For a study, researchers sought to determine the natural progression of non-complicated Alzheimer’s disease (AD) and see if distinct false lumen (FL) flow patterns measured using magnetic resonance imaging (MRI) had independent predictive value for AD-related events beyond known morphologic markers.

About 131 consecutive patients were followed up on following acute AD with persisting patent FL in the descending aorta, 78 with surgically treated type A dissections, and 53 with medically treated type B dissections. By computed CT, the maximum aorta diameter, real lumen compression, entrance tear, and partial FL thrombosis were measured. MRI was used to assess real systolic lumen and FL flow volumes and diastolic antegrade and retrograde flows throughout the first year following AD. 

About 43 patients had aorta-related incidents after a median follow-up period of 8.0 years (IQR: 4.6-10.9 years) (25 died and 18 required endovascular treatment). FL systolic antegrade flow was ≥30% of total systolic antegrade flow, and retrograde diastolic flow was ≥80% of total diastolic FL flow was predictive of aortic events. Aortic diameter >45 mm (HR: 2.91), type B dissection (HR: 2.44), and MRI flow pattern (HR: 16.87) were all independent predictors of AD-related events in multivariate analysis.

Patients with high systolic antegrade flow volume in the FL, considerable diastolic retrograde flow as measured by MRI, and aortic diameter >45 mm are at increased risk for problems and should be managed more aggressively.

Reference: jacc.org/doi/10.1016/j.jacc.2022.04.017