Table_1_Coronary artery disease as an independent predictor of short-term and long-term outcomes in patients with type-B aortic dissection undergoing thoracic endovascular repair.docx

Background and aimsPrevious studies reported a high prevalence of concomitant coronary artery disease (CAD) in patients with Type B aortic dissection (TBAD). However, there is too limited data on the impact of CAD on prognosis in patients with TBAD. The present study aimed to assess the short-term and long-term impact of CAD on patients with acute or subacute TBAD undergoing thoracic endovascular aortic repair (TEVAR).MethodsWe retrospectively evaluated 463 patients with acute or subacute TBAD undergoing TEVAR from a prospectively maintained database from 2010 to 2017. CAD was defined before TEVAR by coronary angiography. Multivariable logistic and cox regression analyses were performed to evaluate the relationship between CAD and the short-term as well as long-term outcomes.ResultsAccording to the results of coronary angiography, the 463 patients were divided into the following two groups: CAD group (N = 148), non-CAD group (N = 315). In total, 12 (2.6%) in-hospital deaths and 54 (12%) all-cause deaths following a median follow-up of 48.1 months were recorded. Multivariable analysis revealed that CAD was an independent predictor of in-hospital major adverse clinical events (MACE) (odd ratio [OR], 2.33; 95% confidence interval [CI], 1.07–5.08; p = 0.033), long-term mortality [hazard ratio (HR), 2.11, 95% CI, 1.19–3.74, P = 0.011] and long-term MACE (HR, 1.95, 95% CI, 1.26–3.02, P = 0.003). To further clarify the relationship between the severity of CAD and long-term outcomes, we categorized patients into three groups: zero-vessel disease, single-vessel disease and multi-vessel disease. The long-term mortality (9.7 vs. 14.4 vs. 21.2%, P = 0.045), and long-term MACE (16.8 vs. 22.2 vs. 40.4%, P = 0.001) increased with the number of identified stenosed coronary vessels. Multivariable analysis indicated that, multi-vessel disease was independently associated with long-term mortality (HR, 2.38, 95% CI, 1.16–4.89, P = 0.018) and long-term MACE (HR, 2.79, 95% CI, 1.65–4.73, P = 0.001), compared with zero-vessel disease.ConclusionsCAD was associated with short-term and long-term worse outcomes in patients with acute or subacute TBAD undergoing TEVAR. Furthermore, the severity of CAD was also associated with worse long-term prognosis. Therefore, CAD could be considered as a useful independent predictor for pre-TEVAR risk stratification in patients with TBAD.</p

Temperature-Dependence of Persistence Length Affects Phenomenological Descriptions of Aligning Interactions in Nematic Semiconducting Polymers

Electronic and optical properties of conjugated polymers are strongly affected by their solid-state microstructure. In nematic polymers, mesoscopic order and structure can be theoretically understood using Maier–Saupe (MS) models, motivating us to apply them to conjugated macromolecular systems and consider the problem of their material-specific parametrization. MS models represent polymers by worm-like chains (WLC) and can describe collective polymer alignment through anisotropic MS interactions. Their strength is controlled by a phenomenological temperature-dependent parameter, υ­(<i>T</i>). We undertake the challenging task of estimating material-specific υ­(<i>T</i>), combining experiments and Self-Consistent Field theory (SCFT). Considering three different materials and a spectrum of molecular weights, we cover the cases of rod-like, semiflexible, and flexible conjugated polymers. The temperature of the isotropic–nematic transition, <i>T</i>_IN, is identified via polarized optical microscopy and spectroscopy. The polymers are mapped on WLC with temperature-dependent persistence length. Fixed persistence lengths are also considered, reproducing situations addressed in earlier studies. We estimate υ­(<i>T</i>) by matching <i>T</i>_IN in experiments and SCFT treatment of the MS model. An important conclusion is that accounting explicitly for changes of persistence length with temperature has significant qualitative effects on υ­(<i>T</i>). We moreover correlate our findings with earlier discussions on the thermodynamic nature of phenomenological MS interactions