“…An intriguing concept of biomechanical-biological interactions in AAA was that of segmental aortic stiffening increasing the axial tensile stress in adjacent, compliant, segments causing increased inflammation and proteolysis, which also correlated with age-related changes in the human aorta (281). Investigations into associations between gene expression and wall stress or the estimated ratio between wall stress and wall strength have pointed to differences in expression of lamin A/C and genes related to ECM and cytokine signaling, while strong associations surviving correction for multiple testing are difficult to obtain (228,229,282). On the protein/structural/cellular level, high ratio between wall stress and wall strength was associated with decreased vSMCs and elastic fibers as well as more cholesterol and calcified plaques, whereas increased wall stress was associated with increased collagen 1, III and total collagen (283).…”