Abstract:The aortic root has a complex anatomy due to a combination of several anatomical structures based on simple and consistent work in it. It is a hollow cylinder with three bulges, which have the main functional effect on the aortic valve opening-closing cycle and coronary circulation. Aneurysm is defined as a dilation of a blood vessel segment having ≥50% increase in diameter, whereas annuloaortic ectasia represents a diffuse dilation <50% of the normal diameter of the related vessel segment. Aortic root aneurys… Show more
“…This is supportive of our The normal aortic root has many complex and variable protein components. Interleaflet triangles contain primarily collagen fibers [26], whereas the sinuses are primarily elastic lamellae [26]. The pathological aortic root results in reduced elastin and fiber fragmentation, as well as decreases in collagen I and III subtypes.…”
Section: Discussionmentioning
confidence: 99%
“…Collagen subtypes in the ascending aorta comprise collagen type I, III and IV [26,39], whereas the aortic root consists of fibrous regions, arterial tissue within the sinuses of Valsalva [47] and is without elastic lamellae [41,44,[48][49][50]. Collagen I, III, and IV have been reported in thick bundles and in increased amounts compared to controls [18,32,42,51], with collagen IV shown to be reduced or missing in other aneurysms [18].…”
Section: Discussionmentioning
confidence: 99%
“…Reported ascending aorta aneurysm pathology has included cystic medionecrosis, aortitis, varying defects in elasticity, fibrosis, elastin and collagen fiber degradation and transmural defects that seemed to predispose to partial dissections and rupture [20][21][22][23][24][25]. Aortic root pathology includes cystic medionecrosis, medial fragmentation, elastic fiber and collagen fragmentation, and mucoid accumulation [26,27]. Direct comparison between regions has described the ascending aorta as having tighter, denser weaves of elastin, and more irregular thickness than in the aortic sinus tissue.…”
Section: Aortic Aneurysm Pathologymentioning
confidence: 99%
“…This technique allowed differentiation between collagen types, the assessment of collagen orientation, and was deemed an easily reproducible technique [30]. Regional analysis of histopathology of the ascending aorta and aortic root has not been performed in detail, and no direct comparison have been made [31][32][33][34], but there have been reports that collagen types in the aortic root aneurysms change significantly; with collagen I and III decreasing and collagens XI and V increasing [26].…”
Background
Although aortic root and ascending aortic aneurysms are treated the same, they differ in embryological development and pathological processes. This study examines the microscopic structural differences between aortic root and ascending aortic aneurysms, correlating these features to the macroscopic pathophysiological processes.
Methods
We obtained surgical samples from ascending aortic aneurysms (n = 11), aortic root aneurysms (n = 3), and non-aneurysmal patients (n = 7), Aortic collagen and elastin content were examined via histological analysis, and immunohistochemistry techniques used to determine collagen I, III, and IV subtypes. Analysis was via observational features, and colour deconvolution quantification techniques.
Results
Elastin fiber disruption and fragmentation was the most extensive in the proximal aneurysmal regions. Medial fibrosis and collagen density increased in proximal aneurysmal regions and aortic root aneurysms (p < 0.005). Collagen I was seen in highest quantity in aortic root aneurysms. Collagen I content was greatest in the sinus tissue regions compared to the valvular and ostial regions (p < 0.005) Collagen III and IV quantification did not vary greatly. The most susceptible regions to ultrastructural changes in disease are the proximal ascending aorta and aortic root.
Conclusions
The aortic root differs histologically from the ascending aorta confirming its unique composition in aneurysm pathology. These findings should prompt further evaluation on the influence of this altered structure on function which could potentially guide clinical management.
“…This is supportive of our The normal aortic root has many complex and variable protein components. Interleaflet triangles contain primarily collagen fibers [26], whereas the sinuses are primarily elastic lamellae [26]. The pathological aortic root results in reduced elastin and fiber fragmentation, as well as decreases in collagen I and III subtypes.…”
Section: Discussionmentioning
confidence: 99%
“…Collagen subtypes in the ascending aorta comprise collagen type I, III and IV [26,39], whereas the aortic root consists of fibrous regions, arterial tissue within the sinuses of Valsalva [47] and is without elastic lamellae [41,44,[48][49][50]. Collagen I, III, and IV have been reported in thick bundles and in increased amounts compared to controls [18,32,42,51], with collagen IV shown to be reduced or missing in other aneurysms [18].…”
Section: Discussionmentioning
confidence: 99%
“…Reported ascending aorta aneurysm pathology has included cystic medionecrosis, aortitis, varying defects in elasticity, fibrosis, elastin and collagen fiber degradation and transmural defects that seemed to predispose to partial dissections and rupture [20][21][22][23][24][25]. Aortic root pathology includes cystic medionecrosis, medial fragmentation, elastic fiber and collagen fragmentation, and mucoid accumulation [26,27]. Direct comparison between regions has described the ascending aorta as having tighter, denser weaves of elastin, and more irregular thickness than in the aortic sinus tissue.…”
Section: Aortic Aneurysm Pathologymentioning
confidence: 99%
“…This technique allowed differentiation between collagen types, the assessment of collagen orientation, and was deemed an easily reproducible technique [30]. Regional analysis of histopathology of the ascending aorta and aortic root has not been performed in detail, and no direct comparison have been made [31][32][33][34], but there have been reports that collagen types in the aortic root aneurysms change significantly; with collagen I and III decreasing and collagens XI and V increasing [26].…”
Background
Although aortic root and ascending aortic aneurysms are treated the same, they differ in embryological development and pathological processes. This study examines the microscopic structural differences between aortic root and ascending aortic aneurysms, correlating these features to the macroscopic pathophysiological processes.
Methods
We obtained surgical samples from ascending aortic aneurysms (n = 11), aortic root aneurysms (n = 3), and non-aneurysmal patients (n = 7), Aortic collagen and elastin content were examined via histological analysis, and immunohistochemistry techniques used to determine collagen I, III, and IV subtypes. Analysis was via observational features, and colour deconvolution quantification techniques.
Results
Elastin fiber disruption and fragmentation was the most extensive in the proximal aneurysmal regions. Medial fibrosis and collagen density increased in proximal aneurysmal regions and aortic root aneurysms (p < 0.005). Collagen I was seen in highest quantity in aortic root aneurysms. Collagen I content was greatest in the sinus tissue regions compared to the valvular and ostial regions (p < 0.005) Collagen III and IV quantification did not vary greatly. The most susceptible regions to ultrastructural changes in disease are the proximal ascending aorta and aortic root.
Conclusions
The aortic root differs histologically from the ascending aorta confirming its unique composition in aneurysm pathology. These findings should prompt further evaluation on the influence of this altered structure on function which could potentially guide clinical management.
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