Effect of inflammation on the biomechanical strength of involved aorta in type A aortic dissection and ascending thoracic aortic aneurysm: An initial research

Özet

Objective: Type A aortic dissection (AD) and ascending thoracic aortic aneurysm (AA) are thoracic vascular diseases with similar initial pathologybut inequable clinical features and outcomes, where local and systemic inflammation play an important part. We aimed to observe andanalyze the differences and correlation between inflammation and pathological changes in the aorta and biomechanical strength between ADand AA.Methods: From August 2011 to February 2013, 20 patients with AD (AD group) and 13 patients with AA (AA group) who underwent aorta surgerywere included. Serum concentrations of total cholesterol (TC), triglycerides (TG), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) levelswere measured just before surgical anesthesia. The longitudinal vessel samples of the affected ascending aorta were harvested during surgeryand prepared for subsequent pathological observation and uniaxial tension test to measure the longitudinal tensile strength (TS). Samples werealso prepared for further measurement of tissue homogenized TNF-α and IL-6 concentrations.Results: No significant difference was seen between the two groups with respect to baseline data, and the serum concentrations of TC and TGof both the groups were within the normal range (p>0.05). Blood and tissue homogenized levels of IL-6 and TNF-α were significantly higher in theAD group than in the AA group (p<0.001). Pathological observation of the aortic tissue showed more inflammatory cells infiltration and elasticfiber destruction in the AD group than in the AA group, indicating significant aortic medial degeneration. Uniaxial tensile tests showed that thelongitudinal TS was significant lower in the AD group than in the AA group (p<0.001). The longitudinal TS showed negative correlations withserum and tissue homogenized concentrations of IL-6 and TNF-α in the AD group (p<0.05), whereas no such significant correlation was seen in the AA group. Conclusion: Patients with AD had acute systemic inflammation, along with acute inflammation and declined biomechanical strength of the affected aorta. The serum and tissue homogenized concentrations of IL-6 and TNF-α showed a significant correlation with the biomechanical strength of affected aorta in AD.