Pirskanen Essi, Laaksonen Mona, Chen Trina, Kholova Ivana, Arponen Otso, Kauhanen Petteri, Lattu Aada, Paavonen Timo, Mennander Ari
Department of Cardiothoracic Surgery, Tampere University, Tampere, FIN.
Department of Pathology, Fimlab Laboratories, Tampere University Hospital and Tampere University, Tampere, FIN.
Cureus. 2025 Aug 13;17(8):e90001. doi: 10.7759/cureus.90001. eCollection 2025 Aug.
Background Ascending aortic dilatation is associated with increased susceptibility to aortic events. Chronic obstructive pulmonary disease (COPD) may add to tissue degeneration and inflammation associated with the risk of increased aortic dilatation. We studied the characteristics and aortic wall degeneration of patients with COPD during ascending aortic dilatation. Methodology We enrolled 35 consecutive patients who underwent elective surgery for ascending aortic dilatation between February 2016 and November 2016. The patients were grouped according to the presence of COPD. The aortic diameters were measured for the aortic valve annulus, aortic root, sinotubular junction, ascending aorta, aortic arch, and descending aorta. An extensive analysis of ascending aortic wall histopathology was performed. Results The patients with chronic obstructive pulmonary disease (COPD) (n=7) all had aortic valve regurgitation, while the aortic wall had more mucoid extracellular matrix accumulation, medial degeneration, elastic fiber fragmentation and loss, and adventitial fibrosis than those without COPD (5.7±1.1 vs. 4.3±1.0 point score units (PSU), =0.006; 2.7±0.5 vs. 1.7±0.8 PSU, =0.006; 4.5±1.2 vs. 3.3±1.2 PSU, =0.034; and 0.5±0.5 vs. 0.1±0.3 PSU, p=0.023, respectively). Only the distal ascending aortic diameter slightly differed in patients with COPD vs. those without (36.5±3.3 vs. 32.2±3.8 mm, p=0.011), although increased aortic dilatation was otherwise present in both groups. Conclusions We identified a subgroup of patients with COPD who had increased aortic wall degeneration during ascending aortic dilatation. Risk stratification of aortic events in patients with COPD warrants further clarification.
背景 升主动脉扩张与主动脉事件易感性增加相关。慢性阻塞性肺疾病（COPD）可能会加剧与升主动脉扩张风险相关的组织退变和炎症。我们研究了升主动脉扩张期间COPD患者的特征及主动脉壁退变情况。方法 我们纳入了2016年2月至2016年11月期间连续35例行升主动脉扩张择期手术的患者。根据是否患有COPD对患者进行分组。测量主动脉瓣环、主动脉根部、窦管交界、升主动脉、主动脉弓和降主动脉的直径。对升主动脉壁组织病理学进行了广泛分析。结果 慢性阻塞性肺疾病（COPD）患者（n = 7）均有主动脉瓣反流，与无COPD患者相比，其主动脉壁有更多黏液样细胞外基质积聚、中层退变、弹性纤维断裂和丢失以及外膜纤维化（分别为5.7±1.1对4.3±1.0评分单位（PSU），p = 0.006；2.7±0.5对1.7±0.8 PSU，p = 0.006；4.5±1.2对3.3±1.2 PSU，p = 0.034；0.5±0.5对0.1±0.3 PSU，p = 0.023）。仅COPD患者与无COPD患者的升主动脉远端直径略有差异（36.5±3.3对32.2±3.8 mm，p = 0.011），尽管两组均存在升主动脉扩张增加的情况。结论 我们识别出了一组在升主动脉扩张期间主动脉壁退变增加的COPD患者。COPD患者主动脉事件风险分层有待进一步明确。
