ArticleFrontiers in cardiovascular medicine2026
Preoperative exercise tolerance, nutritional-inflammatory markers, and outcomes after TEVAR for type B aortic pathology.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Thoracic endovascular aortic repair (TEVAR) is the cornerstone treatment for type B aortic dissection (TBAD), but delayed discharge and mid-term major adverse events (MAEs) remain important clinical challenges. This single-center retrospective cohort study aimed to explore the associations of preoperative exercise tolerance, nutritional and inflammatory markers with short-term and mid-term outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR) for type B aortic pathology. Methods: A retrospective cohort study enrolled 300 consecutive patients who underwent TEVAR for type B aortic pathology (type B acute aortic syndrome, B-AAS) between 2015 and 2020. The study population included three distinct entities: classic TBAD, intramural hematoma (IMH), and penetrating atherosclerotic ulcer (PAU), neither of which are regarded as subtypes of aortic dissection. Preoperative exercise tolerance was assessed by 6-minute walking distance (6MWD) and hand grip strength (HGS), together with geriatric nutritional risk index (GNRI), neutrophil-to-lymphocyte ratio (NLR), and activated partial thromboplastin time (APTT). Primary outcomes were delayed discharge and mid-term MAEs. Delayed discharge was explicitly defined as postoperative hospital stay >10 days, and mid-term major adverse events (MAEs) were recorded during follow-up. Univariate and multivariate regression analyses were performed to identify factors independently associated with outcomes, and interaction analyses were further conducted. Results: Delayed discharge occurred in 18 (6.0%) patients and mid-term MAEs in 38 (12.7%). Independent predictors of delayed discharge included elevated APTT and NLR, and decreased GNRI, 6MWD, and HGS. The nomogram showed good discrimination (AUC: 0.84). Low 6MWD combined with low GNRI or high NLR synergistically increased the risks of delayed discharge and MAEs (both Conclusions: Preoperative exercise tolerance, nutritional status, and inflammatory biomarkers are independent correlative predictors of short-term and mid-term adverse outcomes after TEVAR. Combined assessment of these simple non-invasive indicators may assist preoperative clinical risk stratification.
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