Predicting Late Adverse Events in Uncomplicated Stanford Type B Aortic Dissection: Results From the ROADMAP Validation Study

作者：Dominik Fleischmann, Domenico Mastrodicasa, Martin J. Willemink, Valery L. Turner, Virginia Hinostroza, Nicholas S. Burris, Bo Yang, Kate Hanneman, Maral Ouzounian, Daniel Ocazionez Trujillo, Rana O. Afifi, Anthony L. Estrera, Joan M. Lacomis, Ibrahim Sultan, Thomas G. Gleason, Davide Pacini, Gianluca Folesani, Luigi Lovato, Arthur E. Stillman, Carlo N. De Cecco, Edward P. Chen, Ricarda Hinzpeter, Hatem Alkadhi, Sandeep Hedgire, Thoralf M. Sundt, Sander M. J. van Kuijk, Geert Willem H. Schurink, Anne S. Chin, Marina Codari, Anna M. Sailer, Gabriel Mistelbauer, Mohammad H. Madani, Kathrin Bäumler, Jody Shen, Kwok-Hung Lai, Michael P. Fischbein, D. Craig Miller · 发表于：Circulation Cardiovascular Imaging · 年份：2025 · DOI：10.1161/circimaging.124.016766 · 被引用次数：5 · 研究领域：Aortic Disease and Treatment Approaches、Aortic aneurysm repair treatments、Connective tissue disorders research

BACKGROUND: Risk stratification is highly desirable in patients with uncomplicated Stanford type B aortic dissection but inadequately supported by evidence. We sought to validate externally a published prediction model for late adverse events (LAEs), consisting of 1 clinical (connective tissue disease) and 4 imaging variables: maximum aortic diameter, false lumen circumferential angle, false lumen outflow, and number of identifiable intercostal arteries. METHODS: We assembled a retrospective multicenter cohort (ROADMAP [Registry of Aortic Diseases to Model Adverse Events and Progression]) of 401 patients with uncomplicated Stanford type B aortic dissection presenting to 1 of 8 aortic centers between 2001 and 2013, followed until 2020. LAEs were defined as fatal or nonfatal aortic rupture, new refractory hypertension or pain, organ or limb ischemia, aortic aneurysm formation (≥6 cm), or rapid growth (≥1 cm per year). We applied the original model parameters to the validation cohort and examined the effect on risk categorization using LAE end points. RESULTS: One hundred and seventy-six patients (44%) with incomplete imaging or clinical data were excluded. Of 225 patients in the final cohort, 90 (40%) developed LAEs, predominantly driven by aneurysm formation. Baseline maximum aortic diameter was significantly larger in patients with (42.6 [95% CI, 39.1–45.8] mm) compared with patients without LAEs (39.9 [95% CI, 36.3–44.2] mm; P =0.001). A multivariable Cox regression model in...