Aortic Aneurysms: Vascular Remodeling and Repair 2.0

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 4368

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Center for Cardiovascular Research and Institute of Pharmacology, Charité – Universitätsmedizin Berlin, Hessische Strasse 3-4, D-10115 Berlin, Germany
Interests: vascular remodelling; Renin-Angiotensin-Aldosterone system; extracellular matrix; proteolysis; matrix metalloproteinases; aneurysm
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Dear Colleagues,

Aortic aneurysm is a multifactorial disease that is characterized by vascular remodeling due to degradation of the extracellular matrix and reduced vascular repair. It is commonly associated with atherosclerosis, hypertension, and thrombotic disorders. Our understanding of the pathogenesis of aneurysm has significantly increased over the last few decades, with data pointing to the roles of genetics, hemodynamics, inflammation, and immune response. Nevertheless, no pharmacotherapy is available to date. Present treatment options are restricted to surgical interventions such as endovascular stents or open surgical procedures that are not appropriate for all patients. Thus, there is a need for specific and effective new treatments that prevent aneurysmal growth, reduce the risk of rupture, and prevent aneurysmal extension after surgical repair. New discoveries in the field of translational biology, cell therapy, and regenerative medicine, together with new approaches to experimental design and target drug release, should accelerate the development of new therapies.

This Special Issue invites both original manuscripts that describe novel findings and cutting-edge review articles that illustrate recent advances in molecular and cell biology, pathophysiology, biomarkers, novel non-surgical medications, and targeted drug delivery for aortic aneurysm.

Dr. Elena Kaschina
Guest Editor

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Published Papers (3 papers)

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Review

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11 pages, 1686 KiB  
Review
A Systematic Review and Meta-Analysis of the Incidence and Risk Factors for Major Adverse Cardiovascular Events in Patients with Unrepaired Abdominal Aortic Aneurysms
by Chinmay Sharma, Tejas P. Singh, Shivshankar Thanigaimani, Domenico Nastasi and Jonathan Golledge
Biomedicines 2023, 11(4), 1178; https://doi.org/10.3390/biomedicines11041178 - 14 Apr 2023
Cited by 1 | Viewed by 1347
Abstract
Major adverse cardiovascular events (MACE), including myocardial infarction (MI), stroke and cardiovascular death, cause substantial morbidity and mortality. This review assessed the incidence rate of MACE and the association with modifiable risk factors (diabetes, hypertension) and medication use (aspirin, statins) in patients with [...] Read more.
Major adverse cardiovascular events (MACE), including myocardial infarction (MI), stroke and cardiovascular death, cause substantial morbidity and mortality. This review assessed the incidence rate of MACE and the association with modifiable risk factors (diabetes, hypertension) and medication use (aspirin, statins) in patients with unrepaired abdominal aortic aneurysm (AAA). Electronic databases were searched systematically for observational studies reporting the incidence of MI, stroke or cardiovascular death in patients with unrepaired AAAs. The primary outcome was cardiovascular death reported as an incidence rate (events per 100 person-years (PY)). Fourteen studies, including 69,579 participants with a mean follow-up time of 5.4 years, were included. Meta-analysis revealed the overall incidence of cardiovascular death, MI and stroke of 2.31 per 100 PY (95% CI, 1.63–3.26; I2 = 98%), 1.65 per 100 PY (95% CI, 1.01–2.69, I2 = 88%) and 0.89 per 100 PY (95% CI, 0.53–1.48, I2 = 87.0%), respectively. The mean rates of statin and aspirin prescriptions were 58.1% and 53.5%, respectively. In conclusion, there is a substantial incidence of MACE in patients with unrepaired AAA, but the prescription of preventative medication is suboptimal. Greater emphasis should be placed on secondary prevention in this population. Full article
(This article belongs to the Special Issue Aortic Aneurysms: Vascular Remodeling and Repair 2.0)
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18 pages, 3651 KiB  
Study Protocol
The Maastricht Acquisition Platform for Studying Mechanisms of Cell–Matrix Crosstalk (MAPEX): An Interdisciplinary and Systems Approach towards Understanding Thoracic Aortic Disease
by Berta H. Ganizada, Koen D. Reesink, Shaiv Parikh, Mitch J. F. G. Ramaekers, Asim C. Akbulut, Pepijn J. M. H. Saraber, Gijs P. Debeij, MUMC-TAA Student Team, Armand M. Jaminon, Ehsan Natour, Roberto Lorusso, Joachim E. Wildberger, Barend Mees, Geert Willem Schurink, Michael J. Jacobs, Jack Cleutjens, Ingrid Krapels, Alexander Gombert, Jos G. Maessen, Ryan Accord, Tammo Delhaas, Simon Schalla, Leon J. Schurgers and Elham Bidaradd Show full author list remove Hide full author list
Biomedicines 2023, 11(8), 2095; https://doi.org/10.3390/biomedicines11082095 - 25 Jul 2023
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Abstract
Current management guidelines for ascending thoracic aortic aneurysms (aTAA) recommend intervention once ascending or sinus diameter reaches 5–5.5 cm or shows a growth rate of >0.5 cm/year estimated from echo/CT/MRI. However, many aTAA dissections (aTAAD) occur in vessels with diameters below the surgical [...] Read more.
Current management guidelines for ascending thoracic aortic aneurysms (aTAA) recommend intervention once ascending or sinus diameter reaches 5–5.5 cm or shows a growth rate of >0.5 cm/year estimated from echo/CT/MRI. However, many aTAA dissections (aTAAD) occur in vessels with diameters below the surgical intervention threshold of <55 mm. Moreover, during aTAA repair surgeons observe and experience considerable variations in tissue strength, thickness, and stiffness that appear not fully explained by patient risk factors. To improve the understanding of aTAA pathophysiology, we established a multi-disciplinary research infrastructure: The Maastricht acquisition platform for studying mechanisms of tissue–cell crosstalk (MAPEX). The explicit scientific focus of the platform is on the dynamic interactions between vascular smooth muscle cells and extracellular matrix (i.e., cell–matrix crosstalk), which play an essential role in aortic wall mechanical homeostasis. Accordingly, we consider pathophysiological influences of wall shear stress, wall stress, and smooth muscle cell phenotypic diversity and modulation. Co-registrations of hemodynamics and deep phenotyping at the histological and cell biology level are key innovations of our platform and are critical for understanding aneurysm formation and dissection at a fundamental level. The MAPEX platform enables the interpretation of the data in a well-defined clinical context and therefore has real potential for narrowing existing knowledge gaps. A better understanding of aortic mechanical homeostasis and its derangement may ultimately improve diagnostic and prognostic possibilities to identify and treat symptomatic and asymptomatic patients with existing and developing aneurysms. Full article
(This article belongs to the Special Issue Aortic Aneurysms: Vascular Remodeling and Repair 2.0)
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15 pages, 613 KiB  
Systematic Review
Abdominal Aortic Aneurysm Diameter versus Volume: A Systematic Review
by Gediminas Vaitėnas, Valerija Mosenko, Austėja Račytė, Karolis Medelis, Arminas Skrebūnas and Tomas Baltrūnas
Biomedicines 2023, 11(3), 941; https://doi.org/10.3390/biomedicines11030941 - 17 Mar 2023
Cited by 4 | Viewed by 1366
Abstract
Recently, AAA volume measurement has been proposed as a potentially valuable surveillance method in situations when diameter measurement might fail. Objective: The aim of this systematic review was to analyze the results of previous studies comparing AAA diameter and volume measurements. Methods: A [...] Read more.
Recently, AAA volume measurement has been proposed as a potentially valuable surveillance method in situations when diameter measurement might fail. Objective: The aim of this systematic review was to analyze the results of previous studies comparing AAA diameter and volume measurements. Methods: A systematic search in PubMed, Cochrane, and EMBASE databases was performed to identify studies investigating the use of diameter and volume measurements in AAA diagnosis and prognosis in English, German, and Russian, published until December 2022. The manuscripts were reviewed by three researchers and scored on the quality of the research using MINORS criteria. Results: After screening 752 manuscripts, 19 studies (n = 1690) were included. The majority (n = 17) of the manuscripts appeared to favor volume. It is, however, important to highlight the heterogeneity of methodologies and lack of standardized protocol for measuring both volume and diameter in the included studies, which hindered the interpretation of the results. Conclusions: The clinical relevance of abdominal aortic aneurysm volume measurement is still unclear, although studies show favorable and promising results for volumetric changes in AAA, especially in follow-up after EVAR. Full article
(This article belongs to the Special Issue Aortic Aneurysms: Vascular Remodeling and Repair 2.0)
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