Evidence map›Paper›PMID 33382414›Full record

ArticleEuropean journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery2021

Wall shear stress in the thoracic aorta at rest and with dobutamine stress after arterial switch operation.

Roel L F van der Palen, Joe F Juffermans, Lucia J M Kroft, Mark G Hazekamp, Hildo J Lamb, Nico A Blom, Arno A W Roest, Jos J M Westenberg

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In one paragraph

Article in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.1field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Roel L F van der PalenDivision of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands.
Joe F JuffermansDepartment of Radiology, Leiden University Medical Center, Leiden, Netherlands.
Lucia J M KroftDepartment of Radiology, Leiden University Medical Center, Leiden, Netherlands.
Mark G HazekampDepartment of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands.
Hildo J LambDepartment of Radiology, Leiden University Medical Center, Leiden, Netherlands.
Nico A BlomDivision of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands.
Arno A W RoestDivision of Pediatric Cardiology, Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands.
Jos J M WestenbergDepartment of Radiology, Leiden University Medical Center, Leiden, Netherlands.
Leiden University Medical Center · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesProgressive root dilatation is an important complication in patients with transposition of the great arteries (TGA) after arterial switch operation (ASO) that may be caused by altered flow dynamics. Aortic wall shear stress (WSS) distribution at rest and under dobutamine stress (DS) conditions using 4D flow magnetic resonance imaging were investigated in relation to thoracic aorta geometry.

methods4D flow magnetic resonance imaging was performed in 16 adolescent TGA patients after ASO (rest and DS condition) and in 10 healthy controls (rest). The primary outcome measure was the WSS distribution along the aortic segments and the WSS change with DS in TGA patients. Based on the results, we secondary zoomed in on factors [aortic geometry and left ventricular (LV) function parameters] that might relate to these WSS distribution differences. Aortic diameters, arch angle, LV function parameters (stroke volume, LV ejection fraction, cardiac output) and peak systolic aortic WSS were obtained.

resultsTGA patients had significantly larger neoaortic root and smaller mid-ascending aorta (AAo) dimensions and aortic arch angle. At rest, patients had significantly higher WSS in the entire thoracic aorta, except for the dilated root. High WSS levels beyond the proximal AAo were associated with the diameter decrease from the root to the mid-AAo (correlation coefficient r = 0.54-0.59, P = 0.022-0.031), not associated with the aortic arch angle. During DS, WSS increased in all aortic segments (P < 0.001), most pronounced in the AAo segments. The increase in LV ejection fraction, stroke volume and cardiac output as a result of DS showed a moderate linear relationship with the WSS increase in the distal AAo (correlation coefficient r = 0.54-0.57, P = 0.002-0.038).

conclusionsIncreased aortic WSS was observed in TGA patients after ASO, related to the ASO-specific geometry, which increased with DS. Stress-enhanced elevated WSS may play a role in neoaortic root dilatation and anterior aortic wall thinning of the distal AAo.

Indexed as

Arterial Switch OperationTransposition of Great VesselsAdolescentAortaAorta, ThoracicBlood Flow VelocityDobutamineHemodynamicsHumansStress, MechanicalDobutamine4D flow MRIArterial switch operationDobutamine stressTransposition of the great arteriesWall shear stress

Identifiers

PMID33382414
PMCPMC8083947
OpenAlexW3113505448

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.