Blood circulates through the body and is pumped by the heart into the aorta approximately once a minute. The aorta, the body’s main artery, receives blood from the heart with each heartbeat.
Aortic dilation can affect any part of the aorta, although the exact mechanism remains unclear. One theory suggests that weakening the connective tissue in the vessel wall may contribute. High blood pressure, age, and genetic predispositions increase the likelihood of aortic dilation. Most individuals with this condition do not experience symptoms, often leading to discovery during routine medical examinations.
Filip Hammaréus, a PhD student at Linköping University and intern physician at Ryhov County Hospital, notes the increasing use of imaging in healthcare. Imaging frequently identifies slightly enlarged aortas. However, a minority of cases may progress to severe dilation, potentially leading to aortic rupture, a life-threatening condition.
Regular monitoring of aortic diameter helps assess risk; larger diameters correlate with higher risks. Preventive surgery is sometimes recommended to prevent complications, although rupture can occur unexpectedly before surgery becomes necessary. Innovations in diagnostic tools are crucial for identifying at-risk patients early, improving personalised treatment strategies and reducing costs.
Petter Dyverfeldt, a professor at Linköping University, highlights ongoing research published in the European Heart Journal—Cardiovascular Imaging. This research aims to develop new methods for assessing risk and disease severity beyond aortic diameter measurements.
Normal blood flow exerts a crucial frictional force on the vessel wall, influencing the health of specialised cells within. Changes in blood flow patterns, particularly abnormal or reduced flow, may signal cellular changes leading to vessel wall weakening.
Advanced imaging techniques, such as 4D flow MRI, allow researchers to visualise blood flow dynamics and their impact on the vessel wall. In recent studies, researchers have observed associations between abnormal blood flow patterns in the aortic wall and elevated levels of inflammatory markers and proteins involved in connective tissue metabolism.
According to Filip Hammaréus, these findings build on existing research by demonstrating previously unexplored connections between blood flow dynamics, inflammation, and connective tissue turnover in patients with a dilated aorta. This novel approach combines magnetic resonance imaging with blood biomarker analysis, providing new insights into disease mechanisms.
Petter Dyverfeldt emphasises that traditional measures like aortic diameter alone may not capture the full complexity of aortic dilation. The study’s findings underscore the importance of integrating advanced imaging and biomarker analysis to enhance understanding and management of this condition.
Ongoing research is expanding our understanding of aortic dilation beyond conventional measures. By investigating the intricate relationships between blood flow dynamics, inflammation, and connective tissue metabolism, researchers aim to refine diagnostic and therapeutic approaches, ultimately improving outcomes for individuals with this complex cardiovascular condition.
More information: Filip Hammaréus et al, Wall shear stress measured with 4D flow CMR correlates with biomarkers of inflammation and collagen synthesis in mild-to-moderate ascending aortic dilation and tricuspid aortic valves, European Heart Journal – Cardiovascular Imaging. DOI: 10.1093/ehjci/jeae130
Journal information: European Heart Journal – Cardiovascular Imaging Provided by Linköping University
