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Aortic dilatation

Shohreh Maleki, Sanela Kjellqvist, Valentina Paloschi, Joelle Magné, Rui Miguel Mamede Branca, Lei Du, Kjell Hultenby, Johan Petrini, Jonas Fuxe, Janne Lehtiö, Anders Franco-Cereceda, Per Eriksson, Hanna M Björck
Individuals with a bicuspid aortic valve (BAV) are at significantly higher risk of developing aortic complications than individuals with tricuspid aortic valves (TAV) and defective signaling during the embryonic development and/or life time exposure to abnormal hemodynamic have been proposed as underlying factors. However, an explanation for the molecular mechanisms of aortopathy in BAV has not yet been provided. We combined proteomics, RNA analyses, immunohistochemistry, and electron microscopy to identify molecular differences in samples of non-dilated ascending aortas from BAV (N = 62) and TAV (N = 54) patients...
October 25, 2016: Scientific Reports
Ahmet Dolapoglu, Kim I de la Cruz, Ourania Preventza, Joseph S Coselli
Dilation of the ascending aorta and aortic dissections are often seen in Marfan syndrome; however, true aneurysms of the subclavian and axillary arteries rarely seem to develop in patients who have this disease. We present the case of a 58-year-old man with Marfan syndrome who had undergone a Bentall procedure and thoracoabdominal aortic repair for an aortic dissection and who later developed multiple aneurysmal dilations of his right subclavian and axillary arteries. The aneurysms were successfully repaired by means of a surgical bypass technique in which a Dacron graft was placed between the carotid and brachial arteries...
October 2016: Texas Heart Institute Journal
David Dobarro, Marian Urban, Karen Booth, Neil Wrightson, Javier Castrodeza, Jerome Jungschleger, Nicola Robinson-Smith, Andrew Woods, Gareth Parry, Stephan Schueler, Guy A MacGowan
BACKGROUND: This study examined whether aortic valve opening (AVO) and other echocardiographic parameters influence outcomes in patients on left ventricular (LV) assist device (LVAD) support. Pump thrombosis (PT) and ischemic stroke (IS) are known complications of LVAD, but mechanisms that could influence them are not completely understood. METHODS: This was a retrospective analysis of 147 patients who received a HeartWare Ventricular Assist Device ( HeartWare International) as a bridge to transplant or to candidacy between July 2009 and August 2015, of whom 126 had at least 30 days of follow-up before the first event (30-days-out cohort)...
August 18, 2016: Journal of Heart and Lung Transplantation
Jan L Bruse, Abbas Khushnood, Kristin McLeod, Giovanni Biglino, Maxime Sermesant, Xavier Pennec, Andrew M Taylor, Tain-Yen Hsia, Silvia Schievano
OBJECTIVES: Even after successful aortic coarctation repair, there remains a significant incidence of late systemic hypertension and other morbidities. Independently of residual obstruction, aortic arch morphology alone may affect cardiac function and outcome. We sought to uncover the relationship of arch 3-dimensional shape features with functional data obtained from cardiac magnetic resonance scans. METHODS: Three-dimensional aortic arch shape models of 53 patients (mean age, 22...
September 22, 2016: Journal of Thoracic and Cardiovascular Surgery
Ana B García-Redondo, Andrea Aguado, Ana M Briones, Mercedes Salaices
Reactive oxygen species (ROS) are key signaling molecules that regulate vascular function and structure in physiological conditions. A misbalance between the production and detoxification of ROS increases oxidative stress that is involved in the vascular remodeling associated with cardiovascular diseases such as hypertension by affecting inflammation, hypertrophy, migration, growth/apoptosis and extracellular matrix protein turnover. The major and more specific source of ROS in the cardiovascular system is the NADPH oxidase (NOX) family of enzymes composed of seven members (NOX1-5, DUOX 1/2)...
October 20, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Angelo M Dell'Aquila, Francesco Pollari, Khalil Fattouch, Giuseppe Santarpino, Julia Hillebrand, Stefan Schneider, Jan Landwerht, Giuseppe Nasso, Renato Gregorini, Mauro Del Giglio, Elisa Mikus, Alberto Albertini, Heinz Deschka, Theodor Fischlein, Sven Martens, Alina Gallo, Giovanni Concistrè, Giuseppe Speziale, Tommaso Regesta
This study provides early results of re-operations after the prior surgical treatment of acute type A aortic dissection (AAD) and identifies risk factors for mortality. Between May 2003 and January 2014, 117 aortic re-operations after an initial operation for AAD (a mean time from the first procedure was 3.98 years, with a range of 0.1-20.87 years) were performed in 110 patients (a mean age of 59.8 ± 12.6 years) in seven European institutions. The re-operation was indicated due to a proximal aortic pathology in ninety cases: twenty aortic root aneurysms, seventeen root re-dissections, twenty-seven aortic valve insufficiencies and twenty-six proximal anastomotic pseudoaneurysms...
October 21, 2016: Heart and Vessels
Ahmad Masri, Vidyasagar Kalahasti, Lars G Svensson, Eric E Roselli, Douglas Johnston, Donald Hammer, Paul Schoenhagen, Brian P Griffin, Milind Y Desai
BACKGROUND: -In patients with a dilated proximal ascending aorta and trileaflet aortic valve (TAV), we sought to assess a) factors independently associated with increased long-term mortality and b) the incremental prognostic utility of indexing aortic root to patient height. METHODS: -We studied consecutive patients with a dilated aortic root (≥4 cm) that underwent echocardiography and gated contrast-enhanced thoracic aortic computed tomography or magnetic resonance angiography between 2003-2007...
October 21, 2016: Circulation
Arne O Melleby, Mari E Strand, Andreas Romaine, Kate M Herum, Biljana Skrbic, Christen P Dahl, Ivar Sjaastad, Arnt E Fiane, Jorge Filmus, Geir Christensen, Ida G Lunde
Pressure overload is a frequent cause of heart failure. Heart failure affects millions of patients worldwide and is a major cause of morbidity and mortality. Cell surface proteoglycans are emerging as molecular players in cardiac remodeling, and increased knowledge about their regulation and function is needed for improved understanding of cardiac pathogenesis. Here we investigated glypicans (GPC1-6), a family of evolutionary conserved heparan sulfate proteoglycans anchored to the extracellular leaflet of the cell membrane, in experimental and clinical heart failure, and explored the function of glypican-6 in cardiac cells in vitro...
2016: PloS One
Hongyou Yu, Corey S Moran, Alexandra F Trollope, Lynn Woodward, Robert Kinobe, Catherine M Rush, Jonathan Golledge
Angiogenesis and inflammation are implicated in aortic aneurysm and atherosclerosis and regulated by angiopoietin-2 (Angpt2). The effect of Angpt2 administration on experimental aortic aneurysm and atherosclerosis was examined. Six-month-old male apolipoprotein E deficient (ApoE(-/-)) mice were infused with angiotensin II (AngII) and administered subcutaneous human Fc-protein (control) or recombinant Angpt2 (rAngpt2) over 14 days. Administration of rAngpt2 significantly inhibited AngII-induced aortic dilatation and rupture of the suprarenal aorta (SRA), and development of atherosclerosis within the aortic arch...
October 21, 2016: Scientific Reports
Sarah-Jayne Edmondson, Saina Attaran, Ulrich P Rosendahl
Wegner's granulomatosis (WG) is an autoimmune systemic vasculitis that results in necrotizing granulomas. We report a WG patient with a lung granuloma and aortic root dilatation, who underwent aortic root replacement on cardiopulmonary bypass (CPB). Intraoperatively, the patient suffered an aortic dissection, which was repaired immediately under deep hypothermic circulatory arrest (DHCA). Follow-up imaging showed complete granuloma resolution, despite absence of immunosuppressive therapy. Immune stimulation following CPB is well described; here, the opposite was observed and DHCA effects are discussed...
February 2016: Aorta (Stamford, Conn.)
Jay S Naik, Jessica M Osmond, Benjimen R Walker, Nancy L Kanagy
Hydrogen sulfide (H2S) is a recently described gaseous vasodilator produced within the vasculature by the enzymes cystathionine γ-lyase and 3-mercaptopyruvate sulfurtansferase. Previous data demonstrate that endothelial cells (EC) are the source of endogenous H2S production and are required for H2S-induced dilation. However, the signal transduction pathway activated by H2S within EC has not been elucidated. TRPV4 and large conductance Ca(2+)-activated K channels (BK channels) are expressed in EC. H2S-induced dilation is inhibited by luminal administration of iberiotoxin and disruption of the endothelium...
October 7, 2016: American Journal of Physiology. Heart and Circulatory Physiology
Maral Ouzounian, Vivek Rao, Cedric Manlhiot, Nachum Abraham, Carolyn David, Christopher M Feindel, Tirone E David
BACKGROUND: Although aortic valve-sparing (AVS) operations are established alternatives to composite valve graft (CVG) procedures for patients with aortic root aneurysms, comparative long-term outcomes are lacking. OBJECTIVES: This study sought to compare the results of patients undergoing AVS procedures with those undergoing CVG operations. METHODS: From 1990 to 2010, a total of 616 patients age <70 years and without aortic stenosis underwent elective aortic root surgery (AVS, n = 253; CVG with a bioprosthesis [bio-CVG], n = 180; CVG with a mechanical prosthesis [m-CVG], n = 183)...
October 25, 2016: Journal of the American College of Cardiology
Aart Mookhoek, Kapil Krishnan, Sam Chitsaz, Heide Kuang, Liang Ge, Paul H Schoof, Ad J J C Bogers, Johanna J M Takkenberg, Elaine E Tseng
BACKGROUND: Progressive autograft dilatation after a Ross operation suggests that remodeling does not effectively reproduce native aortic root biomechanics. In the first of this two-part series, we compared mechanical properties of explanted autografts to pulmonary roots at pulmonary pressures. The goal of this study was to compare mechanical properties of explanted autografts to native aortic roots at systemic pressures. METHODS: Autograft specimens were obtained from patients undergoing reoperation after Ross operation...
October 17, 2016: Annals of Thoracic Surgery
Yuji Kanaoka, Takao Ohki, Koji Maeda, Takeshi Baba
PURPOSE: To evaluate risk factors for early (<30 days) type I endoleak following thoracic endovascular aortic repair (TEVAR). METHODS: A retrospective study was conducted of 439 consecutive patients (mean age 74.0±10.0 years; 333 men) who underwent TEVAR at a single center between June 2006 and June 2013. Pathologies included 237 aortic arch aneurysms and 202 descending thoracic aortic aneurysms (dTAA). Maximum TAA diameter was 63.6±13.7 mm. Among the distal aortic arch aneurysms, 124 required coverage of the left subclavian artery (LSA), while the remaining 113 arch aneurysms had debranching (n=40), the chimney technique (n=52), and a branched stent-graft (n=13)...
October 19, 2016: Journal of Endovascular Therapy
Olga Trojnarska, Ludwina Szczepaniak-Chicheł, Marcin Gabriel, Agnieszka Bartczak-Rutkowska, Joanna Rupa-Matysek, Andrzej Tykarski, Stefan Grajek
BACKGROUND: Mortality in cyanotic patients with congenital heart diseases (CHD) is high, mainly due to cardiovascular complications. It is known that endothelial dysfunction, increased arterial stiffness, and impaired vascular function have negative influence on cardiovascular prognosis. The aim of the study was to assess parameters of arterial stiffness and vascular dysfunction in cyanotic patients with CHD as well as their potential relation to impaired blood oxygen saturation and polycythemia parameters typical for cyanosis...
October 15, 2016: Journal of Cardiology
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Hyosoon An, Gi Beom Kim, Jae Suk Baek, Young Ah Lee, Bo Sang Kwon, Eun Jung Bae, Chung Il Noh
OBJECTIVE: Aortic dilatation and dissection are complications in some Turner syndrome (TS) patients. To better understand vascular nature of aorta before adult, we evaluated several elastic properties of the aorta in adolescent with TS in comparison to healthy controls. DESIGN AND METHOD: Various indices of the vascular function of ascending aorta were assessed prospectively in TS (n = 28), with a mean age of 14.9 ± 3.3 years and age-matched control (n = 18) groups with the transthoracic echocardiography...
September 2016: Journal of Hypertension
Audrey Adji, Thomas Weber, Caroline O'Brien, Michael O'Rourke, Alberto Avolio
OBJECTIVE: Relative ease of estimating of Ascending Aortic (AA) pressure non-invasively enables interpretation of age-related pressure waveform changes due to altered pulse wave propagation. AA flow velocity waveforms, measured invasively by ElectroMagnetic (EM) cuff/ catheter, and non-invasively by Cardiac Magnetic Resonance (CMR) also show characteristic aging changes attributable to aortic dilation and subtle impairment of Left Ventricular (LV) function. Conventional Doppler waveforms do not...
September 2016: Journal of Hypertension
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Jae-Kwan Song
The successful clinical introduction of various non-invasive imaging modalities has contributed to the establishment of 'acute aortic syndrome', a relatively new clinical syndrome incorporating several disease entities with similar clinical features (at the time of clinical presentation). Aortic dissection (AD) with intimal flap and two aortic channels (true and false lumens) is the most important disease entity in acute aortic syndrome. Clinical characteristics of AD have been established, with standardized treatment strategies depending on the affected site of the aorta...
September 2016: Journal of Hypertension
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