Acute Aortic Syndrome

Sheikh, Azeem S; Kamran, Ali; Mazhar, Sajjad

doi:10.1161/circulationaha.112.000170

Cited by 47 publications

(48 citation statements)

References 20 publications

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“…1 To delineate treatment, the Stanford classification divides AAD into 2 types, type A and type B. Type A affects the ascending aorta, whereas type B does not.…”

mentioning

confidence: 99%

Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture

Anzai

Shimoda

Endo

et al. 2015

Circulation Research

173

129

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A n acute aortic dissection (AAD) is initiated by an intimal tear, with resultant propagation within the middle third of the medial layer of the aorta. 1 To delineate treatment, the Stanford classification divides AAD into 2 types, type A and type B. Type A affects the ascending aorta, whereas type B does not. Type A AAD is more severe because of the higher mortality rate of 20% by 24 hours, 30% by 48 hours, 40% at 1 week, and 50% at 1 month.2 Thus, surgical repair is the first choice of treatment for patients with type A AAD to prevent life-threatening complications, including aortic rupture and cardiac tamponade. Although type B AAD is generally more benign and medical treatment for high blood pressure and intolerant pain can improve the patient's clinical outcome, a substantial proportion of medically treated patients still encounter catastrophic events within 7 days, such as aortic expansion and subsequent aortic rupture, visceral ischemia, and lung oxygenation impairment.2,3 Thoracic endovascular repair with stent grafting is the emerging therapeutic strategy Methods and Results:

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“…1 To delineate treatment, the Stanford classification divides AAD into 2 types, type A and type B. Type A affects the ascending aorta, whereas type B does not.…”

mentioning

confidence: 99%

Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture

Anzai

Shimoda

Endo

et al. 2015

Circulation Research

173

129

View full text Add to dashboard Cite

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“…Diagnosis of acute AD and collection of blood sample within 24 h after onset were considered the inclusion criteria. We used the Stanford classification system for dividing AD patients into two groups, type A and type B, depending on whether the ascending aorta was involved [1]. In addition, the following conditions were considered as excluding criteria: (1) patients who were not willing to participate; (2) usage of anti-platelets and anti-inflammatory drugs before admission; (3) a course of acute AD over 24 h or of uncertain onset time; (4) patients with other organ failures; (5) patients with emergent surgical intervention; (6) patients with chronic diseases except for hypertension; (7) patients with infection, and (8) recurrent AD.…”

Section: Methodsmentioning

confidence: 99%

“…Aortic dissection (AD) is a serious condition that occurs when the intima of the aorta tears and blood surges through the tear, causing the inner and middle layers of the aorta to separate [1]. The major lethal complication is multiple-organ dysfunction syndrome (MODS).…”

Section: Introductionmentioning

confidence: 99%

Potential Mechanism of Post-Acute Aortic Dissection Inflammatory Responses: The Role of mtDNA from Activated Platelets

Qin¹,

Gu²,

Qian³

et al. 2016

Cardiology

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Background: Acute aortic dissection (AD) is a lethal cardiovascular disease with severe inflammatory complications. Considering the proinflammatory properties of plasma mitochondrial DNA (mtDNA), we postulate that plasma mtDNA from activated platelets may be responsible for post-acute AD inflammatory responses. Methods: We consecutively enrolled 68 patients with acute AD as well as matched hypertensive and healthy participants. Blood samples were collected on admission for blood routine tests, mtDNA assay, and inflammatory cytokine analysis. A computed tomography scan was used to evaluate the extent of dissections. Results: Our results demonstrate that plasma mtDNA, platelet activation, and inflammatory levels were remarkably higher in acute AD patients than in hypertensive or healthy participants. These parameters were also higher in the Stanford A group than in the Stanford B group (p < 0.05). Bivariate correlation analysis demonstrated positive associations between mtDNA and inflammatory levels (tumor necrosis factor-α: r = 0.577; interleukin-6: r = 0.632), mtDNA and platelet activation (r = 0.642), and platelet activation and the extent of dissection (r = 0.635). Conclusion: Our study suggests that acute AD-induced tunica media exposure causes platelet activation, which leads to the initiation of inflammatory responses via the release of mtDNA into the circulation. Our study provides a novel fundamental basis and a potential therapeutic target for the prevention and treatment of post-AD inflammatory responses.

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“…Other symptoms with which dissection can be manifested are syncope (cardiac, vascular, neurological) (9%), ischemic stroke (6%) or acute heart failure (7%) (ref. 9 ). Dissection can be complicated by acute aortic valve insufficiency and acute heart failure.…”

Section: Acute Aortic Dissectionmentioning

confidence: 99%

“…Compromise of visceral arteries (superior mesenteric artery, renal arteries) can cause mesenteric ischemia (3-5%) and renal failure (5-8%) (ref. 9,11 ). Involvement of the iliac arteries can result in acute limb ischemia.…”

Section: Acute Aortic Dissectionmentioning

confidence: 99%

Acute aorta, overview of acute CT findings and endovascular treatment options

Černá¹,

Köcher²,

Thomas³

2017

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Acute aortic pathologies include acute aortic syndrome (aortic dissection, intramural hematoma, penetrating aortic ulcer), impending rupture, aortic aneurysm rupture and aortic trauma. Acute aortic syndrome, aortic aneurysm rupture and aortic trauma are life-threatening conditions requiring prompt diagnosis and treatment. The basic imaging modality for "acute aorta" is CT angiography with typical findings for these aortic pathologies. Based on the CT, it is possible to classify aortic diseases and anatomical classifications are essential for the planning of treatment. Currently, endovascular treatment is the method of choice for acute diseases of the descending thoracic aorta and is increasingly indicated for patients with ruptured abdominal aortic aneurysms.

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Acute Aortic Syndrome

Abstract: A chest radiograph may show widening of the aortic contour; other features may include displaced calcification, aortic kinking, or opacification of the aortopulmonary window.

Cited by 47 publications

References 20 publications

Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture

Adventitial CXCL1/G-CSF Expression in Response to Acute Aortic Dissection Triggers Local Neutrophil Recruitment and Activation Leading to Aortic Rupture

Potential Mechanism of Post-Acute Aortic Dissection Inflammatory Responses: The Role of mtDNA from Activated Platelets

Acute aorta, overview of acute CT findings and endovascular treatment options

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