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Lancet (London, England)Abdominal aortic aneurysms cause 1.3% of all deaths among men aged 65-85 years in developed countries. These aneurysms are typically asymptomatic until the catastrophic... (Review)
Review
Abdominal aortic aneurysms cause 1.3% of all deaths among men aged 65-85 years in developed countries. These aneurysms are typically asymptomatic until the catastrophic event of rupture. Repair of large or symptomatic aneurysms by open surgery or endovascular repair is recommended, whereas repair of small abdominal aortic aneurysms does not provide a significant benefit. Abdominal aortic aneurysm is linked to the degradation of the elastic media of the atheromatous aorta. An inflammatory cell infiltrate, neovascularisation, and production and activation of various proteases and cytokines contribute to the development of this disorder, although the underlying mechanisms are unknown. In this Seminar, we aim to provide an updated review of the pathophysiology, current and new diagnostic procedures, assessment, and treatment of abdominal aortic aneurysm to provide family practitioners with a working knowledge of this disorder.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Humans; Risk Factors
PubMed: 15866312
DOI: 10.1016/S0140-6736(05)66459-8 -
Deutsches Arzteblatt International Oct 2020
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Humans
PubMed: 33568257
DOI: 10.3238/arztebl.2020.0811 -
Circulation Research Feb 2019Aortic aneurysms are a common vascular disease in Western populations that can involve virtually any portion of the aorta. Abdominal aortic aneurysms are much more... (Review)
Review
Aortic aneurysms are a common vascular disease in Western populations that can involve virtually any portion of the aorta. Abdominal aortic aneurysms are much more common than thoracic aortic aneurysms and combined they account for >25 000 deaths in the United States annually. Although thoracic and abdominal aortic aneurysms share some common characteristics, including the gross anatomic appearance, alterations in extracellular matrix, and loss of smooth muscle cells, they are distinct diseases. In recent years, advances in genetic analysis, robust molecular tools, and increased availability of animal models have greatly enhanced our knowledge of the pathophysiology of aortic aneurysms. This review examines the various proposed cellular mechanisms responsible for aortic aneurysm formation and identifies opportunities for future studies.
Topics: Aortic Aneurysm; Cytokines; Extracellular Matrix; Humans; Oxidative Stress; Renin-Angiotensin System
PubMed: 30763207
DOI: 10.1161/CIRCRESAHA.118.313187 -
Journal of Molecular and Cellular... Feb 2022Rupture of aortic aneurysm and dissection (AAD) remains a leading cause of death. Progressive smooth muscle cell (SMC) loss is a crucial feature of AAD that contributes... (Review)
Review
Rupture of aortic aneurysm and dissection (AAD) remains a leading cause of death. Progressive smooth muscle cell (SMC) loss is a crucial feature of AAD that contributes to aortic dysfunction and degeneration, leading to aortic aneurysm, dissection, and, ultimately, rupture. Understanding the molecular mechanisms of SMC loss and identifying pathways that promote SMC death in AAD are critical for developing an effective pharmacologic therapy to prevent aortic destruction and disease progression. Cell death is controlled by programmed cell death pathways, including apoptosis, necroptosis, pyroptosis, and ferroptosis. Although these pathways share common stimuli and triggers, each type of programmed cell death has unique features and activation pathways. A growing body of evidence supports a critical role for programmed cell death in the pathogenesis of AAD, and inhibitors of various types of programmed cell death represent a promising therapeutic strategy. This review discusses the different types of programmed cell death pathways and their features, induction, contributions to AAD development, and therapeutic potential. We also highlight the clinical significance of programmed cell death for further studies.
Topics: Aortic Dissection; Aortic Aneurysm; Apoptosis; Ferroptosis; Humans; Myocytes, Smooth Muscle
PubMed: 34597613
DOI: 10.1016/j.yjmcc.2021.09.010 -
Revue Medicale de Liege May 2018Ruptured abdominal aortic aneurysm is a cardiovascular emergency associated with a 30 day mortality as high as 70 %. However, recent progresses in the management of... (Review)
Review
Ruptured abdominal aortic aneurysm is a cardiovascular emergency associated with a 30 day mortality as high as 70 %. However, recent progresses in the management of these patients have improved the results. From a surgical point of view, endovascular methods such as balloon occlusion and endovascular repair (EVAR) in patients with suitable anatomy are recommended in order to reduce mortality.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Cardiac Surgical Procedures; Endovascular Procedures; Humans
PubMed: 29926569
DOI: No ID Found -
Journal of the American Heart... Dec 2021Aortic aneurysm, including thoracic aortic aneurysm and abdominal aortic aneurysm, is the second most prevalent aortic disease following atherosclerosis, representing...
Aortic aneurysm, including thoracic aortic aneurysm and abdominal aortic aneurysm, is the second most prevalent aortic disease following atherosclerosis, representing the ninth-leading cause of death globally. Open surgery and endovascular procedures are the major treatments for aortic aneurysm. Typically, thoracic aortic aneurysm has a more robust genetic background than abdominal aortic aneurysm. Abdominal aortic aneurysm shares many features with thoracic aortic aneurysm, including loss of vascular smooth muscle cells (VSMCs), extracellular matrix degradation and inflammation. Although there are limitations to perfectly recapitulating all features of human aortic aneurysm, experimental models provide valuable tools to understand the molecular mechanisms and test novel therapies before human clinical trials. Among the cell types involved in aortic aneurysm development, VSMC dysfunction correlates with loss of aortic wall structural integrity. Here, we discuss the role of VSMCs in aortic aneurysm development. The loss of VSMCs, VSMC phenotypic switching, secretion of inflammatory cytokines, increased matrix metalloproteinase activity, elevated reactive oxygen species, defective autophagy, and increased senescence contribute to aortic aneurysm development. Further studies on aortic aneurysm pathogenesis and elucidation of the underlying signaling pathways are necessary to identify more novel targets for treating this prevalent and clinical impactful disease.
Topics: Aortic Aneurysm; Aortic Aneurysm, Abdominal; Aortic Aneurysm, Thoracic; Humans; Muscle, Smooth, Vascular; Myocytes, Smooth Muscle
PubMed: 34796717
DOI: 10.1161/JAHA.121.023601 -
VASA. Zeitschrift Fur Gefasskrankheiten Jan 2023
Topics: Humans; Aortic Aneurysm; Aortic Aneurysm, Abdominal; Neoplasms; Blood Vessel Prosthesis Implantation
PubMed: 36617969
DOI: 10.1024/0301-1526/a001046 -
IUBMB Life Oct 2022Thrombospondins are a family of matricellular proteins with a multimeric structure that is known to be involved in several biological and pathological processes. Their... (Review)
Review
Thrombospondins are a family of matricellular proteins with a multimeric structure that is known to be involved in several biological and pathological processes. Their relationship with vascular disorders has raised special interest recently. Aortic aneurysms are related to the impairment of vascular remodeling, in which extracellular matrix proteins seem to play an important role. Thus, research in thrombospondins, and their potential role in aneurysm development is progressively gaining importance. Nevertheless, studies showing thrombospondin dysregulation in human samples are still scarce. Although studies performed in vitro and in vivo models are essential to understand the molecular mechanisms and pathways underlying the disorder, descriptive studies in human samples are also necessary to ascertain their real value as biomarkers and/or novel therapeutic targets. The present article reviews the latest findings regarding the role of thrombospondins in aortic aneurysm development, paying particular attention to the studies performed in human samples.
Topics: Aortic Aneurysm; Biomarkers; Extracellular Matrix Proteins; Humans; Thrombospondins
PubMed: 35293116
DOI: 10.1002/iub.2610 -
European Journal of Vascular and... Aug 2020
Review
Topics: Aortic Aneurysm; Female; Genetic Counseling; Genetic Predisposition to Disease; Heredity; Humans; Pedigree; Preconception Care; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 32409015
DOI: 10.1016/j.ejvs.2020.03.052 -
American Journal of Physiology. Heart... Dec 2022Phospholipase Cε (PLCε) is a phospholipase C isoform with a wide range of physiological functions. It has been implicated in aortic valve disorders, but its role in...
Phospholipase Cε (PLCε) is a phospholipase C isoform with a wide range of physiological functions. It has been implicated in aortic valve disorders, but its role in frequently associated aortic disease remains unclear. To determine the role of PLCε in thoracic aortic aneurysm and dissection (TAAD) we used PLCε-deficient mice, which develop aortic valve insufficiency and exhibit aortic dilation of the ascending thoracic aorta and arch without histopathological evidence of injury. Fourteen days of infusion of and mice with angiotensin II (ANG II), which induces aortic dilation and dissection, led to sudden death secondary to ascending aortic dissection in 43% of versus 5% of mice ( < 0.05). Medial degeneration and TAAD were detected in 80% of compared with 10% of mice ( < 0.05) after 4 days of ANG II. Treatment with ANG II markedly increased PLCε expression within the ascending aortic adventitia. Total RNA sequencing demonstrated marked upregulation of inflammatory and fibrotic pathways mediated by interleukin-1β, interleukin-6, and tumor necrosis factor-α. In silico analysis of whole exome sequences of 258 patients with type A dissection identified 5 patients with nonsynonymous variants. Our data suggest that PLCε deficiency plays a role in the development of TAAD and aortic insufficiency. We describe a novel phenotype by which PLCε deficiency predisposes to aortic valve insufficiency and ascending aortic aneurysm, dissection, and sudden death in the setting of ANG II-mediated hypertension. We demonstrate variants in patients with type A aortic dissection and aortic insufficiency, suggesting that may also play a role in human aortic disease. This finding is of very high significance because it has not been previously demonstrated that PLCε directly mediates aortic dissection.
Topics: Humans; Mice; Animals; Aortic Valve Insufficiency; Aneurysm, Ascending Aorta; Mice, Inbred C57BL; Aortic Aneurysm; Aortic Dissection; Angiotensin II; Hypertension; Death, Sudden; Aortic Aneurysm, Thoracic
PubMed: 36367690
DOI: 10.1152/ajpheart.00262.2022