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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
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Segmental aortic stiffening contributes to experimental abdominal aortic aneurysm development.

Uwe Raaz1, Alexander M Zöllner1, Isabel N Schellinger1

  • 1From Division of Cardiovascular Medicine, Stanford University School of Medicine, CA (U.R., I.N.S., R.T., F.N., Y.K., M.A., A.D., A.J., J.MS., P.S.T.); Cardiovascular Institute, Stanford University School of Medicine, CA (U.R., A.M.Z., F.N., M.B., F.C.E., Y.K., M.A., R.L.D., J.M.S., P.S.T.); VA Palo Alto Health Care System, CA (U.R., I.N.S., Y.K., M.A., A.D., A.J., J.M.S., P.S.T.); Department of Mechanical Engineering, Stanford University School of Medicine, CA (A.M.Z., E.K.); Department of Cardiothoracic Surgery, Stanford University School of Medicine, CA (F.C.E., E.K.); Department of Medicine, Karolinska Institute, Stockholm, Sweden (S.E., L.M.); Center for Vascular Medicine, Zwickau, Germany (T.H.); Division of Cardiovascular Medicine and Intensive Care Medicine, Saint Mary's Hospital, Siegen, Germany (M.B.); Division of Vascular Surgery, Stanford University School of Medicine, CA (R.L.D.); and Department of Bioengineering, Stanford University School of Medicine, CA (E.K.).

Circulation
|April 24, 2015
PubMed
Summary

Segmental aortic stiffening precedes abdominal aortic aneurysm (AAA) growth by generating wall stress. Interventional stiffening reduced AAA growth, offering new therapeutic targets and diagnostic markers for AAA.

Keywords:
aneurysmaortaarterial stiffnessstress, mechanicalvascular remodeling

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Area of Science:

  • Cardiovascular Biology
  • Biomedical Engineering
  • Pathophysiology

Background:

  • Aortic wall stiffening is common in aging and abdominal aortic aneurysm (AAA).
  • The specific role of aortic stiffening in AAA development remains unclear.

Purpose of the Study:

  • To investigate the role of segmental aortic stiffening in AAA pathophysiology.
  • To identify potential therapeutic targets and diagnostic markers for AAA.

Main Methods:

  • Utilized a murine elastase-induced AAA model.
  • Employed finite-element analysis to assess aortic wall stress.
  • Performed interventional stiffening of adjacent aortic segments.
  • Analyzed gene expression, molecular markers, and performed ex vivo pressurization studies.
  • Conducted human ultrasound studies on infrarenal aortic stiffening.

Main Results:

  • Segmental aortic stiffening was observed to precede AAA growth.
  • Stiffening induced axial wall stress, promoting aneurysm development.
  • Interventional stiffening of adjacent segments reduced AAA growth, associated molecular markers, and inflammation.
  • Human ultrasound confirmed segmental infrarenal aortic stiffening with aging.

Conclusions:

  • Segmental aortic stiffening is a novel early pathomechanism driving AAA growth via wall stress.
  • This mechanism highlights potential therapeutic targets and diagnostic strategies for AAA.
  • Monitoring segmental aortic stiffening may improve AAA risk identification.