2023
“Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute
Zafar M, Ziganshin B, Li Y, Ostberg N, Rizzo J, Tranquilli M, Mukherjee S, Elefteriades J. “Big Data” Analyses Underlie Clinical Discoveries at the Aortic Institute. The Yale Journal Of Biology And Medicine 2023, 96: 427-440. PMID: 37780996, PMCID: PMC10524815, DOI: 10.59249/lndz2964.Peer-Reviewed Original ResearchConceptsBig dataArtificial intelligenceThoracic aortic aneurysmArtificial intelligence techniquesData setsAortic aneurysmLarge clinical data setsIntelligence techniquesAdvanced machineYale-New Haven HospitalClinical data setsAortic aneurysm patientsAortic root dilatationBicuspid aortic valveProspective clinical databaseNew Haven HospitalLarge genetic data setsIntelligenceSequencing filesThoracoabdominal aortaAortic dilatationMale patientsRisk prognosticationRoot dilatationSurgical treatmentSafety of cerebrospinal fluid drainage in descending and thoracoabdominal aortic replacement surgery
Nasir A, Zafar M, Abdelbaky M, Papanikolaou D, Ellauzi H, Shaikh M, Ziganshin B, Elefteriades J. Safety of cerebrospinal fluid drainage in descending and thoracoabdominal aortic replacement surgery. Annals Of Cardiothoracic Surgery 2023, 12: 47683-47483. PMID: 37817851, PMCID: PMC10561341, DOI: 10.21037/acs-2023-scp-0121.Peer-Reviewed Original ResearchCerebrospinal fluid drainageThoracoabdominal aortic aneurysmsSpinal cord injuryOpen surgical repairSurgical repairElectronic health recordsAortic aneurysmFluid drainagePersistent cerebrospinal fluid leakageAortic replacement surgeryMean hospital lengthSpinal cord protectionRetrospective chart reviewThoracic aortic aneurysmThoracoabdominal aortic diseaseCerebrospinal fluid leakageLong-term survivalHospital mortalityHospital lengthPermanent paraplegiaChart reviewMinor complicationsPatient agePostoperative courseCutaneous fistulaNatural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack
Zafar M, Elefteriades J. Natural History and Intervention Thresholds for Ascending Thoracic Aortic Aneurysm—Not an Easy Nut to Crack. JAMA Cardiology 2023, 8: 512-512. PMID: 36920367, DOI: 10.1001/jamacardio.2023.0153.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAscending Thoracic Aortic AneurysmsAortic aneurysmNatural historyIntervention thresholdBicuspid aortopathy does not require earlier surgical intervention
Zafar M, Wu J, Vinholo T, Li Y, Papanikolaou D, Ellauzi H, Ostberg N, Kalyanasundaram A, Kalogerakos P, Mukherjee S, Ziganshin B, Rizzo J, Elefteriades J. Bicuspid aortopathy does not require earlier surgical intervention. Journal Of Thoracic And Cardiovascular Surgery 2023, 168: 760-769.e4. PMID: 37088130, DOI: 10.1016/j.jtcvs.2023.04.017.Peer-Reviewed Original ResearchBicuspid aortic valveAdverse aortic eventsEvent-free survivalAortic eventsAortic sizeAortic diameterAortic growth rateEarly surgical interventionLong-term complicationsRisk of complicationsThoracic aortic aneurysmAortic deathComplication rateSurgical repairOperative repairProphylactic surgerySurgical interventionAortic aneurysmAortic valveSurgical correctionBicuspid aortopathyRelative riskExpert centersTAV-ATAAPatientsAortic Size at the Time of Type A and Type B Dissections
Perez Z, Zafar M, Velasco J, Sonsino A, Ellauzi H, John C, Kalyanasundaram A, Ziganshin B, Elefteriades J. Aortic Size at the Time of Type A and Type B Dissections. The Annals Of Thoracic Surgery 2023, 116: 262-268. PMID: 37062339, DOI: 10.1016/j.athoracsur.2023.03.037.Peer-Reviewed Original ResearchConceptsType B dissectionTime of dissectionB dissectionAortic sizeAortic diameterBicuspid aortic valveThoracic aortic aneurysmAortic interventionAortic dissectionSurgical interventionAortic aneurysmFemale sexAortic valveThoracic aortaProphylactic repairUnadjusted regressionLeft shiftLogistic regressionDissectionNew guidelinesType ASize criteriaOddsInterventionTime of typesNonsize Criteria for Surgical Intervention on the Ascending Thoracic Aorta
Elefteriades J, Ziganshin B, Zafar M. Nonsize Criteria for Surgical Intervention on the Ascending Thoracic Aorta. Aorta 2023, 11: 071-086. PMID: 37172942, PMCID: PMC10232037, DOI: 10.1055/s-0043-1766114.Peer-Reviewed Original ResearchThoracic aortic aneurysmSurgical interventionAortic eventsAortic dissectionSubsternal chest painBlood pressure elevationBicuspid aortic valveAfferent neural pathwaysAscending thoracic aortaEmission Tomography ImagingPositron emission tomography (PET) imagingAortic stressAscending aneurysmAortic surgeryChest painEarly surgerySpecific genetic aberrationsHigh rupture riskMural thickeningRoot dilatationBicuspid valvePressure elevationAneurysm patientsAortic aneurysmAortic riskFate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University
Wu J, Zafar M, Liu Y, Chen J, Li Y, Ziganshin B, Ellauzi H, Mukherjee S, Rizzo J, Elefteriades J. Fate of the unoperated ascending thoracic aortic aneurysm: three-decade experience from the Aortic Institute at Yale University. European Heart Journal 2023, 44: 4579-4588. PMID: 36994934, DOI: 10.1093/eurheartj/ehad148.Peer-Reviewed Original ResearchConceptsAdverse aortic eventsThoracic aortic aneurysmAortic sizeAortic aneurysmCox regressionAortic growthRisk factorsSignificant independent risk factorsMultivariable Cox regressionIndependent risk factorCohort of patientsUnivariable Cox regressionSignificant protective factorAortic deathATAA patientsAortic eventsPrimary endpointSurgical interventionThree-decade experienceNatural historyYearly riskProtective factorsAneurysmsPatientsIntervention criteriaKIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection
Velasco J, Li Y, Ziganshin B, Zafar M, Rizzo J, Ma D, Zang H, Kalyanasundaram A, Elefteriades J. KIF6 Trp719Arg Genetic Variant Increases Risk for Thoracic Aortic Dissection. Genes 2023, 14: 252. PMID: 36833179, PMCID: PMC9956195, DOI: 10.3390/genes14020252.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAortic dissectionOdds ratioVariant statusArg allele carriersThoracic aortic dissectionOccurrence of ADAortic sizeArg alleleMarked adverse impactTAA patientsAortic aneurysmClinical assessmentSurgical decisionAllele carriersIncrease riskVariant patientsArg carriersPilot studyDissectionImportant intracellular functionsConfirmatory findingsPatientsAneurysmsPresent study
2021
A probabilistic and anisotropic failure metric for ascending thoracic aortic aneurysm risk assessment
Liu M, Liang L, Zou Q, Ismail Y, Lou X, Iannucci G, Chen E, Leshnower B, Elefteriades J, Sun W. A probabilistic and anisotropic failure metric for ascending thoracic aortic aneurysm risk assessment. Journal Of The Mechanics And Physics Of Solids 2021, 155: 104539. DOI: 10.1016/j.jmps.2021.104539.Peer-Reviewed Original ResearchATAA patientsAortic wallAortic tissue samplesThoracic aortic aneurysmAortic aneurysmAneurysm rupturePatientsRisk assessmentTissue samplesCharacteristic curveFailure metricsTsai-Hill failure criterionCT imagesRiskTensile failure testsMaximum principal stressRupture risk assessmentPrevious studiesAssessment
2018
Genetic testing to modulate when to operate in thoracic aortic disease
Kostiuk V, Brownstein A, Ziganshin B, Elefteriades J. Genetic testing to modulate when to operate in thoracic aortic disease. Journal Of Visualized Surgery 2018, 4: 193-193. DOI: 10.21037/jovs.2018.07.14.Peer-Reviewed Original ResearchMolecular geneticsThoracic aortic aneurysmSurgical treatment optionsNon-syndromic thoracic aortic aneurysmsMolecular profilingSmooth muscle cell functionFamilial thoracic aortic aneurysmsMultiple genesSpecific genesMuscle cell functionTAA patientsTreatment optionsExtracellular matrixCell functionThoracic aortic diseaseGenesPositive family historyGeneticsProfilingTAA developmentAortic diseaseAortic aneurysmCurrent classificationDisease progressionFamily historyChapter 10 Guilt by Association Paradigm for Detection of Silent Aortic Aneurysms
Findlay R, Thompson O, Ziganshin B, Elefteriades J. Chapter 10 Guilt by Association Paradigm for Detection of Silent Aortic Aneurysms. 2018, 107-118. DOI: 10.1016/b978-0-12-809979-7.00010-9.Peer-Reviewed Original ResearchThoracic aortic aneurysmAortic aneurysmAortic diseaseGiant cell arteritisAortic arch abnormalitiesBicuspid aortic valveThoracic aortic diseaseAbdominal aortic aneurysmConnective tissue disordersCell arteritisClinical findingsHigh morbidityAortic valveIncidental findingArch abnormalitiesClinical markersFamily historyTissue disordersRenal cystsTAA developmentAneurysmsIntracranial aneurysmsEarly detectionDiseasePatientsChapter 22 Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection
Percy A, Mukherjee S, Ziganshin B, Elefteriades J. Chapter 22 Current Status of Medical Therapy of Thoracic Aortic Aneurysm and Dissection. 2018, 235-249. DOI: 10.1016/b978-0-12-809979-7.00022-5.Peer-Reviewed Original ResearchThoracic aortic aneurysmAortic aneurysmMost thoracic aortic aneurysmsAngiotensin receptor blockersClasses of medicationsAortic aneurysm developmentRelevant clinical endpointsAortic aneurysm expansionAsymptomatic patientsLifestyle modificationReceptor blockersMedical therapySurgical repairAortic catastropheClinical evidencePathophysiologic pathwaysSurgical interventionPathophysiologic basisTreatment modalitiesAneurysm expansionClinical endpointsClinical trialsCurrent guidelinesAneurysm formationClinical studiesTime to Move to Earlier Intervention for Thoracic Aortic Aneurysm?
Gryaznov A, Ziganshin B, Elefteriades J. Time to Move to Earlier Intervention for Thoracic Aortic Aneurysm? Structural Heart 2018, 2: 10-22. DOI: 10.1080/24748706.2017.1404664.Peer-Reviewed Original ResearchThoracic aortic aneurysmBody surface areaAortic aneurysmMost life-threatening complicationsAortic growth rateEarly prophylactic interventionAcute aortic dissectionLife-threatening complicationsPatient/yearProphylactic surgical interventionSpecific genetic aberrationsAortic dissectionAortic sizeAortic diseaseCurrent gold standardSurgical interventionPatient heightProphylactic interventionsThoracic aortaAneurysm diseaseCommon causeFamily historyEarly diagnosisEarly interventionGenetic aberrations
2016
Advanced Glycation End Products and its Soluble Receptors in the Pathogenesis of Thoracic Aortic Aneurysm
Prasad K, Sarkar A, Zafar M, Shoker A, Moselhi H, Tranquilli M, Ziganshin B, Elefteriades J. Advanced Glycation End Products and its Soluble Receptors in the Pathogenesis of Thoracic Aortic Aneurysm. Aorta 2016, 4 DOI: 10.12945/j.aorta.2016.15.018.Peer-Reviewed Original Research
2013
Thoracic Aortic Disease
Ziganshin B, Elefteriades J. Thoracic Aortic Disease. 2013, 331-353. DOI: 10.1007/978-1-4471-4441-0_23.Peer-Reviewed Original ResearchThoracic aortic diseaseAortic aneurysmAortic diseaseAortic growth rateAge 65 yearsThoracic aortic aneurysmCurrent diagnostic approachesDate management strategiesDevastating complicationAortic dissectionIndolent processAortic pathologyPathognomonic symptomsFirst manifestationRecent guidelinesCommon causeAneurysmsDiagnostic approachDisease controlDiseaseSilent natureFamilial inheritanceVirulent diseaseTimely detectionGenetic diseases
2012
Respecting Symptoms in Thoracic Aortic Aneurysm Management: A Case of Symptomatic Necrotizing Granulomatous Aortitis
Kuzmik G, Sang A, Cai G, Tranquilli M, Elefteriades J. Respecting Symptoms in Thoracic Aortic Aneurysm Management: A Case of Symptomatic Necrotizing Granulomatous Aortitis. International Journal Of Angiology 2012, 21: 151-154. PMID: 23997559, PMCID: PMC3578625, DOI: 10.1055/s-0032-1315632.Peer-Reviewed Case Reports and Technical NotesAortic aneurysm managementComputed tomography angiographyThoracic aortic aneurysmInterventional criteriaChest painAortic pathologyAortic ruptureNoninfectious etiologiesRadiographic evidenceUnclear etiologyAortic aneurysmTomography angiographyGranulomatous aortitisSurgical decisionAneurysm managementOperating roomAortitisIrregular contoursAneurysmsAortaEtiologySymptomsImminent riskRupturePain
2011
Epidemiology and Natural History of Thoraco-Abdominal Aortic Aneurysms
Stein L, Elefteriades J. Epidemiology and Natural History of Thoraco-Abdominal Aortic Aneurysms. 2011, 25-32. DOI: 10.1007/978-88-470-1857-0_3.Peer-Reviewed Original ResearchThoracic aortic aneurysmAortic aneurysmThoraco-abdominal aortic aneurysmChronic obstructive pulmonary diseaseObstructive pulmonary diseaseSmooth muscle cellsTAAA rupturePulmonary diseaseTertiary centerAortic diameterTAAANatural historyAneurysm growthMuscle cellsOptimal timingAneurysmsPresent unique challengesRiskBetter identificationRupture increasesHypertensionSmokingPatientsDerangementUnique challenges
2007
Gene Expression Signature in Peripheral Blood Detects Thoracic Aortic Aneurysm
Wang Y, Barbacioru CC, Shiffman D, Balasubramanian S, Iakoubova O, Tranquilli M, Albornoz G, Blake J, Mehmet NN, Ngadimo D, Poulter K, Chan F, Samaha RR, Elefteriades JA. Gene Expression Signature in Peripheral Blood Detects Thoracic Aortic Aneurysm. PLOS ONE 2007, 2: e1050. PMID: 17940614, PMCID: PMC2002514, DOI: 10.1371/journal.pone.0001050.Peer-Reviewed Original ResearchMeSH KeywordsAortic Aneurysm, ThoracicCase-Control StudiesCluster AnalysisFalse Positive ReactionsGene ExpressionGene Expression ProfilingGene Expression RegulationGenome, HumanHumansOligonucleotide Array Sequence AnalysisReproducibility of ResultsReverse Transcriptase Polymerase Chain ReactionSensitivity and SpecificityTranscription, GeneticConceptsPeripheral blood cellsGene expression signaturesAortic aneurysmPeripheral bloodTAA patientsExpression signaturesBlood cellsBlood-based gene expression testAdverse clinical outcomesElective surgical repairThoracic aortic aneurysmPeripheral blood samplesPotential diagnostic markerPotential signature genesClassifier genesGene expression testDistinct gene expression signaturesSurgical repairClinical outcomesReal-time PCRBlood samplesRisk individualsTherapeutic interventionsDisease statusHigh mortality
2006
Familial Thoracic Aortic Aneurysms and Dissections—Incidence, Modes of Inheritance, and Phenotypic Patterns
Albornoz G, Coady MA, Roberts M, Davies RR, Tranquilli M, Rizzo JA, Elefteriades JA. Familial Thoracic Aortic Aneurysms and Dissections—Incidence, Modes of Inheritance, and Phenotypic Patterns. The Annals Of Thoracic Surgery 2006, 82: 1400-1405. PMID: 16996941, DOI: 10.1016/j.athoracsur.2006.04.098.Peer-Reviewed Original ResearchConceptsThoracic aortic aneurysmAbdominal aortic aneurysmFamilial thoracic aortic aneurysmsAortic aneurysmMarfan syndromeAortic growth rateNon-Marfan patientsIncidence of hypertensionAggressive clinical entityPredominant inheritance patternSporadic groupMarfan groupStudy patientsCerebral circulationClinical entityThoracic aortaAbdominal aortaInheritance patternMFS groupMFS patientsTAA groupLarge cohortAneurysm sitePatientsAneurysmsMatrix Metalloproteinases in Thoracic Aortic Aneurysm Disease
Botta D, Elefteriades J. Matrix Metalloproteinases in Thoracic Aortic Aneurysm Disease. International Journal Of Angiology 2006, 15: 1-8. DOI: 10.1007/s00547-006-2080-z.Peer-Reviewed Original ResearchAortic aneurysmMatrix metalloproteinasesThoracic aortic aneurysm diseaseAneurysmal aortic segmentsThoracic aortic aneurysmAortic aneurysm diseaseDiseased aortic wallPharmacologic therapySerum levelsAneurysm diseaseAortic segmentsMMP-9Aortic wallClinical monitoringMMP-1Tissue levelsAneurysmsMetalloproteinasesMMPsPivotal roleProteolytic enzymesSite of synthesisPathophysiologyTherapyDisease