Significance of Hemodynamics Biomarkers, Tissue Biomechanics and Numerical Simulations in the Pathogenesis of Ascending Thoracic Aortic Aneurysms

Guidelines for the treatment of aortic wall diseases are based on measurements of maximum aortic diameter. However, aortic rupture or dissections do occur for small aortic diameters. Growing scientific evidence underlines the importance of biomechanics and hemodynamics in aortic disease development and progression. Wall shear stress (WWS) is an important hemodynamics marker that depends on aortic wall morphology and on the aortic valve function. WSS could be helpful to interpret aortic wall remodeling and define personalized risk criteria. The complementarity of Computational Fluid Dynamics and 4D Magnetic Resonance Imaging as tools for WSS assessment is a promising reality. The potentiality of these innovative technologies will provide maps or atlases of hemodynamics biomarkers to predict aortic tissue dysfunction. Ongoing efforts should focus on the correlation between these non-invasive imaging biomarkers and clinico-pathologic situations for the implementation of personalized medicine in current clinical practice.

Automated summary

Guidelines for the treatment of aortic wall diseases are typically based on aortic diameter measurements, but recent scientific evidence suggests that biomechanics and hemodynamics play crucial roles in the development of aortic diseases. Wall shear stress is a key hemodynamics marker that can help interpret aortic wall remodeling and define personalized risk criteria. The use of Computational Fluid Dynamics and 4D Magnetic Resonance Imaging for assessing wall shear stress is a promising approach in predicting aortic tissue dysfunction.