to peak (TTP) strain, and fractional area change (FAC). Computed tomography (CT) was used to assess aortic wall thickness and calcification.
results46 patients undergoing AA grafting were studied; 65% had congenital or genetically-associated AA (30% bicuspid valve, 22% Marfan, 13% other): After grafting (6.4±7.5 months), native descending aortic distension increased, irrespective of whether assessed based on circumferential strain or area-based methods (both p<0.001). Increased distensibility paralleled altered kinetics, as evidenced by decreased time to peak strain (p = 0.01) and increased velocity (p = 0.002). Augmented distensibility and flow velocity occurred despite similar pre- and post-graft blood pressure and medications (all p = NS), and was independent of pre-surgical aortic regurgitation or change in left ventricular stroke volume (both p = NS). Magnitude of change in GCS and FAC was 5-10 fold greater among patients with congenital or genetically associated AA vs. degenerative AA (p<0.001), paralleling larger descending aortic size, greater wall thickness, and higher prevalence of calcific atherosclerotic plaque in the degenerative group (all p<0.05). In multivariate analysis, congenital/genetically associated AA etiology conferred a 4-fold increment in magnitude of augmented native descending aortic strain after proximal grafting (B = 4.19 [CI 1.6, 6.8]; p = 0.002) independent of age and descending aortic size.
conclusionsProsthetic graft replacement of the ascending aorta increases magnitude and rapidity of distal aortic distension. Graft effects are greatest with congenital or genetically associated AA, providing a potential mechanism for increased energy transmission to the native descending aorta and adverse post-surgical aortic remodeling.
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