Lipoprotein(a) in plasma, arterial wall, and thrombus from patients with aortic aneurysm

Pseudoaneurysm is defined as a reperfused pulsatile hematoma, encapsulated and communicated with the damaged vessel's lumen. It originates when there is a disruption of the arterial wall. Hemoptysis is a very rare sign/symptom of a thoracic aortic aneurysm or pseudoaneurysm. There is little information on hemoptysis associated with aortic aneurysm rupture, whose mechanisms are not explained by the presence of an aortopulmonary fistula. Among the hypotheses to explain this phenomenon, is the ability of the bronchial arteries to become hyperplasic and tortuous in the presence of a lesion that modifies the pulmonary architecture, being more susceptible to rupture. There are also descriptions of direct lung parenchymal injury from ruptured aneurysm. The present case illustrates that we must consider the hemoptysis as a warning sign in differential diagnosis of aortic aneurysms and pseudo aneurysms, among other causes, that it can be fatal in a short time due to massive hemorrhage.

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Diet and the content of selenium and lead in patients with abdominal aortic aneurysm

VASA ◽

10.1024/0301-1526/a000135 ◽

2011 ◽

Vol 40 (5) ◽

pp. 381-389 ◽

Cited By ~ 3

Author(s):

Socha ◽

Borawska ◽

Gacko ◽

Guzowski

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Healthy Volunteers ◽

Arterial Wall ◽

Aortic Wall ◽

Dietary Habits ◽

Absorption Spectrometry ◽

Control Group ◽

Abdominal Aortic ◽

The Mean

Background: To evaluate the content of selenium (Se) and lead (Pb) and the influence of dietary habits and smoking in patients with abdominal aortic aneurysm (AAA). Patients and methods: Forty-nine patients with AAA prior to surgical procedures aged 42 - 81 years and a control group of 22 healthy volunteers aged 31 - 72 years and 17 aortic wall samples from deceased were included in the study. Food-frequency questionnaires were implemented in AAA patients to collect the dietary data. Se and Pb concentrations in the serum and blood, respectively, and in arterial wall and parietal thrombus samples were determined by the atomic absorption spectrometry method. Results: The mean Se level in serum of patients with AAA (60.37 ± 21.2 microg/L) was significantly (p < 0.008) lower than in healthy volunteers (75.87 ± 22.4 microg/L). We observed a significant correlation (r = 0.69, p < 0.0001) between the content of Se in serum and the parietal thrombus of examined patients. Se concentration in aortic wall was inversely correlated to the concentration of Pb (r = - 0.38, p < 0.02). We observed significantly lower (p < 0.05) concentrations of Se (39.14 ± 37.1 microg/g) and significantly higher (p < 0.05) concentrations of Pb (202.69 ± 180.6 microg/g) in aortic wall samples of smoking patients than in non-smoking patients (77.56 ± 70.0 microg/g, 73.09 ± 49.8 microg/g; respectively). Conclusions: Se serum level is lower in patients with AAA than in healthy volunteers. In aortic wall, Se concentration is inversely correlated with Pb concentration. Dietary habits and smoking have an influence on the Se and Pb status in patients with AAA.

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Lipoprotein(a) levels and risk of abdominal aortic aneurysm in the Women's Health Initiative

Journal of Vascular Surgery ◽

10.1016/j.jvs.2020.07.106 ◽

2020 ◽

Author(s):

Elizabeth L. Chou ◽

Mary Pettinger ◽

Bernhard Haring ◽

Matthew W. Mell ◽

Mark A. Hlatky ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Women’S Health ◽

Women's Health ◽

Lipoprotein A ◽

Women's Health Initiative ◽

Women’S Health Initiative ◽

Health Initiative ◽

Abdominal Aortic ◽

The Women’S Health Initiative

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LPA Genotypes and Haplotypes Are Associated with Lipoprotein(a) Levels but Not Arterial Wall Properties in Stable Post-Coronary Event Patients with Very High Lipoprotein(a) Levels

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8120181 ◽

2021 ◽

Vol 8 (12) ◽

pp. 181

Author(s):

Andreja Rehberger Likozar ◽

Aleš Blinc ◽

Katarina Trebušak Podkrajšek ◽

Miran Šebeštjen

Keyword(s):

Arterial Wall ◽

Coronary Event ◽

Morphological Properties ◽

Nucleotide Polymorphisms ◽

Gene Encoding ◽

Single Nucleotide ◽

Lipoprotein A ◽

Wall Properties ◽

Artery Disease ◽

Stable Cad

Lipoprotein(a) [Lp(a)] levels are an independent risk factor for coronary artery disease (CAD). Two single-nucleotide polymorphisms (rs10455872, rs3798220) and number of KIV-2 repeats in the gene encoding Lp(a) (LPA) are associated with Lp(a) and CAD. Our aim was to investigate whether in patients with stable CAD and high Lp(a) levels these genetic variants are associated with increased Lp(a) and arterial wall properties. Blood samples underwent biochemical and genetic analyses. Ultrasound measurements for the functional and morphological properties of arterial wall were performed. Genotypes of rs10455872 and haplotypes AT and GT showed significant association with Lp(a) levels. Patients with GG showed significantly higher Lp(a) levels compared with those with AG genotype (2180 vs. 1391 mg/L, p = 0.045). Patients with no AT haplotype had significantly higher Lp(a) compared to carriers of one AT haplotype (2158 vs. 1478 mg/L, p = 0.023) or two AT haplotypes (2158 vs. 1487 mg/L, p = 0.044). There were no significant associations with the properties of the arterial wall. Lp(a) levels significantly correlated also with number of KIV-2 repeats (r = −0.601; p < 0.0001). In our patients, these two LPA polymorphisms and number of KIV-2 repeats are associated with Lp(a), but not arterial wall properties.

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Lipoprotein(a) and abdominal aortic aneurysm risk: The Atherosclerosis Risk in Communities study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2017.10.017 ◽

2018 ◽

Vol 268 ◽

pp. 63-67 ◽

Cited By ~ 5

Author(s):

Yasuhiko Kubota ◽

Aaron R. Folsom ◽

Christie M. Ballantyne ◽

Weihong Tang

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Atherosclerosis Risk In Communities ◽

Lipoprotein A ◽

Abdominal Aortic ◽

Atherosclerosis Risk

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Persistent arterial wall inflammation in patients with elevated lipoprotein(a) despite strong low-density lipoprotein cholesterol reduction by proprotein convertase subtilisin/kexin type 9 antibody treatment

European Heart Journal ◽

10.1093/eurheartj/ehy862 ◽

2018 ◽

Vol 40 (33) ◽

pp. 2775-2781 ◽

Cited By ~ 40

Author(s):

Lotte C A Stiekema ◽

Erik S G Stroes ◽

Simone L Verweij ◽

Helina Kassahun ◽

Lisa Chen ◽

...

Keyword(s):

Cardiovascular Risk ◽

Arterial Wall ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Lipoprotein Cholesterol ◽

Lipid Lowering ◽

Controlled Study ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Lipoprotein A

AbstractAimsSubjects with lipoprotein(a) [Lp(a)] elevation have increased arterial wall inflammation and cardiovascular risk. In patients at increased cardiovascular risk, arterial wall inflammation is reduced following lipid-lowering therapy by statin treatment or lipoprotein apheresis. However, it is unknown whether lipid-lowering treatment in elevated Lp(a) subjects alters arterial wall inflammation. We evaluated whether evolocumab, which lowers both low-density lipoprotein cholesterol (LDL-C) and Lp(a), attenuates arterial wall inflammation in patients with elevated Lp(a).Methods and resultsIn this multicentre, randomized, double-blind, placebo-controlled study, 129 patients {median [interquartile range (IQR)]: age 60.0 [54.0–67.0] years, Lp(a) 200.0 [155.5–301.5] nmol/L [80.0 (62.5–121.0) mg/dL]; mean [standard deviation (SD)] LDL-C 3.7 [1.0] mmol/L [144.0 (39.7) mg/dL]; National Cholesterol Education Program high risk, 25.6%} were randomized to monthly subcutaneous evolocumab 420 mg or placebo. Compared with placebo, evolocumab reduced LDL-C by 60.7% [95% confidence interval (CI) 65.8–55.5] and Lp(a) by 13.9% (95% CI 19.3–8.5). Among evolocumab-treated patients, the Week 16 mean (SD) LDL-C level was 1.6 (0.7) mmol/L [60.1 (28.1) mg/dL], and the median (IQR) Lp(a) level was 188.0 (140.0–268.0) nmol/L [75.2 (56.0–107.2) mg/dL]. Arterial wall inflammation [most diseased segment target-to-background ratio (MDS TBR)] in the index vessel (left carotid, right carotid, or thoracic aorta) was assessed by 18F-fluoro-deoxyglucose positron-emission tomography/computed tomography. Week 16 index vessel MDS TBR was not significantly altered with evolocumab (−8.3%) vs. placebo (−5.3%) [treatment difference −3.0% (95% CI −7.4% to 1.4%); P = 0.18].ConclusionEvolocumab treatment in patients with median baseline Lp(a) 200.0 nmol/L led to a large reduction in LDL-C and a small reduction in Lp(a), resulting in persistent elevated Lp(a) levels. The latter may have contributed to the unaltered arterial wall inflammation.

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Lipoprotein(a) Levels in Patients With Abdominal Aortic Aneurysm

Angiology ◽

10.1177/0003319716637792 ◽

2016 ◽

Vol 68 (2) ◽

pp. 99-108 ◽

Cited By ~ 18

Author(s):

Kazuhiko Kotani ◽

Amirhossein Sahebkar ◽

Maria-Corina Serban ◽

Sorin Ursoniu ◽

Dimitri P. Mikhailidis ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Clinical Utility ◽

Meta Analysis ◽

Random Effects Model ◽

Summary Statistics ◽

Data Synthesis ◽

Lipoprotein A ◽

Abdominal Aortic ◽

Circulating Markers

Circulating markers relevant to the development of abdominal aortic aneurysm (AAA) are currently required. Lipoprotein(a), Lp(a), is considered a candidate marker associated with the presence of AAA. The present meta-analysis aimed to evaluate the association between circulating Lp(a) levels and the presence of AAA. The PubMed-based search was conducted up to April 30, 2015, to identify the studies focusing on Lp(a) levels in patients with AAA and controls. Quantitative data synthesis was performed using a random effects model, with standardized mean difference (SMD) and 95% confidence interval (CI) as summary statistics. Overall, 9 studies were identified. After a combined analysis, patients with AAA were found to have a significantly higher level of Lp(a) compared to the controls (SMD: 0.87, 95% CI: 0.41-1.33, P < .001). This result remained robust in the sensitivity analysis, and its significance was not influenced after omitting each of the included studies from the meta-analysis. The present meta-analysis confirmed a higher level of circulating Lp(a) in patients with AAA compared to controls. High Lp(a) levels can be associated with the presence of AAA, and Lp(a) may be a marker in screening for AAA. Further studies are needed to establish the clinical utility of measuring Lp(a) in the prevention and management of AAA.

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CFD Modelling of Abdominal Aortic Aneurysm on Hemodynamic Loads Using a Realistic Geometry with CT

Computational and Mathematical Methods in Medicine ◽

10.1155/2013/472564 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 44

Author(s):

Eduardo Soudah ◽

E. Y. K. Ng ◽

T. H. Loong ◽

Maurizio Bordone ◽

Uei Pua ◽

...

Keyword(s):

Abdominal Aortic Aneurysm ◽

Aortic Aneurysm ◽

Arterial Wall ◽

Wall Stress ◽

Asymmetry Index ◽

Geometric Parameters ◽

Cfd Modelling ◽

Finite Elements Analysis ◽

Abdominal Aortic

The objective of this study is to find a correlation between the abdominal aortic aneurysm (AAA) geometric parameters, wall stress shear (WSS), abdominal flow patterns, intraluminal thrombus (ILT), and AAA arterial wall rupture using computational fluid dynamics (CFD). Real AAA 3D models were created by three-dimensional (3D) reconstruction of in vivo acquired computed tomography (CT) images from 5 patients. Based on 3D AAA models, high quality volume meshes were created using an optimal tetrahedral aspect ratio for the whole domain. In order to quantify the WSS and the recirculation inside the AAA, a 3D CFD using finite elements analysis was used. The CFD computation was performed assuming that the arterial wall is rigid and the blood is considered a homogeneous Newtonian fluid with a density of 1050 kg/m3and a kinematic viscosity of4×10-3Pa·s. Parallelization procedures were used in order to increase the performance of the CFD calculations. A relation between AAA geometric parameters (asymmetry index (β), saccular index (γ), deformation diameter ratio (χ), and tortuosity index (ε)) and hemodynamic loads was observed, and it could be used as a potential predictor of AAA arterial wall rupture and potential ILT formation.

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