scholarly journals The Role of Inflammation and Myeloperoxidase-Related Oxidative Stress in the Pathogenesis of Genetically Triggered Thoracic Aortic Aneurysms

2020 ◽  
Vol 21 (20) ◽  
pp. 7678 ◽  
Author(s):  
Cassandra Malecki ◽  
Brett D. Hambly ◽  
Richmond W. Jeremy ◽  
Elizabeth N. Robertson
Keyword(s):  
Inflammatory Response ◽  
Cerebral Aneurysms ◽  
Aortic Aneurysms ◽  
Phenotypic Switching ◽  
Weight Of Evidence ◽  
Thoracic Aortic Aneurysms ◽  
Hypohalous Acids ◽  
Artery Disease ◽  
Specific Tissue ◽  
Oxidative Species

Genetically triggered thoracic aortic aneurysms (TAAs) are usually considered to exhibit minimal levels of inflammation. However, emerging data demonstrate that specific features of an inflammatory response can be observed in TAA, and that the extent of the inflammatory response can be correlated with the severity, in both mouse models and in human studies. Myeloperoxidase (MPO) is a key mediator of the inflammatory response, via production of specific oxidative species, e.g., the hypohalous acids. Specific tissue modifications, mediated by hypohalous acids, have been documented in multiple cardiovascular pathologies, including atherosclerosis associated with coronary artery disease, abdominal aortic, and cerebral aneurysms. Similarly, data are now emerging that show the capacity of MPO-derived oxidative species to regulate mechanisms important in TAA pathogenesis, including alterations in extracellular matrix homeostasis, activation of matrix metalloproteinases, induction of endothelial dysfunction and vascular smooth muscle cell phenotypic switching, and activation of ERK1/2 signaling. The weight of evidence supports a role for inflammation in exacerbating the severity of TAA progression, expanding our understanding of the pathogenesis of TAA, identifying potential biomarkers for early detection of TAA, monitoring severity and progression, and for defining potential novel therapeutic targets.

Epidemiology and global burden of peripheral arterial disease and aortic aneurysms

ESC CardioMed ◽  
2018 ◽  
pp. 328-334
Author(s):  
Holger Reinecke ◽  
Nasser Malyar
Keyword(s):  
General Population ◽  
Large Scale ◽  
Arterial Disease ◽  
Aortic Aneurysms ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Thoracic Aortic Aneurysms ◽  
Artery Disease ◽  
Peripheral Arterial ◽  
Older Populations

Peripheral artery disease (PAD) and aortic aneurysms are common diseases in older populations, sharing common aetiological risk factors. From community-based trials assessing ankle–brachial indices, 2–4% of the general population have been shown to be affected by PAD, which increases up to 15% in those above 70 years of age. About 30–40% of the in-hospital cases with PAD have critical limb ischaemia and suffer from a 1-year mortality of 20–40%. Abdominal aortic aneurysms (AAAs) also show a relatively high prevalence of about 1–2% in the general population as found by large-scale, systematic duplex screening. Of these, about 5% come to hospital admittance with a ruptured AAA which is still associated with an in-hospital mortality of up to 50%. The prevalence of thoracic aortic aneurysms (TAAs) was reported to be at about 0.16–0.34% in selected subgroups of the general population. The incident cases of TAAs have risen from 10/100,000 cases in the late 1980s up to about 17/100,000 cases in the first decade of this millennium. It is noteworthy that PAD and aortic aneurysms as well as their associated co-morbidities remain in many cases underdiagnosed and undertreated. This leads to a high cardiovascular morbidity and mortality which could not be obviously markedly reduced in the recent decades. Since nearly all vascular disorders are systemic diseases, not only the specific vessel bed which leads to a presentation should be assessed but also all other possible vascular manifestations should be thoroughly examined to reduce the high rates of adverse events and the persistent poor outcome.

Management of Coronary Artery Disease in Patients With Descending Thoracic Aortic Aneurysms

2015 ◽  
Vol 30 (9) ◽  
pp. 701-706 ◽  
Author(s):  
Bijoy G. Rajbanshi ◽  
Paris Charilaou ◽  
Bulat A. Ziganshin ◽  
Chanaka Rajakaruna ◽  
Tranquilli Maryann ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Artery Disease

scholarly journals Systemic Inflammatory Response and Severe Thrombocytopenia after Endovascular Thoracic Aortic Aneurysm Repair

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Valentina Silvestrin ◽  
Stefano Bonvini ◽  
Michele Antonello ◽  
Franco Grego ◽  
Roberto Vettor ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Inflammatory Response ◽  
Endovascular Repair ◽  
Thoracic Aortic Aneurysm ◽  
Systemic Inflammatory Response ◽  
Aortic Aneurysms ◽  
Severe Thrombocytopenia ◽  
Laboratory Findings ◽  
Thoracic Aortic Aneurysms ◽  
Beneficial Effects

After Endovascular repair of thoracic aortic aneurysm, a systemic inflammatory response, named postimplantation syndrome, can develop. This syndrome is characterized by fever, leukocytosis, and elevated CRP plasma levels and its pathogenetic mechanisms are still unknown. Although this syndrome generally resolves within few days, some patients develop a persisting severe inflammatory reaction leading to mild or severe complications. Here we describe the case of a male patient who developed postimplantation inflammatory syndrome and severe thrombocytopenia after endovascular repair of thoracic aortic aneurysm. Treatment with prednisone (50 mg/bid) for two weeks did not improve the clinical and laboratory findings. We utilized danazol, a weak androgen that has been shown to be effective in the treatment of immune and idiopathic thrombocytopenic purpura, and after 12 days of treatment with danazol (200 mg/bid), the patient improved progressively and platelet number increased up to 53,000/μL. Patients undergoing endovascular repair of thoracic aortic aneurysm should be carefully monitored for the development of postimplantation syndrome. This clinical condition is relatively common after the endovascular repair of aortic aneurysm but is rarely observed after endovascular repair of thoracic aortic aneurysms. The different known therapeutical approaches are still empiric, with reported beneficial effects with the use of NSAID, corticosteroids, and danazol.

scholarly journals Sex differences in vascular physiology and pathophysiology: estrogen and androgen signaling in health and disease

2017 ◽  
Vol 313 (3) ◽  
pp. H524-H545 ◽  
Author(s):  
Austin C. Boese ◽  
Seong C. Kim ◽  
Ke-Jie Yin ◽  
Jean-Pyo Lee ◽  
Milton H. Hamblin
Keyword(s):  
Sex Differences ◽  
Vascular Function ◽  
Cerebral Aneurysms ◽  
Cellular Tissue ◽  
Normal Function ◽  
Aortic Aneurysms ◽  
Biomedical Sciences ◽  
Vascular Physiology ◽  
Health And Disease ◽  
Artery Disease

Sex differences between women and men are often overlooked and underappreciated when studying the cardiovascular system. It has been long assumed that men and women are physiologically similar, and this notion has resulted in women being clinically evaluated and treated for cardiovascular pathophysiological complications as men. Currently, there is increased recognition of fundamental sex differences in cardiovascular function, anatomy, cell signaling, and pathophysiology. The National Institutes of Health have enacted guidelines expressly to gain knowledge about ways the sexes differ in both normal function and diseases at the various research levels (molecular, cellular, tissue, and organ system). Greater understanding of these sex differences will be used to steer future directions in the biomedical sciences and translational and clinical research. This review describes sex-based differences in the physiology and pathophysiology of the vasculature, with a special emphasis on sex steroid receptor (estrogen and androgen receptor) signaling and their potential impact on vascular function in health and diseases (e.g., atherosclerosis, hypertension, peripheral artery disease, abdominal aortic aneurysms, cerebral aneurysms, and stroke).

Cannulation of the Ascending Aorta in Left Thoracotomy for Thoracic Aortic Aneurysms

2007 ◽  
Vol 10 (1) ◽  
pp. E81-E83 ◽  
Author(s):  
Riza Turkoz ◽  
Oner Gulcan ◽  
Orhan Demirturk ◽  
Ayda Turkoz
Keyword(s):  
Ascending Aorta ◽  
Aortic Aneurysms ◽  
Left Thoracotomy ◽  
Thoracic Aortic Aneurysms

The Role of Revascularisation in Patients Undergoing Non-cardiac Surgery

2010 ◽  
Vol 5 (1) ◽  
pp. 104
Author(s):  
Daniel S Menees ◽  
Eric R Bates ◽  
◽  
Keyword(s):  
Cardiac Surgery ◽  
Prediction Models ◽  
Cardiovascular Complications ◽  
Weight Of Evidence ◽  
Beta Blockade ◽  
Cardiac Morbidity ◽  
Increased Risk ◽  
Reduction Strategies ◽  
Artery Disease ◽  
Risk Reduction Strategies

Coronary artery disease (CAD) affects millions of US citizens. As the population ages, an increasing number of people with CAD are undergoing non-cardiac surgery and face significant peri-operative cardiac morbidity and mortality. Risk-prediction models can be used to help identify those patients at increased risk of peri-operative cardiovascular complications. Risk-reduction strategies utilising pharmacotherapy with beta blockade and statins have shown the most promise. Importantly, the benefit of prophylactic coronary revascularisation has not been demonstrated. The weight of evidence suggests reserving either percutaneous or surgical revascularisation in the pre-operative setting for those patients who would otherwise meet independent revascularisation criteria.

Complications After Endovascular Treatment of Thoracic Aortic Aneurysms

2003 ◽  
Vol 10 (4) ◽  
pp. 711-718 ◽  
Author(s):  
Reinhard Scharrer-Pamler ◽  
Thomas Kotsis ◽  
Xaver Kapfer ◽  
Johannes Görich ◽  
Karl-Heinz Orend ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms
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