Systematic Morphological Assesment of the Ascending Aorta Dissection: Application of Cardiovascular Pathology Consensus Statement in Tertiaty Care Hospital in Finland

IF 2.2 4区医学 Q4 IMMUNOLOGY

Apmis Pub Date : 2025-04-01 DOI:10.1111/apm.70023

Trina Chen, Ari Mennander, Timo Paavonen, Ivana Kholová

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Abstract

This study investigated the distinguishing characteristics between acute type A aortic dissection (ATAAD) and aortic wall dilatation. Utilizing systematic histopathology criteria from the Society for Cardiovascular Pathology and the Association for European Cardiovascular Pathology consensus statement, the analysis focused on degeneration, atherosclerosis, and inflammation in patients undergoing surgery in a Finnish tertiary care hospital. The study included 156 patients, those undergoing surgery for ATAAD (n = 116) and those with dilatation (n = 40). Despite similar clinical characteristics, histological analysis of the aortic wall indicated a higher overall degeneration in ATAAD compared to dilatation (2.4 ± 0.6 vs. 1.9 ± 0.8, Point score unit (PSU), p < 0.001). Findings included increased intralamellar mucoid extracellular matrix accumulation (69 vs. 32, p = 0.020; extent 2.0 ± 0.3 vs. 1.7 ± 0.5, PSU, p < 0.001; severity 1.8 ± 0.6 vs. 1.5 ± 0.5, PSU, p = 0.005) elastic fiber thinning (68 vs. 9, p = 0.001; extent 1.0 ± 0.9 vs. 0.4 ± 0.8, PSU, p < 0.001; severity 0.8 ± 0.8 vs. 0.4 ± 0.8, PSU, p = 0.001), elastic fiber disorganization (89 vs. 21, p = 0.005; extent 1.2 ± 0.8 vs. 0.9 ± 0.9, PSU, p = 0.029) and laminar medial collapse (64 vs. 6, p < 0.001; type 0.7 ± 0.7 vs. 0.2 ± 0.4, PSU, p < 0.001; extent 0.9 ± 0.9 vs. 0.9 ± 0.9, PSU, p < 0.001) in ATAAD compared to dilatation. Elastic fiber pathology and laminar medial collapse are distinct features of ATAAD compared to aortic dilatation in patients undergoing ascending aorta surgery.

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升主动脉夹层的系统形态学评估：芬兰三级医院心血管病理共识声明的应用

本研究探讨急性A型主动脉夹层（ATAAD）与主动脉壁扩张的区别特征。利用心血管病理学会和欧洲心血管病理协会共识声明的系统组织病理学标准，分析集中在芬兰三级保健医院接受手术的患者的变性、动脉粥样硬化和炎症。该研究包括156例患者，其中接受ATAAD手术的患者（116例）和扩张患者（40例）。尽管有相似的临床特征，但主动脉壁的组织学分析表明，与扩张相比，ATAAD患者的总体退变更高（2.4±0.6比1.9±0.8，积分单位（PSU）， p < 0.001）。结果包括层间黏液细胞外基质积累增加(69 vs. 32, p = 0.020；程度上2.0±0.3和1.7±0.5,事业单位,p & lt; 0.001;严重程度1.8±0.6 vs. 1.5±0.5，PSU, p = 0.005)弹性纤维变薄(68 vs. 9, p = 0.001；程度上1.0±0.9和0.4±0.8,事业单位,p & lt; 0.001;严重程度0.8±0.8 vs. 0.4±0.8，PSU, p = 0.001)，弹性纤维断裂(89 vs. 21, p = 0.005；范围1.2±0.8 vs. 0.9±0.9，PSU, p = 0.029)和椎板内侧塌陷(64 vs. 6, p < 0.001；0.7±0.7 vs. 0.2±0.4，PSU, p < 0.001；范围0.9±0.9 vs. 0.9±0.9，PSU, p < 0.001)。与接受升主动脉手术的主动脉扩张患者相比，弹性纤维病理和椎板内侧塌陷是ATAAD的明显特征。

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来源期刊

Apmis 医学-病理学

CiteScore

5.20

自引率

0.00%

发文量

审稿时长

2 months

期刊介绍： APMIS, formerly Acta Pathologica, Microbiologica et Immunologica Scandinavica, has been published since 1924 by the Scandinavian Societies for Medical Microbiology and Pathology as a non-profit-making scientific journal.