Potential influencing factors of aortic diameter at specific segments in population with cardiovascular risk

Jin

Front. Cardiovasc. Med.

et al. 2022

ObjectiveTo generate reference values of the normal areas of the abdominal aorta at various levels among Chinese people and to explore the factors that may promote the expansion of the abdominal aorta.MethodsThe areas of normal abdominal aortas were gauged at various levels based on inner-to-inner measurements in 1,066 Chinese adult patients (>18 years) without the abdominal aortic disease. The areas of subphrenic abdominal, suprarenal abdominal, infrarenal abdominal, and distal abdominal aortas were measured. The demographic and clinical characteristics were collected into a specifically designed electronic database. Multivariable linear regression was used to analyze the potential risk factors promoting the expansion of the abdominal aorta.ResultsIn males, the median areas of the subphrenic abdominal aorta, suprarenal abdominal aorta, infrarenal abdominal aorta, and distal abdominal aorta were 412.1, 308.0, 242.2, and 202.2 mm2, respectively. In females, the median areas of the subphrenic abdominal aorta, suprarenal abdominal aorta, infrarenal abdominal aorta, and distal abdominal aorta were 327.7, 243.4, 185.4, and 159.6 mm2, respectively. The areas of the abdominal aorta at different levels were larger in males than in females and increased with age. Multiple linear stepwise regression analysis showed that the subphrenic abdominal aortic area was significantly related to age (β = 0.544, p < 0.001), sex (β = 0.359, p < 0.001), and hypertension (β = 0.107, p < 0.001). Suprarenal abdominal aortic area was related to age (β = 0.398, p < 0.001), sex (β = 0.383, p < 0.001), history of smoking (β = 0.074, p = 0.005), and hypertension (β = 0.111, p < 0.001). The infrarenal abdominal aortic area was correlated with age (β = 0.420, p < 0.001), sex (β = 0.407, p < 0.001), and history of smoking (β = 0.055, p = 0.036). The distal abdominal aortic area was correlated with age (β = 0.463, p < 0.001), sex (β = 0.253, p < 0.001), and hypertension (β = 0.073, p = 0.013).ConclusionThe abdominal aortic areas at different levels were larger in males than in females. Aging, hypertension, and smoking prompt the expansion of abdominal aorta.

Section: Discussionsupporting

confidence: 82%

“…A history of smoking was also a positive factor of partial abdominal aortic area. This is similar to the factors associated with abdominal aortic diameter (15). Female sex was associated The abdominal aortic diameter is currently a standard for the diagnosis and treatment of AAA, and it is an accessible and valid indicator.…”

Section: Discussionsupporting

confidence: 71%

Reference values of normal abdominal aortic areas in Chinese population measured by contrast-enhanced computed tomography

Jin

Front. Cardiovasc. Med.

et al. 2022

“…Additional work should investigate the specific biologic pathways that govern the relationships between ascending thoracic aortic size and BP, including investigating the effect of comorbid conditions such as type II diabetes, which observationally has been shown to be protective against TAA, 28 , 29 and hypercholesterolemia which has been shown to possibly contribute to TAA development. 30 , 31 Finally, while our MR results were statistically robust when using MR methods that make different assumptions about the presence of pleiotropy (weighted median, inverse variance weighted, MR Egger), and when testing for the presence of reverse-causality via MR-Steiger, these methods are not perfect for attribution of causality. 13 …”

Section: Discussionmentioning

confidence: 78%

Relationship Between Ascending Thoracic Aortic Diameter and Blood Pressure: A Mendelian Randomization Study

DePaolo

Levin

Tcheandjieu

et al. 2023

ATVB

Background: Observational studies identified elevated blood pressure (BP) as a strong risk factor for thoracic aortic dilation, and BP reduction is the primary medical intervention recommended to prevent progression of aortic aneurysms. However, although BP may impact aortic dilation, aortic size may also impact BP. The causal relationship between BP and thoracic aortic size has not been reliably established. Methods: Genome-wide association studies summary statistics were obtained for BP and ascending thoracic aortic diameter (AscAoD). Causal effects of BP on AscAoD were estimated using 2-sample Mendelian randomization using a range of pleiotropy-robust methods. Results: Genetically predicted increased systolic BP, diastolic BP, and mean arterial pressure all significantly associate with higher AscAoD (systolic BP: β estimate, 0.0041 mm/mm Hg [95% CI, 0.0008–0.0074]; P =0.02, diastolic BP: β estimate, 0.0272 mm/mm Hg [95% CI, 0.0224–0.0320]; P <0.001, and mean arterial pressure: β estimate, 0.0168 mm/mm Hg [95% CI, 0.0130–0.0206]; P <0.001). Genetically predicted pulse pressure, meanwhile, had an inverse association with AscAoD (β estimate, −0.0155 mm/mm Hg [95% CI, −0.0213 to −0.0096]; P <0.001). Multivariable Mendelian randomization analyses showed that genetically predicted increased mean arterial pressure and reduced pulse pressure were independently associated with AscAoD. Bidirectional Mendelian randomization demonstrated that genetically predicted AscAoD was inversely associated with pulse pressure (β estimate, −2.0721 mm Hg/mm [95% CI, −3.1137 to −1.0306]; P <0.001) and systolic BP (β estimate, −1.2878 mm Hg/mm [95% CI, −2.3533 to −0.2224]; P =0.02), while directly associated with diastolic BP (0.8203 mm Hg/mm [95% CI, 0.2735–1.3672]; P =0.004). Conclusions: BP likely contributes causally to ascending thoracic aortic dilation. Increased AscAoD likely contributes to lower systolic BP and pulse pressure, but not diastolic BP, consistent with the hemodynamic consequences of a reduced aortic diameter.

“…Endothelial cells produce NO which will diffuse into the blood vessels’ smooth muscle cells and activate the soluble guanylate cyclase (sGC) enzyme, which can lead to increased formation of cyclic GMP from its GTP precursor. Cyclic GMP stimulates the relaxation of the smooth muscles of blood vessels so that vasodilation will occur [ 38 ]. Our results of this research show that oral administration of fucoidan nanoparticles increased cGMP expression in aortic tissue in diabetic rats.…”

Section: Discussionmentioning

confidence: 99%

Molecular Mechanism of Fucoidan Nanoparticles as Protector on Endothelial Cell Dysfunction in Diabetic Rats’ Aortas

et al. 2023

Antioxidants have an important role in protecting against diabetes complications such as vascular endothelial cell damage. Fucoidan has strong antioxidant properties, therefore the aim of this study was to investigate the protective mechanism of fucoidan nanoparticles through the pathway of antioxidant activity against streptozotocin-induced diabetic aortic endothelial cell dysfunction in rats. Fucoidan nanoparticles are made utilizing high-energy ball milling. This research consists of five groups, namely: control rats, rats were administered aquadest; diabetic rats, rats were administered streptozotocin (STZ); fucoidan nanoparticle rats, rats were administered STZ and fucoidan nanoparticles. Aortic tissue was collected for the evaluation of ROS (reactive oxygen species), Malondialdehyde (MDA), superoxide Dismutase (SOD), Glutathione Peroxidase (GPx), Nuclear factor erythroid-2-related factor 2 (Nrf2), Nitric Oxide (NO), cyclic Guanosine Monophosphate (cGMP), relaxation response of acetylcholine (Ach), and the diameter of the aorta. The size distribution of the fucoidan nanoparticles was 267.2 ± 42.8 nm. Administration of fucoidan nanoparticles decreased the levels of ROS and MDA, and increased the levels of SOD, levels of GPx, Nrf2 expression, NO levels, cGMP expression, the relaxation response of Ach, and lumen diameter of the aorta, which are significantly different when compared with diabetic rats, p < 0.05. In this study, we concluded that the mechanism pathway of fucoidan nanoparticles prevents aortic endothelial cell dysfunction in diabetic rats through antioxidant activity by reducing ROS and MDA and incrementing SOD levels, GPx levels, and Nrf2 expression. All of these can lead to an elevated relaxation response effect of Ach and an increase in the lumen diameter of the aorta, which indicates a protective effect of fucoidan nanoparticles on aortic endothelial cells.