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. 2021 May 13;23:51. doi: 10.1186/s12968-021-00741-4

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 4 — Conceptual model depicting the proposed relations between growth and 4D Flow-derived markers of FL pressurization. False lumen ejection fraction (FLEF): The top row depicts increased retrograde flow (light blue) relative to antegrade flow (light red) with increasing aortic growth rate, hypothesized to be related to increased FL pressurization. Maximum systolic deceleration rate (MSDR): The middle row depicts the acceleration of blood through a proximal portion of the FL (the light purple shaded area), with MSDR representing the mean rate of change between peak acceleration and peak deceleration (i.e. the downward slope between peaks). With increasing FL pressurization, higher resistance FL flow leads to faster flow deceleration (i.e. a more pronounced, steeper slope). FL maximal relative pressure (FL ΔP_max): The bottom row depicts the observed trend between decreased relative pressure between the aortic root and the distal FL (the striped region in the TBAD to the left) and increasing aortic growth rate. Increased FL pressurization leads to increased resistance to flow, and thus dampening of relative pressure gradients