Central Artery Stiffness and Thoracic Aortopathy.

Central Artery Stiffness and Thoracic Aortopathy. Am J Physiol Heart Circ Physiol. 2018 Nov 09;: Authors: Humphrey JD, Tellides G Abstract Thoracic aortopathy - especially aneurysm, dissection, and rupture - is responsible for significant morbidity and mortality. Uncontrolled hypertension and aging are primary risk factors for such conditions and they contribute, respectively, to increasing the mechanical stress on the wall and increasing its structural vulnerability. Select genetic mutations also predispose to these lethal conditions, and the collection of known mutations suggests that dysfunctional mechanosensing and mechanoregulation of extracellular matrix may contribute to pathogenesis and disease progression. In the absence of a well-accepted pharmacotherapy, non-surgical treatments tend to focus on reducing the mechanical loading on the aorta, particularly via the use of anti-hypertensive medications and recommendations to avoid strenuous exercises such as weight lifting. In this brief review, we discuss the important effects of central artery stiffening on global hemodynamics and in particular on increasing the pulse pressure that acts on the proximal thoracic aorta. We consider Marfan syndrome as an illustrative aortopathy but discuss other conditions leading to thoracic aortic aneurysm and dissection. We highlight the importance of phenotyping the aorta biomechanically, not just clinically, and emphasize the utility of mous...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research