Simple Renal Cysts as Markers of Thoracic Aortic Disease

Abstract

BackgroundThoracic aortic aneurysm is usually a clinically silent disease; timely detection is largely dependent upon identification of clinical markers of thoracic aortic disease (TAD); (bicuspid aortic valve, intracranial aortic aneurysm, bovine aortic arch, or positive family history). Recently, an association of simple renal cysts (SRC) with abdominal aortic aneurysm and aortic dissection was established. The aim of our study was to evaluate the prevalence of SRC in patients with TAD in order to assess whether the presence of SRC can be used as a predictor of TAD.Methods and ResultsWe evaluated the prevalence of SRC in 842 patients with TAD (64.0% males) treated at our institution from 2004 to 2013 and compared to a control group of patients (n=543; 56.2% males). Patients were divided into 4 groups: ascending aortic aneurysm (456; 54.2%); descending aortic aneurysm (86; 10.2%); type A aortic dissection (118; 14.0%); and type B aortic dissection (182; 21.6%). SRC were identified by abdominal computed tomography or magnetic resonance imaging of these patients. Prevalence of SRC is 37.5%, 57.0%, 44.1%, and 47.3% for patients with ascending aneurysm, descending aneurysm, type A dissection, and type B dissection, respectively. Prevalence of SRC in the control group was 15.3%. Prevalence of SRC was not significantly different between male and female aortic disease patients, despite reported general male predominance (2:1), which was also observed in our control group (1.7:1).ConclusionsThis study establishes an increased prevalence of SRC in patients with TAD. SRC can potentially be used as a marker for timely detection of patients at risk of TAD.

Association between renal cysts and abdominal aortic aneurysm: A case-control study

“…Ziganshin et al 15 demonstrated a prevalence of renal cysts of 15.3% in the control group, compared to the prevalence of 44.9% observed in our control group. This difference may be explained by the average age of our control group, which was significantly higher (63.5 vs. 41.4 years).…”

“…Recently, Ziganshin et al 15 demonstrated that patients with aortic aneurysm had 2.8 times greater prevalence of renal cyst compared to the control group. Ziganshin et al 15 demonstrated a prevalence of renal cysts of 15.3% in the control group, compared to the prevalence of 44.9% observed in our control group.…”

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

“…We found that in all four of these groups of patients with thoracic aortic disease, the prevalence of SRC was significantly higher than in our control group and higher than reported for the general population ( Figure 7A) (34). The prevalence of SRC was also higher in the thoracic aortic disease group when broken down by age groups, a valuable observation since age is an important contributor to the natural history of SRC ( Figure 7B) (34). Moreover, the male preponderance for SRC that is seen in the general population (on average 2:1 male to female ratio) is lost in all four groups of patients with disease of the thoracic aorta ( Figure 7C) (34).…”

“…Another study found a higher prevalence of renal cysts in patients with Marfan syndrome compared to non-Marfan controls (33). A study from our group evaluated the frequency of SRC in patients with ascending and descending aortic aneurysm, as well as Type A and Type B dissection (34). We found that in all four of these groups of patients with thoracic aortic disease, the prevalence of SRC was significantly higher than in our control group and higher than reported for the general population ( Figure 7A) (34).…”

“…A study from our group evaluated the frequency of SRC in patients with ascending and descending aortic aneurysm, as well as Type A and Type B dissection (34). We found that in all four of these groups of patients with thoracic aortic disease, the prevalence of SRC was significantly higher than in our control group and higher than reported for the general population ( Figure 7A) (34). The prevalence of SRC was also higher in the thoracic aortic disease group when broken down by age groups, a valuable observation since age is an important contributor to the natural history of SRC ( Figure 7B) (34).…”