{"id":"https://openalex.org/W7225423282","doi":"https://doi.org/10.64898/2026.11.05.26367281","title":"Digital Twin-Based Risk Stratification Integrating Aortic Shape and Wall Mechanics in Acute Uncomplicated Type B Aortic Dissection","display_name":"Digital Twin-Based Risk Stratification Integrating Aortic Shape and Wall Mechanics in Acute Uncomplicated Type B Aortic Dissection","publication_year":2026,"publication_date":"2026-11-06","ids":{"openalex":"https://openalex.org/W7225423282","doi":"https://doi.org/10.64898/2026.11.05.26367281"},"language":"en","primary_location":{"id":"doi:10.64898/2026.11.05.26367281","doi":"https://doi.org/10.64898/2026.11.05.26367281","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367281","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367281.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367281.full.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5161032267","display_name":"Minliang Liu","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Minliang Liu","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5025834275","display_name":"Zhongxi Zhou","orcid":"https://orcid.org/0009-0001-4969-1645","observed_orcids":["https://orcid.org/0009-0001-4969-1645"]},"institutions":[{"id":"https://openalex.org/I12315562","display_name":"Texas Tech University","ror":"https://ror.org/0405mnx93","country_code":"US","type":"education","lineage":["https://openalex.org/I12315562"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Zhongxi Zhou","raw_affiliation_strings":["Texas Tech University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Texas Tech University;","institution_ids":["https://openalex.org/I12315562"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5101277286","display_name":"Yuhang Du","orcid":"https://orcid.org/0009-0001-3809-962X","observed_orcids":["https://orcid.org/0009-0001-3809-962X","https://orcid.org/0000-0002-4734-7656"]},"institutions":[{"id":"https://openalex.org/I12315562","display_name":"Texas Tech University","ror":"https://ror.org/0405mnx93","country_code":"US","type":"education","lineage":["https://openalex.org/I12315562"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Yuhang Du","raw_affiliation_strings":["Texas Tech University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Texas Tech University;","institution_ids":["https://openalex.org/I12315562"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084100793","display_name":"Hannah L. Cebull","orcid":"https://orcid.org/0000-0002-8800-2136","observed_orcids":["https://orcid.org/0000-0002-8800-2136"]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Hannah L. Cebull","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5161138523","display_name":"Hai Dong","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Hai Dong","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104831791","display_name":"John N. Oshinski","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John N. Oshinski","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5090408695","display_name":"John Alex Elefteriades","orcid":"https://orcid.org/0000-0001-6255-8139","observed_orcids":["https://orcid.org/0000-0001-6255-8139"]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"John A Elefteriades","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5050649061","display_name":"Rudolph L. Gleason","orcid":"https://orcid.org/0000-0002-6357-4955","observed_orcids":["https://orcid.org/0000-0002-6357-4955"]},"institutions":[{"id":"https://openalex.org/I130701444","display_name":"Georgia Institute of Technology","ror":"https://ror.org/01zkghx44","country_code":"US","type":"education","lineage":["https://openalex.org/I130701444"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Rudolph L. Gleason","raw_affiliation_strings":["Georgia Institute of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Georgia Institute of Technology","institution_ids":["https://openalex.org/I130701444"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5075568610","display_name":"Bradley G. Leshnower","orcid":"https://orcid.org/0000-0002-2290-1729","observed_orcids":["https://orcid.org/0000-0002-2290-1729"]},"institutions":[{"id":"https://openalex.org/I150468666","display_name":"Emory University","ror":"https://ror.org/03czfpz43","country_code":"US","type":"education","lineage":["https://openalex.org/I150468666"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Bradley G. Leshnower","raw_affiliation_strings":["Emory University;"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Emory University;","institution_ids":["https://openalex.org/I150468666"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":["https://openalex.org/A5161032267"],"corresponding_institution_ids":["https://openalex.org/I150468666"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10618","display_name":"Aortic Disease and Treatment Approaches","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10618","display_name":"Aortic Disease and Treatment Approaches","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10983","display_name":"Aortic aneurysm repair treatments","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11310","display_name":"Connective tissue disorders research","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/1311","display_name":"Genetics"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/digital-twin","display_name":"digital twin","score":0.9470000267028809},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.9819999933242798},{"id":"https://openalex.org/keywords/aortic-wall-stress","display_name":"aortic wall stress","score":0.8550000190734863},{"id":"https://openalex.org/keywords/fluid-structure-interaction","display_name":"fluid-structure interaction","score":0.8460000157356262},{"id":"https://openalex.org/keywords/statistical-shape-models","display_name":"statistical shape models","score":0.8830000162124634},{"id":"https://openalex.org/keywords/endovascular-repair","display_name":"endovascular repair","score":0.8579999804496765},{"id":"https://openalex.org/keywords/patient-specific-modeling","display_name":"patient-specific modeling","score":0.5230000019073486}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.779699981212616},{"id":"https://openalex.org/C3020404979","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk stratification","level":2,"score":0.7479000091552734},{"id":"https://openalex.org/C2779993142","wikidata":"https://www.wikidata.org/wiki/Q594660","display_name":"Aortic dissection","level":3,"score":0.6643999814987183},{"id":"https://openalex.org/C164705383","wikidata":"https://www.wikidata.org/wiki/Q10379","display_name":"Cardiology","level":1,"score":0.6248000264167786},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.545199990272522},{"id":"https://openalex.org/C2779980429","wikidata":"https://www.wikidata.org/wiki/Q101004","display_name":"Aorta","level":2,"score":0.4343000054359436},{"id":"https://openalex.org/C2775862295","wikidata":"https://www.wikidata.org/wiki/Q2660911","display_name":"Dissection (medical)","level":2,"score":0.39070001244544983},{"id":"https://openalex.org/C168743327","wikidata":"https://www.wikidata.org/wiki/Q1826427","display_name":"Random effects model","level":3,"score":0.35670000314712524},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3474000096321106},{"id":"https://openalex.org/C7515471","wikidata":"https://www.wikidata.org/wiki/Q1936882","display_name":"Stress testing (software)","level":2,"score":0.3447999954223633},{"id":"https://openalex.org/C170700871","wikidata":"https://www.wikidata.org/wiki/Q193378","display_name":"Biomechanics","level":2,"score":0.337799996137619},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.3043999969959259},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.2897999882698059},{"id":"https://openalex.org/C2986432223","wikidata":"https://www.wikidata.org/wiki/Q5449740","display_name":"Risk model","level":2,"score":0.2872999906539917},{"id":"https://openalex.org/C3019007443","wikidata":"https://www.wikidata.org/wiki/Q568742","display_name":"3d model","level":2,"score":0.2842000126838684},{"id":"https://openalex.org/C2781285907","wikidata":"https://www.wikidata.org/wiki/Q616032","display_name":"Aortic arch","level":3,"score":0.2662000060081482}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.11.05.26367281","doi":"https://doi.org/10.64898/2026.11.05.26367281","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367281","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367281.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.11.05.26367281","doi":"https://doi.org/10.64898/2026.11.05.26367281","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.11.05.26367281","pdf_url":"https://www.medrxiv.org/content/medrxiv/early/2026/11/06/2026.11.05.26367281.full.pdf","source":{"id":"https://openalex.org/S3005729997","display_name":"medRxiv","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core"],"host_organization":null,"host_organization_name":null,"host_organization_lineage":["https://openalex.org/P4310315909"],"host_organization_lineage_names":["Cold Spring Harbor Laboratory Press"],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"medRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":0.98580002784729,"display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225423282.pdf","grobid_xml":"https://content.openalex.org/works/W7225423282.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7160872053","https://openalex.org/W4400839496","https://openalex.org/W7225409847","https://openalex.org/W4318762438","https://openalex.org/W7117407924","https://openalex.org/W4312209700","https://openalex.org/W2992393740","https://openalex.org/W2600573538","https://openalex.org/W7220855195","https://openalex.org/W2901870664"],"abstract_inverted_index":{"Objective":[0],"This":[1],"study":[2],"evaluated":[3],"whether":[4],"patient-specific":[5,224],"digital":[6],"twins":[7],"integrating":[8,206],"3D":[9],"aortic":[10,24,32,84,117,128,141,152],"anatomy":[11],"and":[12,60,64,73,133,162,178,193,208,230],"structural":[13,179],"wall":[14,209],"stress":[15,75,210],"could":[16],"identify":[17],"patients":[18,40,125,240],"with":[19,49,104],"acute":[20],"uncomplicated":[21],"type":[22],"B":[23],"dissection":[25],"(AUTBAD)":[26],"at":[27,159,166,190,197],"high":[28],"risk":[29,97,213,226],"for":[30,101],"adverse":[31],"events.":[33],"Methods":[34],"We":[35],"analyzed":[36],"CTAs":[37],"from":[38,42,53,83,244],"50":[39],"extracted":[41],"a":[43],"400":[44],"AUTBAD":[45,219,225],"patient":[46],"database":[47],"treated":[48],"optimal":[50],"medical":[51],"therapy":[52],"1999-2025.":[54],"Digital":[55,203],"twin":[56,204],"models":[57,80],"were":[58,69,77],"constructed,":[59],"statistical":[61],"shape":[62,72],"modeling":[63,205],"reduced-order":[65],"fluid-structure":[66],"interaction":[67],"analysis":[68],"performed.":[70],"Anatomic":[71],"biomechanical":[74,231],"data":[76,232],"integrated":[78],"into":[79],"predicting":[81],"freedom":[82],"events,":[85],"defined":[86],"as":[87],"intervention":[88],"or":[89,144],"aortic-related":[90,135],"death,":[91],"using":[92,228],"leave-one-out":[93],"cross-validation.":[94],"A":[95],"cross-validated":[96,173],"score":[98],"was":[99,119,186],"generated":[100],"each":[102],"patient,":[103],"higher":[105,108],"scores":[106],"indicating":[107],"event":[109],"risk.":[110],"Results":[111],"At":[112],"diagnosis,":[113],"the":[114,172],"median":[115],"descending":[116,140],"diameter":[118,142],"40.61":[120,146],"mm.":[121],"During":[122],"follow-up,":[123],"35":[124],"experienced":[126],"an":[127],"event:":[129],"28":[130],"interventions":[131],"(56%)":[132],"7":[134],"deaths":[136],"(14%).":[137],"Stratification":[138],"by":[139],"above":[143],"below":[145],"mm":[147],"yielded":[148],"higher-":[149,181],"versus":[150,157,164,182,188,195],"lower-risk":[151,183],"event-free":[153,184],"survival":[154,185],"of":[155,238],"72.0%":[156],"84.0%":[158],"1":[160,191],"year":[161,192],"27.8%":[163],"56.7%":[165],"6":[167,198],"years":[168,199],"(p=0.035;":[169],"C-index=0.590).":[170],"In":[171],"multidimensional":[174],"model":[175],"combining":[176],"morphology":[177,207],"stress,":[180],"60.0%":[187],"96.0%":[189],"12.5%":[194],"68.9%":[196],"(p<0.001;":[200],"C-index=0.792).":[201],"Conclusions":[202],"provided":[211],"greater":[212],"separation":[214],"than":[215],"univariable":[216],"predictors":[217],"in":[218],"patients.":[220],"With":[221],"independent":[222],"validation,":[223],"stratification":[227],"geometric":[229],"may":[233,242],"ultimately":[234],"contribute":[235],"to":[236],"identification":[237],"high-risk":[239],"who":[241],"benefit":[243],"early":[245],"endovascular":[246],"repair.":[247]},"counts_by_year":[],"updated_date":"2026-11-09T13:22:03.289127","created_date":"2026-11-07T00:00:00"}