非线性尺寸效应和在上升性大动脉的插曲性进展
Carlos Alberto Campello Jorge1,2, Prabhvir S Marway1,2, Gregory Spahlinger1,2
1Department of Radiology, University of Michigan.
medRxiv : the preprint server for health sciences
|September 26, 2025
概括
上升的大动脉生长是非线性的和偶发的,不是连续的. 基线大小和生长显示出U形关系,近四分之一的患者经历了生长爆发.
科学领域:
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
- 医学成像分析 医学成像分析
背景情况:
- 预测上升大动脉 (AsAo) 的增长是复杂的.
- 传统模型假设线性,连续增长,可能过度简化疾病的进展.
研究的目的:
- 评估基线AsAo大小和随后的增长之间的非线性关联.
- 确定患者的生长轨迹是连续的还是偶发的.
主要方法:
- 对3315名具有≥2次成像扫描的患者进行回顾性研究 (2012-2024年).
- 使用多变量回归和通用添加模型 (GAMs) 来分析基线Z分数和增长.
- 在一组1055名患者中分类的纵向表型 (稳定,稳定与噪音,连续,偶发).
主要成果:
- 基线Z-score显示出与生长有显著的U形关联 (p<0.001).
- 在小 (Z<0) 和严重扩张 (Z>5) 基线大小时,生长率更高.
- 50.4% 稳定,21.6% 稳定与噪音,5.4% 持续,22.6% 间歇增长.
- 在那些有可测量的增长的人中,81%的人表现出偶发性增长.
结论:
- 随着Ao的增长更好地被非线性,间歇的模式描述,而不是线性,连续的模式.
- 插曲性生长很常见,特别是在有可测量的大动脉扩张的患者中.
- 研究结果建议重新评估胸前大动脉疾病的监测策略和风险沟通.
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