Document Detail

Medial degeneration does not involve uniformly the whole ascending aorta: morphological, biochemical and clinical correlations.
MedLine Citation:
PMID:  11932167     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To investigate whether and how the severity of medial degeneration (MD) lesions varies along the circumference of the dilated intrapericardial aorta. METHODS: Two groups of aortic wall specimens, respectively harvested 1cm distal to the non-coronary (NC) sinus (right postero-lateral wall) and to the right coronary sinus (anterior wall) in 22 patients undergoing surgery for dilatation of the intrapericardial aorta associated with aortic valve disease, were separately sent for pathology, morphometry and ultrastructural examination. MD lesions found at histology were classified into three degrees of severity. MD mean degree and morphometric findings in postero-lateral ('NC') and anterior ('coronary') specimens were compared by paired t-test. Correlation between degree of aortic dilatation at echocardiography and severity of MD was assessed separately for each of the two groups of specimens. After the preliminary results of the morphological study, we decided to send the specimens for biochemical investigation of protein electrophoretic patterns. This was performed in the last seven patients of this series. RESULTS: At histology, MD was found in all cases. A higher mean MD degree was found in the NC group (2.59+/-0.50 versus 1.59+/-0.67 in the coronary group; P<0.001). At morphometry, normal smooth muscle cells in the NC specimens were significantly reduced (P=0.012) and the length (P=0.011) and number (P=0.015) of elastic fibres reduced and increased, respectively. Correlation between aortic ratio and MD degree was significant in the NC specimens (P<0.001), not in the coronary ones (P=0.227). Quantitative differences between coronary and NC proteins from the same patient and between coronary proteins from different patients were found at electrophoresis. However, at this stage of the study, the sample was too small to allow for the identification of proteins involved in those differences. CONCLUSIONS: MD lesions in dilated intrapericardial aorta are more severe in the right postero-lateral wall area, likely due to haemodynamic stress asymmetry.
L Agozzino; F Ferraraccio; S Esposito; A Trocciola; A Parente; A Della Corte; M De Feo; M Cotrufo
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  21     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-04     Completed Date:  2002-06-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  675-82     Citation Subset:  IM    
Department of Public Medicine, Section of Pathology, Second University of Naples, Naples, Italy.
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MeSH Terms
Aorta / pathology*,  ultrasonography
Aortic Valve / pathology,  ultrasonography
Aortic Valve Insufficiency / diagnosis
Aortic Valve Stenosis / diagnosis
Coronary Vessels / cytology,  ultrastructure
Dilatation, Pathologic / diagnosis*
Echocardiography, Doppler
Electrophoresis, Gel, Two-Dimensional
Middle Aged
Muscle, Smooth, Vascular / cytology,  metabolism
Reproducibility of Results
Severity of Illness Index
Statistics as Topic
Comment In:
Eur J Cardiothorac Surg. 2002 Dec;22(6):1036-7; author reply 1037-8   [PMID:  12467841 ]

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