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Rhythmic structures of the aorta in children and young adults
1USSR Cardiology Research Centre, Academy of Medical Sciences, Moscow.
Insights
Rhythmic structures (RS) in the aorta increase with age, transforming into fibrous plaques (FP) in 40% of young men. This study details the development of these arterial changes from infancy through early adulthood.
Area of Science:
- Cardiovascular pathology
- Pediatric cardiology
- Vascular biology
Background:
- Aortic and coronary artery diseases are significant health concerns.
- Early detection and understanding of arterial changes are crucial for preventative strategies.
- The development of arterial structures in children and young adults requires further investigation.
Purpose of the Study:
- To investigate the occurrence and development of rhythmic structures (RS) in the aorta of children and young men.
- To characterize the histological changes associated with RS formation and transformation into fibrous plaques (FP).
- To compare arterial changes in the aorta with those observed in coronary arteries.
Main Methods:
- Histological examination of 517 aortic samples from individuals aged 0-14 years.
- Analysis of 70 aortic samples from men aged 20-29 years.
- Microscopic evaluation of elastic fiber organization, smooth muscle cell migration, and intimal thickening.
Main Results:
- Rhythmic structures (RS) were present in 4% of stillborns and increased with age, found in 60% after the first year.
- In men aged 20-29 years, 40% showed RS transformed into fibrous plaques (FP), compared to 7% with FP when RS were absent.
- RS development involves disorganized elastic fibers, smooth muscle cell migration, intimal thickening, and eventual fibrous transformation.
Conclusions:
- Aortic RS are a precursor to fibrous plaques (FP), with prevalence increasing significantly with age.
- The histological progression of RS to FP involves distinct cellular and extracellular matrix changes.
- Similar intimal hyperplasia phenomena, termed 'cushions,' are observed in pediatric coronary arteries, suggesting common developmental pathways.
Abstract:
517 samples of the aorta (descending thoracic and abdominal) from children aged 0 to 14 years and 70 men aged 20-29 years were investigated. Rhythmic structures (RS) were found in 4% of still-borns and in children in their first days of life. Thereafter, the occurrence of RS systematically increased with age, and after the first year of life they occurred in 60% of cases. In men aged 20-29 years RS were transformed in 40% into ribbon-shaped fibrous plaques (FP); in cases when RS were absent, small FP occurred only in 7% of cases. The initial phase of RS development is characterized by impaired and disorganized elastic fibres at the border between the intima and the media. This is followed by migration of smooth muscle cells from the media into the intima and intimal thickening, accompanied with neoformation of irregularly arranged elastic fibres. The next phase, is characterized by fibrous transformation of RS into FP. Similar to aortic RS coronary arteries of children develop "cushions" as a result of hyperplasia of intimal elastic fibres and smooth muscle cells.