Publications by authors named "Paula Rudenick"

Article Synopsis
  • A study evaluated the long-term outcomes of patients with acute aortic dissection (AD) who had a patent false lumen, indicating that even without immediate complications, there is a risk for future events.
  • Researchers assessed various anatomical and flow characteristics using MRI and CT scans and followed 131 patients over an average of 8 years, discovering significant predictors of aortic-related events.
  • Key findings revealed that high systolic flow and significant diastolic retrograde flow in the false lumen, along with larger aortic diameter, were strong risk factors, suggesting that patients with these indicators may benefit from more proactive treatment approaches.
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The mechanisms leading to cardiac remodeling in Marfan syndrome (MFS) are a matter of debate since it could be either due to structural dysfunction of the myocardial extracellular matrix or to increased afterload caused by the dilated aorta. We aim to characterize the presence of abnormal myocardial function in MFS and to investigate its potential association with increased afterload. Aorta, left ventricle (LV) and the postsystolic thickening (PST) were analyzed in echocardiography in Fbn1 mice and in patients with MFS in comparison with wild type (WT) mice and healthy humans.

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Aortic wall stiffness, tear size and location and the presence of abdominal side branches arising from the false lumen (FL) are key properties potentially involved in FL enlargement in chronic aortic dissections (ADs). We hypothesize that temporal variations on FL flow patterns, as measured in a cross-section by phase-contrast magnetic resonance imaging (PC-MRI), could be used to infer integrated information on these features. In 33 patients with chronic descending AD, instantaneous flow profiles were quantified in the FL at diaphragm level by PC-MRI.

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Objective: The aortic isthmus (AoI) blood flow has a characteristic shape with a small end-systolic notch observed during the third trimester of pregnancy. However, what causes the appearance of this notch is not fully understood. We used a lumped model of the fetal circulation to study the possible factors causing the end-systolic notch and the changes of AoI flow through gestation.

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Introduction: Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood-flow redistribution in order to maintain perfusion to the brain. However, some hemodynamic parameters that might be more directly related to staging of the disease cannot be measured non-invasively in clinical practice. For this, we developed a patient-specific model of the fetal circulation to estimate vascular properties of each individual.

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Descending aortic dissection (DAD) is associated with high morbidity and mortality rates. Aortic wall stiffness is a variable often altered in DAD patients and potentially involved in long-term outcome. However, its relevance is still mostly unknown.

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Intrauterine growth restriction (IUGR) due to placental insufficiency is associated with blood flow redistribution in order to maintain delivery of oxygenated blood to the brain. Given that, in the fetus the aortic isthmus (AoI) is a key arterial connection between the cerebral and placental circulations, quantifying AoI blood flow has been proposed to assess this brain sparing effect in clinical practice. While numerous clinical studies have studied this parameter, fundamental understanding of its determinant factors and its quantitative relation with other aspects of haemodynamic remodeling has been limited.

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Article Synopsis
  • An aortic dissection (AD) is a severe condition characterized by the tearing of the arterial wall, leading to the formation of a false lumen, which poses management and treatment challenges due to the risk of further complications.
  • The study focused on how factors like blood flow dynamics and wall stress influence the progression of chronic type B aortic dissections and their associated risks.
  • Researchers validated a computational fluid dynamics (CFD) tool by comparing its results against experimental data from physical models, finding strong correlations especially when the dissection tear was sufficiently large.
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Objective: Management and follow-up of chronic aortic dissections continue to be a clinical challenge due to progressive dilatation and subsequent rupture. To predict complications, guidelines suggest follow-up of aortic diameter. However, dilatation is triggered by hemodynamic parameters (pressures/wall shear stresses) and geometry of false (FL) and true lumen (TL), information not captured by diameter alone.

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The management and follow-up of chronic type B aortic dissections continues being a clinical challenge. Patients with chronic type B dissection have high mid/long term mortality mainly due to progressive aortic dilatation and subsequent rupture.

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