Lim Jiaqi, Truong Hung Dong, Song Tae Yoon, Giam Wilkin Jing Han, Koh Evelyn Linyi, Tan Justin Kok Soon
Department of Biomedical Engineering, National University of Singapore, Block E7 #06-02, 15 Kent Ridge Cres, Singapore, 119276, Singapore.
NUS Graduate School - Integrative Sciences and Engineering Programme, National University of Singapore, 21 Lower Kent Ridge Road, Singapore, 119077, Singapore.
Sci Rep. 2024 Dec 30;14(1):31986. doi: 10.1038/s41598-024-83622-x.
Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide with abdominal aortic aneurysm (AAA) and renal artery stenosis (RAS) standing out as significant contributors to the vascular pathology spectrum. While these conditions have traditionally been approached as distinct entities, emerging evidence suggests a compelling interdependent relationship between AAA and RAS, challenging the conventional siloed understanding. The confluence of AAA and RAS represents a complex interplay within the cardiovascular system, one that is often overlooked in clinical practice and research. Here, we reveal a bidirectional consequential impact between these two diseases. The location of the AAA sac was investigated for its specific influence on the risk of RAS development. Although studies have shown a higher coincidence between the suprarenal AAA and RAS, our findings demonstrated that the presence of a suprarenal AAA correlated with the lowest risk of RAS development among the three investigated AAA locations. Notably, we also highlighted that the pre-existence of stenosis in the renal artery poses an elevated risk for the formation of suprarenal AAA, assessed by an increased wall shear stress gradient on the aortic wall. Our findings prompt a paradigm shift in the understanding and treatment of AAA and RAS in clinical practice.
心血管疾病仍然是全球发病和死亡的主要原因，腹主动脉瘤（AAA）和肾动脉狭窄（RAS）是血管病理学范畴的重要因素。虽然这些病症传统上被视为不同的实体，但新出现的证据表明，AAA和RAS之间存在着令人信服的相互依存关系，这对传统的孤立理解提出了挑战。AAA和RAS的合并代表了心血管系统内的复杂相互作用，这在临床实践和研究中常常被忽视。在这里，我们揭示了这两种疾病之间的双向因果影响。研究了AAA瘤体的位置对RAS发生风险的具体影响。尽管研究表明肾上腺上方的AAA与RAS之间的巧合性更高，但我们的研究结果表明，在三个研究的AAA位置中，肾上腺上方的AAA的存在与RAS发生风险最低相关。值得注意的是，我们还强调，肾动脉狭窄的预先存在会增加肾上腺上方AAA形成的风险，这通过主动脉壁上增加的壁面剪应力梯度来评估。我们的研究结果促使临床实践中对AAA和RAS的理解和治疗发生范式转变。
