Aortic Aneurysm Associated With Decreased Incidence Of Atherosclerosis

An aortic aneurysm is a widening of the major artery leading fromthe heart that may rupture, causing hemorrhage, or may split intolayers, jeopardizing blood flow to internal organs. When split intolayers it is called "aortic dissection."

"This is a silver lining in the cloud of aneurysm disease,"said John Elefteriades, M.D., section chief of cardiothoracic surgeryin the Department of Surgery and senior author of the study.

He said the study was prompted by clinical observations thatpatients with aortic aneurysm and dissection-men and women, young andelderly-had a noteworthy absence of atherosclerosis. Most patients,Elefteriades said, begin showing the earliest signs of atherosclerosisin their 20s. "Surprisingly, the arteries of the patients withascending aortic aneurysm looked like a baby's or a young child's," hesaid.

This study included 64 patients between 36 and 82 years of agewith aortic aneurysm or dissection. The control group consisted of 86trauma patients who had undergone computerized tomography of the chest.The lower prevalence of calcification in patients with ascending aorticaneurysm and dissection was independent of the major risk factors forheart disease-age, gender, high cholesterol, hypertension, diabetes andsmoking history. In fact, the aneurysm patients appeared to besignificantly protected despite a higher cholesterol level.

In earlier studies Elefteriades and his colleaguesdemonstrated the heritable nature of ascending aortic aneurysm anddissection. He said it is conceivable that the mutations inherent inaortic aneurysm also play a role in the atherosclerotic process.

"If patients with certain heritable aortic pathologies exhibitdecreased systemic atherosclerosis, this finding would be important byvirtue of providing new insights into the pathophysiology of the mostcommon cause of death in the western world, heart and blood vesseldisease due to atherosclerosis," he said.

Chest: (September 2005)