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An Emergent Nexus between Striae and Thoracic Aortic Dissection
Benjamin J Landis1,2, Courtney E Vujakovich1, Lindsey R Elmore1
1Riley Hospital for Children Heart Center, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN 46202, USA.
Genes
|January 21, 2022
Summary
Skin striae, a connective tissue abnormality, are linked to thoracic aortic aneurysm (TAA) and aortic dissection (TAD) in adults. This finding may improve risk stratification for aortopathy severity.
Area of Science:
- Cardiovascular Medicine
- Genetics
- Dermatology
Background:
- Current thoracic aortic aneurysm (TAA) risk stratification lacks precision, impacting clinical decisions.
- Previous studies in children suggested a link between skin striae and accelerated aortic dilation.
- Connective tissue abnormalities are increasingly recognized in aortopathy.
Purpose of the Study:
- To investigate the association between connective tissue abnormalities and clinical outcomes in adults with aortopathy.
- To determine if specific connective tissue signs correlate with disease severity or events like aortic dissection.
- To explore the prevalence of connective tissue dysfunction in adult patients with thoracic aortic disease.
Main Methods:
- Retrospective analysis of 241 adult participants with TAA or aortic dissection (TAD) and trileaflet aortic valve enrolled between 2016-2019.
- Data collection via structured interviews to ascertain clinical history and physical findings.
- Multivariate analysis to identify significant associations between connective tissue abnormalities and clinical endpoints.
Main Results:
- 47% of participants exhibited connective tissue abnormalities, including abdominal hernia (20%) and atypical skin striae (13%).
- Skin striae and hypertension were significantly associated with a history of aortic dissection (TAD).
- Skin striae correlated with younger age at TAD diagnosis or prophylactic aortic surgery.
Conclusions:
- Systemic connective tissue dysfunction is common in adults with thoracic aortopathy.
- Skin striae emerge as a potential biomarker for increased aortopathy severity and risk.
- These findings offer new avenues for clinical risk stratification and basic research into aortopathy.
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