title: Type A dissection and chronic dilatation: tenascin-C as a key factor in destabilization of the aortic wall.
abstract: OBJECTIVE
  Tenascin-C plays an important role in myocardial and vascular remodelling. We hypothesized that tenascin-C is a key factor in the development of degenerative disease of the ascending aorta, leading to chronic dilatation and acute aortic dissection.
  
  
  METHODS
  Ascending aortic wall specimens were obtained during surgery for chronic dilatation (n=52) and acute Type A dissection (n=30). Patients (n=12) undergoing aortic valve replacement served as controls. Tenascin-C expression was evaluated by immunostaining and semi-quantitatively assessed using the ImageJ software. TN-C levels in peripheral blood were determined by enzyme-linked immunosorbent assay.
  
  
  RESULTS
  Histological examination showed a clear difference between chronic dilatation and acute dissection. In chronic dilatation, tenascin-C staining was homogenously distributed throughout the media parallel to vascular smooth muscle cells. In acute dissection, a strong staining with a heterogenous and spotty distribution was detected. Control aortas showed no tenascin-C staining. Tenascin-C expression was significantly higher in Type-A dissection compared with chronic dilatation. This was accompanied by a significant elevation of tenascin-C levels in peripheral blood in acute dissection. There was no statistical correlation between the tenascin-C level in peripheral blood and the aortic diameter either in dissection or in dilatation.
  
  
  CONCLUSIONS
  Tenascin-C is a marker of progressive destabilization of the aortic wall independent of size in chronic dilatation and acute dissection. Therefore, it might be a valuable tool in guiding intervention strategies in patients with disease of the ascending aorta.
authors: Department of Cardiac Surgery, LK St. Pölten, St. Poelten, Austria. karola.trescher@meduniwien.ac.at
authors: Karola
authors: K
authors: Trescher
authors: Barbara
authors: B
authors: Thometich
authors: Svitlana
authors: S
authors: Demyanets
authors: Hermann
authors: H
authors: Kassal
authors: Roland
authors: R
authors: Sedivy
authors: Reginald
authors: R
authors: Bittner
authors: Christoph
authors: C
authors: Holzinger
authors: Bruno K
authors: BK
authors: Podesser
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000097:blood / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D001011:Aorta / Q000737:chemistry* / Q000473:pathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000097:blood / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004108:Dilatation, Pathologic; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D019063:Tenascin / Q000032:analysis* / Q000097:blood
chemical_list: D015415:Biomarkers; D019063:Tenascin
keywords: Aorta/aortic pathology; Aortic aneurysm; Aortic dissection
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