Document Detail

A particular phenotype of ascending aorta aneurysms as precursor of type A aortic dissection.
MedLine Citation:
PMID:  22893662     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We aimed to identify a phenotype of ascending thoracic aortic aneurysm (TAA), which, more than others, evolves into type A dissection (TAD).
METHODS: Aortic specimens were obtained from patients undergoing surgical repair of TAA and TAD (108 and 26, respectively). Histopathological and immunohistochemical analyses were performed by using adequate tissue specimens, appropriate techniques and criteria.
RESULTS: We identified the three following TAA phenotypes: phenotype I (cystic medial degeneration balanced by a substitutive fibrosis, in absence of medial apoptosis and with a faint collagenase concentration), phenotype II (cystic medial degeneration of higher grade, respectively, than substitutive fibrosis, with focal medial apoptosis and moderate collagenase concentration), and phenotype III (elevated cystic medial degeneration without substitutive fibrosis, with plurifocal medial apoptosis and severe collagenase concentration). The same medial degenerative lesions of TAA phenotype III were observed in TAD tissue samples.
CONCLUSIONS: The morphological identity of medial lesions observed in both the TAA phenotype III and in TAD aortas might be assumed to be the precursor-and consequently the optimal biomarker- of dissection, independently of aneurysm diameter or valvular disorder. Identification of genetic risk factors, useful both in diagnostics and in developing more targeted treatment for individual patients, might also be needed.
Calogera Pisano; Emiliano Maresi; Daniele Merlo; Carmela Rita Balistreri; Giuseppina Candore; Marco Caruso; Massimiliano Codispoti; Giovanni Ruvolo
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-08-14
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  15     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-10-26     Completed Date:  2013-04-11     Revised Date:  2013-11-05    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  840-6     Citation Subset:  IM    
Unit of Cardiac Surgery, Department of Surgery and Oncology, University of Palermo, Palermo, Italy.
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MeSH Terms
Aneurysm, Dissecting / enzymology,  etiology*,  pathology
Aorta, Thoracic / enzymology,  pathology*
Aortic Aneurysm, Thoracic / complications*,  enzymology,  pathology
Biological Markers / analysis
Disease Progression
Matrix Metalloproteinase 9 / analysis
Middle Aged
Reg. No./Substance:
0/Biological Markers; EC Metalloproteinase 9

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