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New classification of aortic dissection during the cardiac cycle as pulsating type and static type evaluated by

Taichi Murayama1, Nobusada Funabashi, Masae Uehara

  • 1Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba 260-8670, Japan.

International Journal of Cardiology
|February 6, 2009
PubMed

Insights

This study characterizes two types of thoracic aortic dissection (AD): pulsating, where the true lumen (TL) expands, and static, where lumens remain unchanged. Pulsating AD is more common in acute phases or when entry is not distal with retrograde flow.

Area of Science:

  • Cardiovascular Imaging
  • Thoracic Surgery
  • Medical Diagnostics

Background:

  • Thoracic aortic dissection (AD) presents with dynamic changes in true lumen (TL) and false lumen (FL) volumes during the cardiac cycle.
  • Distinguishing between pulsating and static AD types is crucial for understanding disease progression and stability.

Purpose of the Study:

  • To characterize pulsating and static types of thoracic aortic dissection (AD) based on four-dimensional computed tomography (4DCT) imaging.
  • To identify factors associated with each AD type.

Main Methods:

  • Twenty subjects with AD and ten controls underwent electrocardiogram (ECG)-gated multislice computed tomography (MSCT).
  • TL and FL areas of the descending thoracic aorta were measured at multiple cardiac phases (0-90% R-R interval) and anatomical levels.
  • AD subjects were classified as pulsating or static based on TL area changes (>125% variation).

Main Results:

  • Five subjects were classified as pulsating-type AD and five as static-type AD.
  • Pulsating-type AD had a shorter mean duration from onset (4.3 months) compared to static-type AD (42.0 months).
  • Distal entry with retrograde FL flow was absent in pulsating-type AD but present in 40% of static-type AD cases.

Conclusions:

  • Pulsating-type AD is more prevalent in acute phases or when the entry site is not distal with retrograde FL.
  • This classification may help differentiate unstable AD (pulsating) from stable AD (static).
  • Further research into the clinical implications of these AD types is warranted.
Abstract

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