Unbound MEDLINE

Are we ignoring the dilated thoracic aorta?

Abstract

The pathophysiology of thoracic aortic aneurysm (TAA) formation involves a complex interplay of genetic predisposition, cardiovascular risk factors, and hemodynamic forces. The medical community has resorted to the use of pharmacologic agents based on weak data transplanted from either abdominal aortic aneurysms (AAAs) or Marfan syndrome. However, aneurysms differ significantly based on their anatomic location and etiology. Epidemiologic and experimental data demonstrate that different genetic and nongenetic risk factors as well as diverse physiologic processes are responsible for the development and progression of sporadic TAA, familial TAA, and AAA. Therefore, these disease processes need to be considered as distinct entities and not hastily grouped together. The extrapolation of data from one aneurysmal disease process to another is still ill-founded and potentially harmful. Clinical trials in TAA are required before medical therapies, such as β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, statins, or macrolide antibiotics, can be recommended.

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  • Publisher Full Text
  • Authors

    Castellano JM, Kovacic JC, Sanz J, Fuster V

    Institution

    Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, New York, New York 10029-6574, USA.

    Source

    Annals of the New York Academy of Sciences 1254: 2012 Apr pg 164-74

    MeSH

    Adrenergic beta-Antagonists
    Aneurysm, Dissecting
    Angiotensin Receptor Antagonists
    Angiotensin-Converting Enzyme Inhibitors
    Animals
    Anti-Bacterial Agents
    Aortic Aneurysm, Thoracic
    Aortic Valve
    Ehlers-Danlos Syndrome
    Genetic Predisposition to Disease
    Hemodynamics
    Humans
    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Loeys-Dietz Syndrome
    Magnetic Resonance Angiography
    Marfan Syndrome
    Risk Factors
    Tomography, X-Ray Computed

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22548582