Department of Thoracic Surgery, Shunde Hospital of Southern Medical University (The First People's Hospital of Shunde), Foshan, Guangdong, 528308, China.
Department of Cardiovascular Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, 510180, China.
BMC Cardiovasc Disord. 2024 Oct 16;24(1):560. doi: 10.1186/s12872-024-04206-1.
Understanding the distinct anatomical differences between patients with type B aortic dissection (TBAD) and control patients (CPs) can enhance our knowledge of normal and pathological aortic dimensions. This study aimed to deepen our knowledge of these dimensions by measuring and comparing the anatomical indices of the aortic arch in male patients with TBAD and non-TBAD male patients.
In this cross-sectional observational study, 62 TBAD patients (TBADPs) and 43 CPs were assessed. Using a fit centerline approach, we identified three pivotal anatomical landmarks: Point A, Point B, and Point C. These landmarks represented intersections of the aortic arch with the brachiocephalic trunk, left common carotid artery, and left subclavian artery, respectively. These points defined Zones 1, 2, and 3, which collectively span the entire proximal aorta from the proximal end of the aortic valve to Point C. Our analyses compared key anatomical indices such as diameter of the circumscribed circle (Dcirc), ellipticity, curvature, tortuosity between TBADP and CP at critical points and regions.
TBADPs showed a more circular cross-sectional shape at Points A, B and C, as indicated by reduced values of Dcirc_A (P = 0.031), ellipticity_A (P = 0.034) and ellipticity_B (P = 0.048), together with a significant decrease in Dcirc_C (P = 0.015) and ellipticity_C (P = 0.007). The aortic arch in TBADPs showed enhanced tortuosity in Zone 1 (p = 0.002) and extended elongation in Zone 3 (p = 0.001).
The study found that the aortic arch in male TBAD patients is more circular near its primary branches, has greater tortuosity in Zone 1, and is longer in Zone 3 compared to male control patients.
了解 B 型主动脉夹层（TBAD）患者和对照患者（CPs）之间明显的解剖差异，可以增强我们对正常和病理性主动脉尺寸的认识。本研究旨在通过测量和比较男性 TBAD 患者和非 TBAD 男性患者的主动脉弓解剖指标，加深对这些尺寸的认识。
在这项横断面观察性研究中，评估了 62 名 TBAD 患者（TBADPs）和 43 名 CPs。我们使用拟合中心线方法，确定了三个关键解剖学标志点：A 点、B 点和 C 点。这些标志点分别代表主动脉弓与头臂干、左颈总动脉和左锁骨下动脉的交点。这些点定义了 Zones 1、2 和 3，它们共同涵盖了从主动脉瓣近端到 C 点的整个近端主动脉。我们的分析比较了关键的解剖学指标，如限定圆直径（Dcirc）、椭圆度、曲率、在关键点和区域的 TBADP 和 CP 之间的迂曲度。
TBADPs 在 A、B 和 C 点处呈现出更圆的横截面形状，表现为 Dcirc_A 值降低（P=0.031）、椭圆度_A 值降低（P=0.034）和椭圆度_B 值降低（P=0.048），同时 Dcirc_C 值降低（P=0.015）和椭圆度_C 值降低（P=0.007）。TBADPs 的主动脉弓在 Zone 1 处的迂曲度增加（p=0.002），在 Zone 3 处的延伸度增加（p=0.001）。
研究发现，男性 TBAD 患者的主动脉弓在其主要分支附近更圆，在 Zone 1 处的迂曲度更大，在 Zone 3 处的长度更长，与男性对照患者相比。
