The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management
ABSTRACT: Thoracic aortopathies result in aneurysmal expansion of the aorta that can lead to rapidly fatal aortic dissection or rupture. Despite the availability of abundant non-invasive imaging tools, the greatest contemporary challenge in the management of thoracic aortic aneurysm (TAA) is the lac...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Journal of Cardiovascular Magnetic Resonance |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1097664725000274 |
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| author | James Nadel José Rodríguez-Palomares Alkystis Phinikaridou Claudia Prieto Pier-Giorgio Masci René Botnar |
| author_facet | James Nadel José Rodríguez-Palomares Alkystis Phinikaridou Claudia Prieto Pier-Giorgio Masci René Botnar |
| author_sort | James Nadel |
| collection | DOAJ |
| description | ABSTRACT: Thoracic aortopathies result in aneurysmal expansion of the aorta that can lead to rapidly fatal aortic dissection or rupture. Despite the availability of abundant non-invasive imaging tools, the greatest contemporary challenge in the management of thoracic aortic aneurysm (TAA) is the lack of reliable metrics for risk stratification, with absolute aortic diameter, growth rate, and syndromic factors remaining the primary determinants by which prophylactic surgical intervention is adjudged. Advanced cardiovascular magnetic resonance (CMR) techniques present a potential key to unlocking insights into TAA that could guide disease surveillance and surgical intervention. CMR has the capacity to encapsulate the aorta as a complex biomechanical structure, permitting the determination of aortic volume, morphology, composition, distensibility, and fluid dynamics in a time-efficient manner. Nevertheless, current standard-of-care imaging protocols do not harness its full capacity. This state-of-the-art review explores the emerging role of CMR in the assessment of TAA and presents a blueprint for the required paradigm shift away from aortic size as the sole metric for risk-stratifying TAA. |
| format | Article |
| id | doaj-art-6ef266b20e24479da44aa46f2eb0dca6 |
| institution | DOAJ |
| issn | 1097-6647 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Cardiovascular Magnetic Resonance |
| spelling | doaj-art-6ef266b20e24479da44aa46f2eb0dca62025-08-20T03:10:21ZengElsevierJournal of Cardiovascular Magnetic Resonance1097-66472025-01-0127110186510.1016/j.jocmr.2025.101865The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve managementJames Nadel0José Rodríguez-Palomares1Alkystis Phinikaridou2Claudia Prieto3Pier-Giorgio Masci4René Botnar5Biomedical Engineering and Imaging Sciences, King’s College London, London, UK; Clinical Cardiology Group, Heart Research Institute, Newtown, Australia; Department of Cardiology, St. Vincent’s Hospital, Darlinghurst, Australia; Corresponding author.Department of Cardiology, Vall d’Hebron Hospital Universitari, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain; Cardiovascular Diseases, Vall d′Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain; CIBER de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, SpainBiomedical Engineering and Imaging Sciences, King’s College London, London, UKBiomedical Engineering and Imaging Sciences, King’s College London, London, UK; School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, ChileBiomedical Engineering and Imaging Sciences, King’s College London, London, UKBiomedical Engineering and Imaging Sciences, King’s College London, London, UK; School of Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile; Millennium Institute for Intelligent Healthcare Engineering, Santiago, Chile; Institute of Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile; Institute for Advanced Study, Technical University of Munich, Garching, GermanyABSTRACT: Thoracic aortopathies result in aneurysmal expansion of the aorta that can lead to rapidly fatal aortic dissection or rupture. Despite the availability of abundant non-invasive imaging tools, the greatest contemporary challenge in the management of thoracic aortic aneurysm (TAA) is the lack of reliable metrics for risk stratification, with absolute aortic diameter, growth rate, and syndromic factors remaining the primary determinants by which prophylactic surgical intervention is adjudged. Advanced cardiovascular magnetic resonance (CMR) techniques present a potential key to unlocking insights into TAA that could guide disease surveillance and surgical intervention. CMR has the capacity to encapsulate the aorta as a complex biomechanical structure, permitting the determination of aortic volume, morphology, composition, distensibility, and fluid dynamics in a time-efficient manner. Nevertheless, current standard-of-care imaging protocols do not harness its full capacity. This state-of-the-art review explores the emerging role of CMR in the assessment of TAA and presents a blueprint for the required paradigm shift away from aortic size as the sole metric for risk-stratifying TAA.http://www.sciencedirect.com/science/article/pii/S1097664725000274AortopathyAortic aneurysmCardiac magnetic resonance imaging4D flow |
| spellingShingle | James Nadel José Rodríguez-Palomares Alkystis Phinikaridou Claudia Prieto Pier-Giorgio Masci René Botnar The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management Journal of Cardiovascular Magnetic Resonance Aortopathy Aortic aneurysm Cardiac magnetic resonance imaging 4D flow |
| title | The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management |
| title_full | The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management |
| title_fullStr | The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management |
| title_full_unstemmed | The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management |
| title_short | The future of cardiovascular magnetic resonance imaging in thoracic aortopathy: blueprint for the paradigm shift to improve management |
| title_sort | future of cardiovascular magnetic resonance imaging in thoracic aortopathy blueprint for the paradigm shift to improve management |
| topic | Aortopathy Aortic aneurysm Cardiac magnetic resonance imaging 4D flow |
| url | http://www.sciencedirect.com/science/article/pii/S1097664725000274 |
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