Guilt by association: a paradigm for detection of silent aortic disease

Ziganshin, Bulat A.; Elefteriades, John A.

doi:10.21037/acs.2016.05.13

Cited by 26 publications

(15 citation statements)

References 63 publications

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“…The main risk factors for AAA are cigarette smoking, advanced age, male sex and family history,7 while the major risk factors for TAD are hypertension, bicuspid aortic valve (BAV) and a family history/genetic predisposition 8. Our group has introduced the paradigm ‘Guilt by association’ for the identification of TAAs, which uses various clinical markers linked to TAAs, including intracranial aneurysms, aortic arch anomalies, simple renal cysts (SRC), BAV, family history of aortic disease, a positive thumb-palm sign and temporal arteritis 9…”

Section: Introductionmentioning

confidence: 99%

Simple renal cysts and bovine aortic arch: markers for aortic disease

et al. 2019

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ObjectiveThis study aimed to assess the prevalence of thoracic aortic disease (TAD) and abdominal aortic aneurysms (AAA) among patients with simple renal cyst (SRC) and bovine aortic arch (BAA).MethodsThrough a retrospective search for patients who underwent both chest and abdominal CT imaging at our institution from 2012 to 2016, we identified patients with SRC and BAA and propensity score matched them to those without these features by age, gender and presence of hypertension, hyperlipidaemia, diabetes and chronic kidney disease.ResultsOf a total of 35 498 patients, 6366 were found to have SRC. Compared with the matched population without SRC, individuals with SRC were significantly more likely to have TAD (10.1% vs 3.9%), ascending aortic aneurysm (8.0% vs 3.2%), descending aortic aneurysm (3.3% vs 0.9%), type A aortic dissection (0.6% vs 0.2%), type B aortic dissection (1.1% vs 0.3%) and AAA (7.9% vs 3.3%). The 920 patients identified with BAA were significantly more likely to have TAD (21.8% vs 4.5%), ascending aortic aneurysm (18.4% vs 3.2%), descending aortic aneurysm (6.5% vs 2.0%), type A aortic dissection (1.4% vs 0.4%) and type B aortic dissection (2.4% vs 0.7%) than the matched population without BAA. SRC and BAA were found to be significantly associated with the presence of TAD (OR=2.57 and 7.69, respectively) and AAA (OR=2.81 and 2.56, respectively) on multivariable analysis.ConclusionsThis study establishes a substantial increased prevalence of aortic disease among patients with SRC and BAA. SRC and BAA should be considered markers for aortic aneurysm development.

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Section: Introductionmentioning

confidence: 99%

Simple renal cysts and bovine aortic arch: markers for aortic disease

et al. 2019

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“…In previous works, whole genome profiling has revealed an important role of pathways of the immune system and cell adhesion in the pathogenesis of abdominal aortic aneurysms (AAA) 13 , 14 . The multifactorial disease of ATAA is regarded as a “silent killer” due to its lack of clinical symptoms before late complications 15 . Several other conditions, including AAA, have been shown as predisposing factors to ATAA 15 .…”

Section: Introductionmentioning

confidence: 99%

“…The multifactorial disease of ATAA is regarded as a “silent killer” due to its lack of clinical symptoms before late complications 15 . Several other conditions, including AAA, have been shown as predisposing factors to ATAA 15 . Hence it is crucial to research the processes, which are active and affect these, often lethal and requiring aortic surgery to prevent aortic rupture and dissection.…”

Section: Introductionmentioning

confidence: 99%

Differentially expressed genes and canonical pathways in the ascending thoracic aortic aneurysm – The Tampere Vascular Study

Sulkava

Raitoharju

Mennander

et al. 2017

Sci Rep

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Ascending thoracic aortic aneurysm (ATAA) is a multifactorial disease with a strong inflammatory component. Surgery is often required to prevent aortic rupture and dissection. We performed gene expression analysis (Illumina HumanHT-12 version 3 Expression BeadChip) for 32 samples from ATAA (26 without/6 with dissection), and 28 left internal thoracic arteries (controls) collected in Tampere Vascular study. We compared expression profiles and conducted pathway analysis using Ingenuity Pathway Analysis (IPA) to reveal differences between ATAA and a healthy artery wall. Almost 5000 genes were differentially expressed in ATAA samples compared to controls. The most downregulated gene was homeobox (HOX) A5 (fold change, FC = −25.3) and upregulated cadherin-2 (FC = 12.6). Several other HOX genes were also found downregulated (FCs between -25.3 and -1.5, FDR < 0.05). 43, mostly inflammatory, canonical pathways in ATAA were found to be significantly (p < 0.05, FDR < 0.05) differentially expressed. The results remained essentially the same when the 6 dissected ATAA samples were excluded from the analysis. We show for the first time on genome level that ATAA is an inflammatory process, revealing a more detailed molecular pathway level pathogenesis. We propose HOX genes as potentially important players in maintaining aortic integrity, altered expression of which might be important in the pathobiology of ATAA.

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“…Arch anomalies found on the patient's imaging studies, such as a bovine arch and an aberrant vertebral artery, are also associated with thoracic aortic disease. 5 Despite the moderate dilatation of her aorta, of approximately 4.2 to 4.3 cm, intraoperative findings included a dissection that had terminated for the time-being but was nonetheless capable of future activity.…”

Section: Discussionmentioning

confidence: 99%

Symptoms Matter: A Symptomatic but Radiographically Elusive Ascending Aortic Dissection

et al. 2018

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Symptoms attributable to a thoracic aortic aneurysm (TAA) are a separate indication for prophylactic repair, irrespective of aortic size. We present the case of a 56-year-old female with a history of a thoracic ascending aortic aneurysm (TAAA) and four other heart and arch vessel abnormalities who presented to us with chest pain radiating to her back. Computed Tomography and echocardiography showed no evidence of a dissection and revealed a maximal ascending aortic diameter of 4.2 cm. The patient subsequently underwent root-sparing ascending aortic and hemiarch replacement due to her threatening symptomatology. A focal dissection was discovered intraoperatively, resembling a similar case previously reported by our team.

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Guilt by association: a paradigm for detection of silent aortic disease

Cited by 26 publications

References 63 publications

Simple renal cysts and bovine aortic arch: markers for aortic disease

Simple renal cysts and bovine aortic arch: markers for aortic disease

Differentially expressed genes and canonical pathways in the ascending thoracic aortic aneurysm – The Tampere Vascular Study

Symptoms Matter: A Symptomatic but Radiographically Elusive Ascending Aortic Dissection

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