Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT 06510, USA.
Department of Cardiovascular and Endovascular Surgery, Kazan State Medical University, 420012 Kazan, Russia.
Biomolecules. 2020 Jan 24;10(2):182. doi: 10.3390/biom10020182.
Thoracic aortic aneurysm and dissection (TAAD) affects many patients globally and has high mortality rates if undetected. Once thought to be solely a degenerative disease that afflicted the aorta due to high pressure and biomechanical stress, extensive investigation of the heritability and natural history of TAAD has shown a clear genetic basis for the disease. Here, we review both the cellular mechanisms and clinical manifestations of syndromic and non-syndromic TAAD. We particularly focus on genes that have been linked to dissection at diameters <5.0 cm, the current lower bound for surgical intervention. Genetic screening tests to identify patients with TAAD associated mutations that place them at high risk for dissection are also discussed.
胸主动脉瘤和夹层(TAAD)影响全球许多患者,如果未被发现,死亡率很高。TAAD 曾被认为是一种单纯的退行性疾病,由于高压和生物力学压力的作用而影响主动脉,但对 TAAD 的遗传性和自然史的广泛研究表明,该病具有明显的遗传基础。在这里,我们回顾了综合征性和非综合征性 TAAD 的细胞机制和临床表现。我们特别关注与直径<5.0cm 的夹层相关的基因,这是目前手术干预的下限。我们还讨论了用于识别具有 TAAD 相关突变的患者的遗传筛查测试,这些突变使他们面临高夹层风险。