HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Daniel Y. Loisance Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kirsch, E.W. M. Articles by Loisance, D. Y. Search for Related Content PubMed PubMed Citation Articles by Kirsch, E.W. M. Articles by Loisance, D. Y.

J Thorac Cardiovasc Surg 2006;132:1010-1016
© 2006 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Heterogeneity in the remodeling of aneurysms of the ascending aorta with tricuspid aortic valves

^a Surgical Research Center, Paris XII University, IFR de Médecine, Hôpital Henri Mondor, Créteil, France
^b Chirurgie Thoracique et Cardiovasculaire, Hôpital Henri Mondor, Créteil, France
^c Vascular Surgery Department, Hôpital Henri Mondor, Créteil, France.

Received for publication January 30, 2006; accepted for publication April 24, 2006.

^_* Address for reprints: Matthias Kirsch, MD, PhD, Department of Cardiothoracic Surgery, Hospital Henri Mondor, 51 Avenue M^al de Lattre de Tassigny, 94 000 Créteil Cedex, France. (Email: matthias.kirsch{at}hmn.aphp.fr).

OBJECTIVES: The study addresses mechanisms driving the formation of ascending aortic aneurysms by comparing the maximal dilatation area with the transition area immediately adjacent to the normal aortic tissue left in place during surgical repair.

METHODS: Aortic wall specimens were taken from the maximal dilatation area and transition area in 10 patients undergoing surgery for ascending aortic aneurysms and fixed for histology and immunohistochemistry for vascular smooth muscle cells (alpha-actin), endothelial cells (CD31), and macrophages (CD68). Tissue concentrations of vascular endothelial growth factor, matrix metalloproteinase-2, and matrix metalloproteinase-9 were determined by enzyme-linked immunosorbent assay. The results are expressed as medians with their 25th and 75th centiles.

RESULTS: Vascular smooth muscle cells were significantly more abundant in the maximal dilatation area than in the transition area (20.3 [14.8-24.4]/10^–2 mm² vs 8.0 [6.4-9.3]/10^–2 mm², respectively, P = .002). In the maximal dilatation area, vascular smooth muscle cells had lost their typical lamellar organization, whereas it was preserved in the transition area. Microvessels were significantly more abundant in the media of transition area than in the maximal dilatation area (7.5 [2.9-10.1]/mm² vs 1.75 [1.5-2.0]/mm², respectively, P = .008) and were associated with an inflammatory cell infiltration that predominated in their immediate vicinity. There were no significant differences in vascular endothelial growth factor, matrix metalloproteinase-2, and matrix metalloproteinase-9 between both areas.

CONCLUSIONS: The transition area appears as a disease progression front characterized by microvessel formation and inflammatory cell infiltration. In contrast, increased vascular smooth muscle cell density in the maximal dilatation area suggests a healing process, although inefficient to prevent aortic dilatation.

This article has been cited by other articles:

				I. K. Toumpoulis, J. T. Oxford, D. B. Cowan, C. E. Anagnostopoulos, C. K. Rokkas, T. P. Chamogeorgakis, D. C. Angouras, R. J. Shemin, M. Navab, M. Ericsson, et al. Differential expression of collagen type V and XI alpha-1 in human ascending thoracic aortic aneurysms. Ann. Thorac. Surg., August 1, 2009; 88(2): 506 - 513. [Abstract] [Full Text] [PDF]

				A. Della Corte, C. Quarto, C. Bancone, C. Castaldo, F. Di Meglio, D. Nurzynska, L. S. De Santo, M. De Feo, M. Scardone, S. Montagnani, et al. Spatiotemporal patterns of smooth muscle cell changes in ascending aortic dilatation with bicuspid and tricuspid aortic valve stenosis: Focus on cell matrix signaling J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 8 - 18. [Abstract] [Full Text] [PDF]