Bossone Eduardo, Eagle Kim A
Cardiology Division, Department of Internal Medicine, A. Cardarelli Hospital, Naples, Italy.
Division of Cardiovascular Medicine, Department of Internal Medicine, Michigan Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Nat Rev Cardiol. 2021 May;18(5):331-348. doi: 10.1038/s41569-020-00472-6. Epub 2020 Dec 22.
The aorta is the 'greatest artery', through which oxygenated blood is delivered from the left ventricle to end organs with each cardiac cycle (200 million litres of blood transported in an average lifetime). The aorta can be affected by a wide spectrum of acute factors (such as cocaine use, weight lifting and trauma) and chronic acquired and/or genetic conditions (such as systemic arterial hypertension and phaeochromocytoma), which variously lead to increased aortic wall stress. The medial layer of the aorta can also be subject to abnormalities (such as Marfan syndrome, bicuspid aortic valve, inflammatory vasculitis, atherosclerosis and infections). Despite important advances in diagnostic and therapeutic interventions, data derived from registries and population-based studies highlight that the burden of aortic diseases remains high. Therefore, specific resources need to be allocated to design and implement preventive strategies (healthy lifestyles, modifications to cardiovascular risk factors, and educational and screening programmes) at individual and community levels. In this Review, we discuss the epidemiology, management and outcomes of the most common aortic diseases, namely, aortic aneurysms and acute aortic syndromes.
主动脉是“最大的动脉”，在每个心动周期中，含氧血液通过它从左心室输送到终末器官（平均一生中输送2亿升血液）。主动脉会受到多种急性因素（如使用可卡因、举重和创伤）以及慢性获得性和/或遗传性疾病（如系统性动脉高血压和嗜铬细胞瘤）的影响，这些因素会不同程度地导致主动脉壁压力增加。主动脉的中层也可能出现异常（如马凡综合征、二叶式主动脉瓣、炎症性血管炎、动脉粥样硬化和感染）。尽管在诊断和治疗干预方面取得了重要进展，但来自登记处和基于人群研究的数据表明，主动脉疾病的负担仍然很高。因此，需要分配特定资源，在个人和社区层面设计和实施预防策略（健康的生活方式、改变心血管危险因素以及教育和筛查计划）。在本综述中，我们讨论最常见的主动脉疾病，即主动脉瘤和急性主动脉综合征的流行病学、管理和结局。
