Guidelines for the treatment of aortic wall diseases are based on measurements of maximum aortic
diameter. However, aortic rupture or dissections do occur for small aortic diameters. Growing scientific evidence
underlines the importance of biomechanics and hemodynamics in aortic disease development and progression.
Wall shear stress (WWS) is an important hemodynamics marker that depends on aortic wall morphology and on
the aortic valve function. WSS could be helpful to interpret aortic wall remodeling and define personalized risk
criteria. The complementarity of Computational Fluid Dynamics and 4D Magnetic Resonance Imaging as tools
for WSS assessment is a promising reality. The potentiality of these innovative technologies will provide maps or
atlases of hemodynamics biomarkers to predict aortic tissue dysfunction. Ongoing efforts should focus on the
correlation between these non-invasive imaging biomarkers and clinico-pathologic situations for the implementation
of personalized medicine in current clinical practice.
Keywords: Magnetic resonance imaging, computational fluid dynamics, ascending thoracic aorta aneurysms, vascular remodeling, wall shear
stress, aortic dissection.
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