TY - JOUR
T1 - Is the intimal thickness a key contributor to thoracic aortopathy?
AU - Grewal, Nimrat
AU - Poelmann, Robert
N1 - Publisher Copyright: © 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Background: An aortic dissection is the most devastating complication of thoracic aortic disease. Several non- and syndromic conditions such as a bicuspid aortic valve (BAV) and Marfan syndrome (MFS) have a severely increased risk to develop a thoracic aortic aneurysm and dissection. To date, the medial layer has been extensively studied in search of the pathogenetic mechanisms leading to aortic complications. Objective: We aim to determine whether intimal layer pathology is characteristic in all thoracic aortopathy regardless of the underlying etiology. Method: A total of 176 aortic wall specimen were studied for the intimal layer architecture including the intimal thickness, endothelial cell morphology, and atherosclerosis. Specimens were derived from four patient groups: BAV (n = 70, age 57 ± 8.9 years), isolated tricuspid aortic valve (TAV) (n = 38, age 64.9 ± 11.0 years), MFS with a TAV (n = 8, age 34.2 ± 11.0 years), type A dissections with a TAV (n = 60, age 62.7 ± 10 years). Results: The intimal layer is significantly thinner in BAV, MFS, and type A aortic dissection as compared to the isolated TAV patients (p < 0.001). Intimal atherosclerosis was also significantly less present in the three groups as compared to the isolated TAV (p < 0.05). Discussion: A thin intimal layer is a common finding in the thoracic aortopathy patients. Studies aiming at preventing future aortic complications should focus on the intimal pathology as a common effector pathway in thoracic aortopathy.
AB - Background: An aortic dissection is the most devastating complication of thoracic aortic disease. Several non- and syndromic conditions such as a bicuspid aortic valve (BAV) and Marfan syndrome (MFS) have a severely increased risk to develop a thoracic aortic aneurysm and dissection. To date, the medial layer has been extensively studied in search of the pathogenetic mechanisms leading to aortic complications. Objective: We aim to determine whether intimal layer pathology is characteristic in all thoracic aortopathy regardless of the underlying etiology. Method: A total of 176 aortic wall specimen were studied for the intimal layer architecture including the intimal thickness, endothelial cell morphology, and atherosclerosis. Specimens were derived from four patient groups: BAV (n = 70, age 57 ± 8.9 years), isolated tricuspid aortic valve (TAV) (n = 38, age 64.9 ± 11.0 years), MFS with a TAV (n = 8, age 34.2 ± 11.0 years), type A dissections with a TAV (n = 60, age 62.7 ± 10 years). Results: The intimal layer is significantly thinner in BAV, MFS, and type A aortic dissection as compared to the isolated TAV patients (p < 0.001). Intimal atherosclerosis was also significantly less present in the three groups as compared to the isolated TAV (p < 0.05). Discussion: A thin intimal layer is a common finding in the thoracic aortopathy patients. Studies aiming at preventing future aortic complications should focus on the intimal pathology as a common effector pathway in thoracic aortopathy.
KW - Aortopathy
KW - Bicuspid aortic valve
KW - Marfan syndrome
KW - Pathology
KW - Type A dissection
UR - http://www.scopus.com/inward/record.url?scp=85160846729&partnerID=8YFLogxK
U2 - https://doi.org/10.1007/s12055-023-01528-1
DO - https://doi.org/10.1007/s12055-023-01528-1
M3 - Review article
C2 - 38093926
SN - 0970-9134
VL - 39
SP - 233
EP - 238
JO - Indian Journal of Thoracic and Cardiovascular Surgery
JF - Indian Journal of Thoracic and Cardiovascular Surgery
ER -