Key result
Overt aortic dissection is linked to high shear stress entrance tears in ~74% of cases vs PAU.
Why the study?
The influences of shear stress and atherosclerosis on intimal tear and penetrating atherosclerotic ulcer in acute aortic syndromes have not been fully examined.
Comparison
Sites of high shear stress vs sites of low shear stress in the aorta
Design
Observational study
Authors
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Supports distinct pathomechanisms for overt AD versus PAU; hypothesis-generating for shear stress-guided surveillance.
Observational (n=128)
No
Absolute Event Rate: 73.5% vs 20%
p-value: p=<0.0001
High shear stress and less severe atherosclerosis are associated with intimal tears progressing to overt aortic dissection, whereas low shear stress and more severe atherosclerosis are associated with penetrating atherosclerotic ulcers.
Taguchi et al. (2013) conducted an observational in Acute aortic syndromes (overt aortic dissection and intramural hematoma with penetrating atherosclerotic ulcer) (n=128). Overt aortic dissection vs. Intramural hematoma with penetrating atherosclerotic ulcer was evaluated on Proportion of entrance tears located at sites of high shear stress (p=<0.0001). Entrance tears were significantly more likely to occur at sites of high shear stress in patients with overt aortic dissection compared to those with penetrating atherosclerotic ulcer (73.5% vs 20.0%, p<0.0001).
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