Anatomical remodeling of the aortic wall in relation with the cause of death
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Published on: December 2, 2016
Doru Adrian Şeicaru1, Mirela Albu, Răzvan Mihail Pleşea
1Departments of Pathology, Carol Davila University of Medicine and Pharmacy, and Fundeni Clinical Institute, Bucharest, Romania; emil.plesea@umfcd.ro.
Insights
Aortic morphology, including diameter, intima, and media thickness, varies with cause of death, sex, and location. Cardiovascular disease deaths showed distinct aortic changes compared to non-cardiovascular deaths.
Area of Science:
- Cardiovascular pathology
- Histopathology
- Aortic diseases
Background:
- The aorta's morphological characteristics are crucial for understanding cardiovascular health.
- Variations in aortic dimensions and wall thickness can indicate underlying pathological processes.
Purpose of the Study:
- To investigate the relationship between aortic diameter, intima thickness, and media thickness with the cause of death.
- To analyze how these aortic parameters differ between individuals who died from cardiovascular (CV) versus non-cardiovascular (NCV) diseases.
Main Methods:
- Autopsy samples from 28 CV and 62 NCV deceased individuals were analyzed.
- Histopathological techniques were used to process aortic cross-sections.
- Aortic diameter, intima, and media thickness were quantified using specialized imaging software.
Main Results:
- Aortic diameter decreased distally, was larger in women than men, and in CV than NCV cases.
- Intima thickness increased distally and was notably higher in women with CV disease.
- Media thickness was generally greater in the CV disease group across most aortic segments.
Conclusions:
- Aortic morphological parameters are significantly influenced by the cause of death, patient's sex, and anatomical region.
- These findings highlight the aorta's adaptive or pathological remodeling in response to disease states.
Aim:
The authors set out to evaluate the correlations between three of the main morphological aortic parameters (aortic diameter, intima, and media thickness) and the cause of death.
Materials And Methods:
Study group included 28 people died of a cardiovascular (CV) disease and 62 people died of a noncardiovascular (NCV) disease. Four aortic cross-sections (base, cross, thoracic, abdominal) were collected during autopsy from the selected cases, fixed in 10% buffered formalin and photographed together with a calibrating ruler. Then, they were processed using the classical histopathological (HP) technique (formalin fixation and paraffin embedding), stained with Hematoxylin-Eosin (HE) and Orcein, and the obtained histological slides were transformed into virtual slides. Aortic diameters were determined on calibrated photos using a custom-made software, developed in MATLAB (MathWorks, USA). Intima and media thicknesses were determined on virtual slides using a dedicated image analysis software.
Results And Discussions:
The most frequent CV causes of death were the ischemic heart diseases and the most frequent NCV causes of death were the inflammatory diseases. Aortic diameter decreased from the aortic origin till the aortic end, with larger values in women than in men and in CV diseases than in NCV diseases. The difference in the remodeling of the aortic diameter between the two groups is smaller towards the abdominal region. Intima thickness increased from the aortic origin till the aortic end and was larger especially in women died of CV diseases, whereas in men there were some shifts at the extremities of the aorta. The difference in the remodeling of the intimal thickness between the two groups is extremely variable. Media was thicker in almost all of its segments in CV group than in NCV. It was a divergent evolution of the correlation degree trends in the two groups.
Conclusions:
The three morphological parameters of the aorta (diameter, intima, and media thicknesses) are more or less influenced by the pathological status that caused patient's death by the patient's sex and by the topographic region where the measurement was made.
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