Different patterns of atherosclerotic remodeling in the thoracic and abdominal aorta.
OBJECTIVE
To investigate the relationship between the vascular diameter and the extent and histologic characteristics of atherosclerosis in the thoracic and abdominal aortas of patients who died of atherosclerotic disease.


METHODS
We measured the vascular diameter and evaluated the percentage atrophy of the medial layer of the thoracic and abdominal aortas of 19 patients who died due to atherosclerotic disease. The extent of plaques, calcification, ulceration, thrombosis, and the amount of fat in the plaques were evaluated semiquantitatively.


RESULTS
Atherosclerosis was more severe in the abdominal than the thoracic aorta as indicated by the higher sum of the macroscopic scores (P = .02) and the higher percentage atrophy of the medial layer (P < .001). The diameter of the thoracic, but not of the abdominal aorta, correlated with age (r = 0.56; P = .01), plaque score (r = 0.59; P = .008), calcification score (r = 0.749; P < .001), and fat score (r = 0.48; P = .04). Multiple linear regression showed that age (P = .06) and calcification score (P = .001) were the parameters with the strongest association to thoracic aorta diameter.


CONCLUSIONS
There are some differences regarding atherosclerosis in the thoracic compared to the abdominal aorta. Progressive thoracic aorta atherosclerosis is associated with fat deposition in the plaques, inducing arterial dilation. In the abdominal aorta, atherosclerosis can either have a similar evolution or be associated with less fat deposition in the arterial wall, which would result in more rigidity, hindering compensatory arterial enlargement.
Benvenuti
Luiz Alberto
LA
Laboratory of Pathology, Heart Institute, Hospital das Clínicas, University of São Paulo, Brazil. anpluiz@incor.usp.br
Onishi
Ronaldo Yukinori
RY
Gutierrez
Paulo Sampaio
PS
de Lourdes Higuchi
Maria
M
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000473:pathology*; D001013:Aorta, Thoracic / Q000473:pathology*; D001018:Aortic Diseases / Q000473:pathology*; D050197:Atherosclerosis / Q000473:pathology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged