Open AccessMagnetic resonance angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome
Author(s) -
Julius Matthias Weinrich,
Alexander Lenz,
Gerhard Schön,
Cyrus Behzadi,
Isabel Molwitz,
Frank Oliver Henes,
Bjoern P. Schoennagel,
Gerhard Adam,
Yskert Von Kodolitsch,
Peter Bannas
Publication year - 2022
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0262826
Subject(s) - marfan syndrome , magnetic resonance imaging , medicine , magnetic resonance angiography , aortic root , radiology , angiography , cardiology , aorta
Background To identify magnetic resonance (MR) angiography derived predictors of progressive dilatation and surgery of the aortic root in Marfan syndrome. Material and methods We retrospectively included 111 patients (32.7±16.5 years, range: 7–75 years) with a total of 446 MR angiographies. Aortic diameter growth rates of the entire thoracic aorta and Z-scores were estimated from annual diameter measurements. Aortic root shape was subdivided into three different types: (T0) normal; (T1) localized dilatation; (T2) generalized aortic root dilatation. Aortic diameter, Z-score, age, and aortic root shape at baseline were tested as predictors of aortic root dilatation using a multivariate logistic regression model. Results The highest aortic growth rate was observed at the level of the sinuses of Valsalva. Higher aortic root diameters and Z-scores at baseline predicted an increased growth of the aortic root (p = 0.003 and p 0.05). However, significantly more patients undergoing surgery had a generalized aortic dilatation (19/28, 76.9%) than a localized aortic root dilatation (9/28, 32.1%) (p = 0.001). Conclusion Larger baseline aortic root diameter and Z-score as well as young age predict solely progressive aortic root dilatation in Marfan patients. MR angiography derived type of aortic root shape does not predict aortic growth, but patients with generalized aortic root dilatation are referred more frequently for aortic surgery.