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Diabetes & Vascular Disease Research Sep 2018Diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm; however, the mechanisms underlying this relationship remain poorly understood. The... (Review)
Review
INTRODUCTION
Diabetes mellitus appears to be negatively associated with abdominal aortic aneurysm; however, the mechanisms underlying this relationship remain poorly understood. The aim of this article is to provide a comprehensive review of the currently understood biological pathways underlying this relationship.
METHODS
A review of the literature ('diabetes' OR 'hyperglycaemia' AND 'aneurysm') was performed and relevant studies grouped into biological pathways.
RESULTS
This review identified a number of biological pathways through which diabetes mellitus may limit the presence, growth and rupture of abdominal aortic aneurysms. These include those influencing extracellular matrix volume, extracellular matrix glycation, the formation of advanced glycation end-products, inflammation, oxidative stress and intraluminal thrombus biology. In addition, there is an increasing evidence to suggest that the medications used to treat diabetes can also limit the development and progression of abdominal aortic aneurysms.
CONCLUSION
The negative association between diabetes and abdominal aortic aneurysm is robust. Future studies should attempt to target the pathways identified in this review to develop novel therapeutic agents aimed at slowing or even halting aneurysm progression.
Topics: Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Biomarkers; Blood Glucose; Diabetes Mellitus; Dilatation, Pathologic; Disease Progression; Extracellular Matrix; Glycation End Products, Advanced; Humans; Hypoglycemic Agents; Inflammation Mediators; Oxidative Stress; Risk Factors; Vascular Remodeling
PubMed: 29874945
DOI: 10.1177/1479164118780799 -
Ethiopian Journal of Health Sciences Oct 2022Mean aortic and common iliac artery diameters are the best indicators for the diagnosis of aortic and iliac ectasia and aneurysm, as well as the appropriate selection of...
BACKGROUND
Mean aortic and common iliac artery diameters are the best indicators for the diagnosis of aortic and iliac ectasia and aneurysm, as well as the appropriate selection of angiographic catheter size and grafts for endovascular procedures. Currently, there is a lack of evidence regarding the normal abdominal aortic and common iliac artery diameters in Ethiopian adults. This study aimed to assess the mean diameter and associated factors of the abdominal aorta and common iliac arteries on abdominal CT scans of Ethiopian adults visiting Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.
METHODS
Institution-based prospective cross-sectional study was conducted. A convenience sampling method was employed. Data were collected from consecutive eligible adults who came for abdominal CT scans during the study period, using interviewer-administered structured questionnaires. The data was cleaned and analyzed using SPSS version 22. Student t-test and Pearson correlation were used to perform statistical analysis and the results were presented using tables and figures.
RESULTS
There were a total of 136 study participants of whom eighty-one(59.6%) were females and fifty-five (40.4%) were males. The mean age was 48.5 ± 13 with a range of 23 to77 years. The mean transverse diameter of the aorta at the aortic hiatus (T12)level was 2.30 ± 0.25cm in males and 2.03±0.19cm in females. The mean transverse diameter of the suprarenal aorta was 2.04 ± 0.21cm in males and 1.83 ± 0.21 cm in females while the infrarenal one was 1.77 ± 0.16cm in males and 1.54 ± 0.15cm in females. Participants who are male and older with large body Surface Area were found to have relatively larger aortic and iliac diameters.
CONCLUSION
In this study, the mean diameter of the aorta and common iliac artery was significantly associated with age, sex, and BSA.
Topics: Adult; Female; Male; Humans; Young Adult; Aorta, Abdominal; Iliac Artery; Cross-Sectional Studies; Ethiopia; Prospective Studies; Tomography, X-Ray Computed
PubMed: 36339953
DOI: 10.4314/ejhs.v32i1.4S -
European Journal of Vascular and... May 2022The aims of the present study were to assess the relative proportion of collagen and elastin in the arterial wall and to evaluate the collagen microstructure from the...
OBJECTIVE
The aims of the present study were to assess the relative proportion of collagen and elastin in the arterial wall and to evaluate the collagen microstructure from the aortic root to the external iliac artery.
METHODS
Arterial wall tissue samples sampled during post-mortem examination from 16 sites in 14 individuals without aneurysm disease were fixed and stained for collagen and elastin. Stained sections were imaged and analysed to calculate collagen and elastin content as a percentage of overall tissue area. Scanning electron microscopy was used to quantify the collagen microstructure at six specific arterial regions.
RESULTS
From the aortic root to the level of the suprarenal aorta, the percentages (area fractions) of collagen (ascending, descending, and suprarenal aorta respectively with 95% confidence interval [CI] 37.5%, 31.7 - 43.2; 38.9%, 33.1 - 44.7; 44.8%, 37.4 - 52.1) and elastin (43.0%, 37.3 - 48.8; 40.3%, 34.8 - 46.1; 32.4%, 25.2 - 39.6) in the aortic wall were similar. From the suprarenal aorta to the internal iliac arteries, the percentage of collagen increased (abdominal aorta, common and internal iliac arteries and external iliac artery respectively with 95% CI 50.6%, 42.7 - 58.7; 51.2%, 45.5 - 56.9; 49.2%, 42.0 - 56.4) reaching a double percentage for elastin (23.6%, 15.7 - 31.6; 20.8%, 15.1 - 26.5; 22.2%, 14.9 - 29.5). Mean collagen fibre diameter (MFD) and average segment length (ASL) were significantly larger in the external iliac artery (MFD 6.03, 95% CI 5.95 - 6.11; ASL 22.21, 95% CI 20.80 - 23.61) than in the ascending aorta (MFD 5.81, 5.72 - 5.89; ASL 19.47, 18.07 - 20.88) and the abdominal aorta (MFD 5.92, 5.84 - 6.00; ASL 21.10, 19.69 - 22.50).
CONCLUSION
In subjects lacking aneurysmal disease, the aorta and iliac arteries are not structurally uniform along their length. There is an increase in collagen percentage and decrease in elastin percentage progressing distally along the aorta. Mean collagen fibre diameter and average segment length are larger in the external iliac artery, compared with the ascending and the abdominal aorta.
Topics: Aorta, Abdominal; Collagen; Elastin; Extracellular Matrix; Humans; Iliac Artery
PubMed: 35346566
DOI: 10.1016/j.ejvs.2022.02.005 -
Medicine Dec 2018Cardiovascular (CV) morbidity, atherosclerosis, and obesity are all targets of clinical concern and vast research, as is the association between them. Aim of this study...
Cardiovascular (CV) morbidity, atherosclerosis, and obesity are all targets of clinical concern and vast research, as is the association between them. Aim of this study is to assess the impact of adipose tissue (including visceral and subcutaneous fat) on abdominal aorta calcification measured on non-enhanced computed tomography (CT). We retrospectively included 492 patients who underwent non-enhanced CT scans during workup for clinically suspected renal colic. All scans were reviewed for abdominal aorta calcification, liver attenuation, and thickness of visceral and subcutaneous fat. Multivariate general linear regression models were used to assess the association between abdominal aorta calcium score and adiposity measures. In the model that included only adiposity measures; visceral fat thickness had statistically significant direct association with abdominal aorta calcium score (B = 67.1, P <.001), whereas subcutaneous pelvic fat thickness had a significant inverse association with abdominal aorta calcium score (B = -22.34, P <.001). Only the association of subcutaneous pelvic fat thickness with abdominal aorta calcium score remained statistically significant when controlling for age, sex, smoking, hypertension, diabetes mellitus, and hyperlipidemia (B = -21.23, P <.001). In this model, the association of visceral fat remained statistically significant in females (B = 84.28, P = .001) but not in males (B = 0.47, P = .973). Visceral fat thickness and subcutaneous pelvic fat thickness were found to have opposing associations with abdominal aorta calcium score. This suggests that while visceral fat may have a lipotoxic effect on aortic atherosclerotic processes, subcutaneous pelvic fat may have a protective role in these processes.
Topics: Abdominal Fat; Adult; Aorta, Abdominal; Aortic Diseases; Female; Humans; Male; Middle Aged; Sex Factors; Tomography, X-Ray Computed; Vascular Calcification
PubMed: 30544382
DOI: 10.1097/MD.0000000000013233 -
Journal of Vascular Surgery Jun 2022The maximal aortic diameter is currently the only clinically applied predictor of abdominal aortic aneurysm (AAA) progression. It is known that the risk of rupture is...
OBJECTIVE
The maximal aortic diameter is currently the only clinically applied predictor of abdominal aortic aneurysm (AAA) progression. It is known that the risk of rupture is associated with aneurysm size; hence, accurate monitoring of AAA expansion is crucial. Aneurysmal vessel wall calcification and its implication on AAA expansion are insufficiently explored. We evaluated the vascular calcification using longitudinal computed tomography angiographies (CTA) of patients with an AAA and its association with AAA growth.
METHODS
We conducted a retrospective study of 102 patients with an AAA with a total of 389 abdominal CTAs at 6-month intervals, treated and followed at the Division of Vascular Surgery, Department of General Surgery, Medical University of Vienna. Digitally stored CTAs were reviewed for vascular calcification (volume and score) of the infrarenal aorta and common iliac arteries as well as for morphometric AAA analysis. In the prognostic setting, slow versus fast AAA progression was defined as a less than 2 mm or a 2-mm or greater increase in AAA diameter over 6 months. In addition, to analyze the association of vascular calcification and the AAA growth rate with longitudinal monitoring data, a specifically tailored log-linear mixed model was used.
RESULTS
An inverse relation of increased abdominal vessel wall calcification and short-term AAA progression was detected. Compared with fast progressing AAA, the median calcification volume of the infrarenal aorta (1225.3 mm³ vs 519.8 mm³; P = .003), the median total calcification volume (2014.1 mm³ vs 1434.9 mm³; P = .008), and the median abdominal total customized Agatston calcium (cAC) score (1663.5 vs 718.4; P = .003) were significantly increased in slow progressing AAA. Importantly, a log-linear mixed model efficiently predicted AAA expansion based on current diameter and abdominal total cAC score (P = .042).
CONCLUSIONS
We assessed the prognostic value of CTA-measured vascular calcification for AAA progression. Increased vascular calcification stabilizes the aortic aneurysmal wall and likely protects against progressive AAA expansion, resulting in a significant decrease of aneurysm growth over time. As a consequence, this may have implications for rupture risk, mortality, morbidity, and cost.
Topics: Aorta, Abdominal; Aortic Aneurysm, Abdominal; Humans; Prognosis; Retrospective Studies; Vascular Calcification
PubMed: 34921970
DOI: 10.1016/j.jvs.2021.11.062 -
Internal Medicine (Tokyo, Japan) Nov 2022
Topics: Humans; Aorta, Abdominal; Syndrome; Cerebral Infarction
PubMed: 35431304
DOI: 10.2169/internalmedicine.9281-21 -
BMC Cardiovascular Disorders Feb 2022Aortic diameter is a critical parameter for the diagnosis of aortic dilated diseases. Aortic dilation has some common risk factors with cardiovascular diseases. This... (Observational Study)
Observational Study
BACKGROUND
Aortic diameter is a critical parameter for the diagnosis of aortic dilated diseases. Aortic dilation has some common risk factors with cardiovascular diseases. This study aimed to investigate potential influence of traditional cardiovascular risk factors and the measures of subclinical atherosclerosis on aortic diameter of specific segments among adults.
METHODS
Four hundred and eight patients with cardiovascular risk factors were prospectively recruited in the observational study. Comprehensive transthoracic M-mode, 2-dimensional Doppler echocardiographic studies were performed using commercial and clinical diagnostic ultrasonography techniques. The aortic dimensions were assessed at different levels: (1) the annulus, (2) the mid-point of the sinuses of Valsalva, (3) the sinotubular junction, (4) the ascending aorta at the level of its largest diameter, (5) the transverse arch (including proximal arch, mid arch, distal arch), (6) the descending aorta posterior to the left atrium, and (7) the abdominal aorta just distal to the origin of the renal arteries. Multivariable linear regression analysis was used for evaluating aortic diameter-related risk factors, including common cardiovascular risk factors, co-morbidities, subclinical atherosclerosis, lipid profile, and hematological parameters.
RESULTS
Significant univariate relations were found between aortic diameter of different levels and most traditional cardiovascular risk factors. Carotid intima-media thickness was significantly correlated with diameter of descending and abdominal aorta. Multivariate linear regression showed potential effects of age, sex, body surface area and some other cardiovascular risk factors on aortic diameter enlargement. Among them, high-density lipoprotein cholesterol had a significantly positive effect on the diameter of ascending and abdominal aorta. Diastolic blood pressure was observed for the positive associations with diameters of five thoracic aortic segments, while systolic blood pressure was only independently related to mid arch diameter.
CONCLUSION
Aortic segmental diameters were associated with diastolic blood pressure, high-density lipoprotein cholesterol, atherosclerosis diseases and other traditional cardiovascular risk factors, and some determinants still need to be clarified for a better understanding of aortic dilation diseases.
Topics: Adult; Aged; Aged, 80 and over; Aorta, Abdominal; Aorta, Thoracic; Blood Pressure; Cardiovascular Diseases; Echocardiography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Population Surveillance; Reference Values; Retrospective Studies; Ultrasonography
PubMed: 35120453
DOI: 10.1186/s12872-022-02479-y -
Heart (British Cardiac Society) Jun 2016Abdominal aortic aneurysms (AAAs) are an important cause of morbidity and, when ruptured, are associated with >80% mortality. Current management decisions are based on... (Review)
Review
Abdominal aortic aneurysms (AAAs) are an important cause of morbidity and, when ruptured, are associated with >80% mortality. Current management decisions are based on assessment of aneurysm diameter by abdominal ultrasound. However, AAA growth is non-linear and rupture can occur at small diameters or may never occur in those with large AAAs. There is a need to develop better imaging biomarkers that can identify the potential risk of rupture independent of the aneurysm diameter. Key pathobiological processes of AAA progression and rupture include neovascularisation, necrotic inflammation, microcalcification and proteolytic degradation of the extracellular matrix. These processes represent key targets for emerging imaging techniques and may confer an increased risk of expansion or rupture over and above the known patient-related risk factors. Magnetic resonance imaging, using ultrasmall superparamagnetic particles of iron oxide, can identify and track hotspots of macrophage activity. Positron emission tomography, using a variety of targeted tracers, can detect areas of inflammation, angiogenesis, hypoxia and microcalcification. By going beyond the simple monitoring of diameter expansion using ultrasound, these cellular and molecular imaging techniques may have the potential to allow improved prediction of expansion or rupture and to better guide elective surgical intervention.
Topics: Animals; Aorta, Abdominal; Aortic Aneurysm, Abdominal; Aortography; Biomarkers; Computed Tomography Angiography; Dilatation, Pathologic; Disease Progression; Humans; Macrophages; Magnetic Resonance Angiography; Positron Emission Tomography Computed Tomography; Predictive Value of Tests; Prognosis; Risk Factors; Ultrasonography
PubMed: 26879242
DOI: 10.1136/heartjnl-2015-308779 -
Internal Medicine (Tokyo, Japan) 2023A 74-year-old woman was admitted because of malaise and a low-grade fever. Her C-reactive protein level was 0.96 mg/dL. Computed tomography (CT) revealed diffuse uniform...
A 74-year-old woman was admitted because of malaise and a low-grade fever. Her C-reactive protein level was 0.96 mg/dL. Computed tomography (CT) revealed diffuse uniform thickening of the arterial wall from the abdominal aorta to the common iliac artery and right hydronephrosis. F-fluordesoxyglucose positron emission tomography-CT showed an accumulation in the same area. These findings suggested Takayasu arteritis and retroperitoneal fibrosis as differential diagnoses. Takayasu arteritis is characterized by thickening of the arterial walls, and retroperitoneal fibrosis is characterized by membranous lesions covering the outer surface of the arterial walls. Thus, Takayasu arteritis was deemed the most likely diagnosis. Steroid treatment was effective.
Topics: Female; Humans; Aged; Takayasu Arteritis; Retroperitoneal Fibrosis; Tomography, X-Ray Computed; Aorta, Abdominal; Arteries
PubMed: 37258208
DOI: 10.2169/internalmedicine.0305-22 -
Journal of the American Heart... Aug 2021Background Current right ventricular (RV) volume overload (VO) is established in adult mice. There are no neonatal mouse VO models and how VO affects postnatal RV...
Background Current right ventricular (RV) volume overload (VO) is established in adult mice. There are no neonatal mouse VO models and how VO affects postnatal RV development is largely unknown. Methods and Results Neonatal VO was induced by the fistula between abdominal aorta and inferior vena cava on postnatal day 7 and confirmed by abdominal ultrasound, echocardiography, and hematoxylin and eosin staining. The RNA-sequencing results showed that the top 5 most enriched gene ontology terms in normal RV development were energy derivation by oxidation of organic compounds, generation of precursor metabolites and energy, cellular respiration, striated muscle tissue development, and muscle organ development. Under the influence of VO, the top 5 most enriched gene ontology terms were angiogenesis, regulation of cytoskeleton organization, regulation of vasculature development, regulation of mitotic cell cycle, and regulation of the actin filament-based process. The top 3 enriched signaling pathways for the normal RV development were PPAR signaling pathway, citrate cycle (Tricarboxylic acid cycle), and fatty acid degradation. VO changed the signaling pathways to focal adhesion, the PI3K-Akt signaling pathway, and pathways in cancer. The RNA sequencing results were confirmed by the examination of the markers of metabolic and cardiac muscle maturation and the markers of cell cycle and angiogenesis. Conclusions A neonatal mouse VO model was successfully established, and the main processes of postnatal RV development were metabolic and cardiac muscle maturation, and VO changed that to angiogenesis and cell cycle regulation.
Topics: Animals; Animals, Newborn; Aorta, Abdominal; Arteriovenous Shunt, Surgical; Disease Models, Animal; Gene Expression Profiling; Gene Expression Regulation, Developmental; Male; Mice, Inbred C57BL; RNA-Seq; Time Factors; Transcriptome; Vena Cava, Inferior; Ventricular Dysfunction, Right; Ventricular Function, Right; Mice
PubMed: 34387124
DOI: 10.1161/JAHA.121.020854