Ascending aorta dilation in association with bicuspid aortic valve: a maturation defect of the aortic wall
| Autor: | Hans-Hinrich Sievers, Nimrat Grewal, Salah A. Mohamed, J.H.N. Lindeman, Adriana C. Gittenberger-de Groot, Robert E. Poelmann, Ad J.J.C. Bogers, Marie-José Goumans, Robert J.M. Klautz, Marco C. DeRuiter, Meindert Palmen |
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| Přispěvatelé: | Cardiothoracic Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Vascular smooth muscle Biopsy Heart Valve Diseases Muscle Smooth Vascular/pathology Aorta Thoracic Biomarkers/metabolism Muscle Smooth Vascular Immunoenzyme Techniques Bicuspid aortic valve Bicuspid Aortic Valve Disease Medicine Aorta Aortic Diseases/pathology Vascular/pathology biology Blotting Heart Valve Diseases/pathology Nuclear Proteins Middle Aged Lamin Type A Progerin Protein Precursors/metabolism Aortic Valve cardiovascular system Cardiology Muscle Female Smooth Cardiology and Cardiovascular Medicine Western Dilatation Pathologic Pulmonary and Respiratory Medicine medicine.medical_specialty Smooth muscle cell differentiation Calponin Blotting Western Aortic Diseases medicine.artery Internal medicine Ascending aorta Humans Protein Precursors Aged Nuclear Proteins/metabolism Pathologic business.industry Thoracic/pathology Aortic Valve/abnormalities Lamin Type A/metabolism medicine.disease Dilatation biology.protein Smoothelin Surgery business Aorta Thoracic/pathology Biomarkers |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery, 148(4), 1583-90. Mosby Inc. The Journal of Thoracic and Cardiovascular Surgery, 148(4), 1583-1590 Journal of thoracic and cardiovascular surgery, 148(4), 1583-1590. Mosby Inc. Journal of Thoracic and Cardiovascular Surgery, 148(4), 1583-1590. Mosby Inc. |
| ISSN: | 0022-5223 1583-1590 |
| Popis: | Objective Patients with a bicuspid aortic valve have increased susceptibility to the development of ascending aortic dilation and dissection compared with persons with a tricuspid valve. To unravel a possible different mechanism underlying dilation in bicuspidy and tricuspidy, a comparison of the structure of the aortic wall was made. Methods Ascending aortic wall biopsies were divided into 4 groups: bicuspid (n = 36) and tricuspid (n = 23) without and with dilation. The expression of vascular smooth muscle cell maturation markers including lamin A/C, which plays a pivotal role in smooth muscle cell differentiation, and its splicing variant progerin indicative of aging, were studied immunohistochemically. Attention was also paid to the inflammatory status. Results There is a significant difference in the structure and maturation of the aortic wall in bicuspidy, persisting in the dilated aortic wall, presenting with a thinner intima, lower expression of α smooth muscle actin, smooth muscle 22α, calponin, and almost absent expression of smoothelin. We show for the first time significantly lowered lamin A/C expression in bicuspidy. Progerin was found to be significantly increased in the media of the dilated wall in tricuspidy, also showing increased periaortic inflammation. Conclusions The structure of the nondilated and dilated aortic wall in bicuspidy and tricuspidy are intrinsically different, with the latter having more aspects of aging. In bicuspidy there is a defective smooth muscle cell differentiation possibly linked to lowered lamin A/C expression. Based on this vessel wall immaturity and increased susceptibility to dilation, different diagnostic and therapeutic approaches are warranted. |
| Databáze: | OpenAIRE |
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