title: Familial aortic dissection in absence of ascending aortic aneurysms: a lethal syndrome associated with precocious systemic hypertension.
abstract: The interaction of elevated blood pressure and aortic metabolism in the genesis of aortic dissection is uncharacterized. A kindred with fatal familial aortic dissection in association with precocious systemic hypertension and in absence of a definable connective tissue syndrome has undergone genealogical, clinical, pathological, and biochemical evaluation. Six family members spanning three generations have died of acute dissection. Five men died at a mean age of 28 years (range 22-34), while the proband's paternal grandmother died at 62 years of age. All were hypertensive. A constellation of subtle clinical features points toward deficient integrity of connective tissues; however, major hallmarks of known connective tissue syndromes including aortic root ectasia or aneurysms are absent. Studies of cultured dermal and aortae fibroblasts of two of the proband's brothers mitigate against Ehlers-Danlos IV syndrome. This family's susceptibility to aortic dissection reflects the synergistic liability of coexistent elevated blood pressure and metabolic abnormalities in the genesis of aortic degeneration.
authors.affiliation: Department of Pathology, University of Nebraska Medical Center, Omaha 68105.
authors.forename: B M
authors.initials: BM
authors.lastname: McManus
authors.forename: R S
authors.initials: RS
authors.lastname: Cassling
authors.forename: T J
authors.initials: TJ
authors.lastname: Soundy
authors.forename: J E
authors.initials: JE
authors.lastname: Wilson
authors.forename: T D
authors.initials: TD
authors.lastname: Sears
authors.forename: W C
authors.initials: WC
authors.lastname: Rogler
authors.forename: B A
authors.initials: BA
authors.lastname: Buehler
authors.forename: J F
authors.initials: JF
authors.lastname: Wolford
authors.forename: M J
authors.initials: MJ
authors.lastname: Duggan
authors.forename: P H
authors.initials: PH
authors.lastname: Byers
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000473:pathology; D001018:Aortic Diseases / Q000150:complications / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D001019:Aortic Rupture / Q000235:genetics / Q000473:pathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D011347:Procollagen / Q000378:metabolism; D012189:Retrospective Studies; D014648:Varicose Veins / Q000150:complications / Q000235:genetics
chemical_list: D011347:Procollagen