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Unveiling cellular and molecular aspects of ascending thoracic aortic aneurysms and dissections.
- Source :
-
Basic research in cardiology [Basic Res Cardiol] 2024 Jun; Vol. 119 (3), pp. 371-395. Date of Electronic Publication: 2024 May 03. - Publication Year :
- 2024
-
Abstract
- Ascending thoracic aortic aneurysm (ATAA) remains a significant medical concern, with its asymptomatic nature posing diagnostic and monitoring challenges, thereby increasing the risk of aortic wall dissection and rupture. Current management of aortic repair relies on an aortic diameter threshold. However, this approach underestimates the complexity of aortic wall disease due to important knowledge gaps in understanding its underlying pathologic mechanisms.Since traditional risk factors cannot explain the initiation and progression of ATAA leading to dissection, local vascular factors such as extracellular matrix (ECM) and vascular smooth muscle cells (VSMCs) might harbor targets for early diagnosis and intervention. Derived from diverse embryonic lineages, VSMCs exhibit varied responses to genetic abnormalities that regulate their contractility. The transition of VSMCs into different phenotypes is an adaptive response to stress stimuli such as hemodynamic changes resulting from cardiovascular disease, aging, lifestyle, and genetic predisposition. Upon longer exposure to stress stimuli, VSMC phenotypic switching can instigate pathologic remodeling that contributes to the pathogenesis of ATAA.This review aims to illuminate the current understanding of cellular and molecular characteristics associated with ATAA and dissection, emphasizing the need for a more nuanced comprehension of the impaired ECM-VSMC network.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Animals
Aorta, Thoracic pathology
Aorta, Thoracic physiopathology
Vascular Remodeling
Extracellular Matrix pathology
Extracellular Matrix metabolism
Phenotype
Aortic Aneurysm, Thoracic pathology
Aortic Aneurysm, Thoracic genetics
Aortic Aneurysm, Thoracic metabolism
Aortic Aneurysm, Thoracic physiopathology
Aortic Dissection pathology
Aortic Dissection genetics
Aortic Dissection metabolism
Muscle, Smooth, Vascular pathology
Muscle, Smooth, Vascular metabolism
Myocytes, Smooth Muscle pathology
Myocytes, Smooth Muscle metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1435-1803
- Volume :
- 119
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Basic research in cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 38700707
- Full Text :
- https://doi.org/10.1007/s00395-024-01053-1