The mechanism and therapy of aortic aneurysms

Gao, Jianing; Cao, Hanwen; Hu, Gaofei; Wu, Yufei; Xu, Yangkai; Cui, Hongtu; Lü, Hong; Zheng, Lemin

doi:10.1038/s41392-023-01325-7

Cited by 70 publications

(43 citation statements)

References 338 publications

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“…Eine veränderte Permeabilität und endotheliale Dysfunktion kann zum einen akut, zum Beispiel im Rahmen infektiöser Erkrankungen wie COVID-19 oder Schlaganfällen, zum anderen auch chronisch im Rahmen von Krebserkrankungen oder Diabetes mellitus auftreten [ 11 , 12 ]. Ebenso liegt für Aortendissektionen und -aneurysmen ein eindeutiger Bezug zur Endothelbarriere in Form einer endothelialen Dysfunktion vor [ 13 ], hervorgerufen durch oxidativen und biomechanischen Stress (besprochen in [ 14 ]). Dies legt die Vermutung nahe, dass Zell-Zell-Kontakte, die einzelne Endothelzellen miteinander verknüpfen und eine Kommunikation über die Zelle hinaus ermöglichen, zum Pathomechanismus beitragen.…”

Section: Aufbau Und Funktion Der Endothelzellbarriereunclassified

Interaction between the gut microbiome and the aorta: effect of short-chain fatty acids on endothelial integrity

2023

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Section: Aufbau Und Funktion Der Endothelzellbarriereunclassified

Interaction between the gut microbiome and the aorta: effect of short-chain fatty acids on endothelial integrity

2023

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“…AAA is also an important cause of sudden death in older adults’ population due to aortic rupture and other cardiovascular complications. Although the etiology of AAA is partly unraveled, AAA is considered to be resulted from several risk factors including older age, smoking, hypertension, hyperlipidemia, atherosclerosis, and family history 3 , 4 . However, the role of obesity as a risk factor for AAA was previously discussed but still remains understudied and poorly understood for a long period of time.…”

Section: Introductionmentioning

confidence: 99%

Body mass index and the risk of abdominal aortic aneurysm presence and postoperative mortality: a systematic review and dose-response meta-analysis

Wu,

Zhang,

Jiang

et al. 2024

International Journal of Surgery

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Background: The clinical data regarding the relationships between body mass index (BMI) and abdominal aortic aneurysm (AAA) are inconsistent, especially for the obese and overweight patients. The aims of this study were to determine whether obesity is associated with the presence of AAA and to investigate the quantitative relationship between BMI and the risk of AAA presence and post-operative mortality. Materials and Methods: PubMed, Web of Science and Embase databases were used to search for pertinent studies updated to December 2023. The pooled relative risk (RR) with 95% confidence interval (CI) was estimated by conventional meta-analysis based on random effects model. Dose-response meta-analyses using robust-error meta-regression (REMR) model were conducted to quantify the associations between BMI and AAA outcome variables. Subgroup analysis, sensitivity analysis and publication bias analysis were performed according to the characteristics of participants. Results: 18 studies were included in our study. The meta-analysis showed a higher prevalence of AAA with a RR of 1.07 in patients with obesity. The dose-response meta-analysis revealed a non-linear relationship between BMI and the risk of AAA presence. A “U” shape curve reflecting the correlation between BMI and the risk of post-operative mortality in AAA patients was also uncovered, suggesting the “safest” BMI interval [28.55, 31.05] with the minimal RR. Conclusions: Obesity is positively but nonlinearly correlated with the increased risk of AAA presence. BMI is related to AAA post-operative mortality in a “U” shaped curve, with the lowest RR observed among patients suffering from overweight and obesity. These findings offer a preventive strategy for AAA morbidity and provide guidance for improving the prognosis in patients undergone AAA surgical repair.

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“…Aortic aneurysms and dissection are believed to be, at least in part, induced by alterations in blood flow dynamics ( 1 ). Rapid advances in imaging technology have allowed for innovations in aortic and cardiovascular imaging ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Blood flow assessment technology in aortic surgery: a narrative review

Hohri,

Chung,

Kandula

et al. 2024

J Thorac Dis

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Background and Objective Blood flow assessment is an emerging technique that allows for assessment of hemodynamics in the heart and blood vessels. Recent advances in cardiovascular imaging technologies have made it possible for this technique to be more accessible to clinicians and researchers. Blood flow assessment typically refers to two techniques: measurement-based flow visualization using echocardiography or four-dimensional flow magnetic resonance imaging (4D flow MRI), and computer-based flow simulation based on computational fluid dynamics modeling. Using these methods, blood flow patterns can be visualized and quantitative measurements of mechanical stress on the walls of the ventricles and blood vessels, most notably the aorta, can be made. Thus, blood flow assessment has been enhancing the understanding of cardiac and aortic diseases; however, its introduction to clinical practice has been negligible yet. In this article, we aim to discuss the clinical applications and future directions of blood flow assessment in aortic surgery. We then provide our unique perspective on the technique’s translational impact on the surgical management of aortic disease. Methods Articles from the PubMed database and Google Scholar regarding blood flow assessment in aortic surgery were reviewed. For the initial search, articles published between 2013 and 2023 were prioritized, including original articles, clinical trials, case reports, and reviews. Following the initial search, additional articles were considered based on manual searches of the references from the retrieved literature. Key Content and Findings In aortic root pathology and ascending aortic aneurysms, blood flow assessment can elucidate postoperative hemodynamic changes after surgical reconfiguration of the aortic valve complex or ascending aorta. In cases of aortic dissection, analysis of blood flow can predict future aortic dilatation. For complicated congenital aortic anomalies, surgeons may use preoperative imaging to perform “virtual surgery”, in which blood flow assessment can predict postoperative hemodynamics for different surgical reconstructions and assist in procedural planning even before entering the operating room. Conclusions Blood flow assessment and computational modeling can evaluate hemodynamics and flow patterns by visualizing blood flow and calculating biomechanical forces in patients with aortic disease. We anticipate that blood flow assessment will become an essential tool in the treatment planning and understanding of the progression of aortic disease.

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The mechanism and therapy of aortic aneurysms

Cited by 70 publications

References 338 publications

Interaction between the gut microbiome and the aorta: effect of short-chain fatty acids on endothelial integrity

Interaction between the gut microbiome and the aorta: effect of short-chain fatty acids on endothelial integrity

Body mass index and the risk of abdominal aortic aneurysm presence and postoperative mortality: a systematic review and dose-response meta-analysis

Blood flow assessment technology in aortic surgery: a narrative review

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