title: Different patterns of atherosclerotic remodeling in the thoracic and abdominal aorta.
abstract: 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.
authors.affiliation: Laboratory of Pathology, Heart Institute, Hospital das Clínicas, University of São Paulo, Brazil. anpluiz@incor.usp.br
authors.forename: Luiz Alberto
authors.initials: LA
authors.lastname: Benvenuti
authors.forename: Ronaldo Yukinori
authors.initials: RY
authors.lastname: Onishi
authors.forename: Paulo Sampaio
authors.initials: PS
authors.lastname: Gutierrez
authors.forename: Maria
authors.initials: M
authors.lastname: de Lourdes Higuchi
mesh_terms: 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