The influence of wall stress on AAA growth and biomarkers

L. Speelman, F.A.M.V.I. Hellenthal, B. Pulinx, E.M.H. Bosboom, M. Breeuwer, M.R. Sambeek, F.N. Vosse, van de, M.J.H.M. Jacobs, W.K.W.H. Wodzig, G.W.H. Schurink

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Abstract

Objectives: This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or downregulation of specific circulating biomarkers. Levels of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1, C-reactive protein and alpha 1-antitrypsin were therefore evaluated.MethodsThirty-seven patients (maximum AAA diameter 41–55 mm) with two, three or four consecutive computed tomography angiography (CTA) scans were prospectively included. Diameter growth rate in mm/year was determined between each pair of two sequential CTA scans. AAA wall stress was computed by finite element analysis, based on the first of the two sequential CTA scans only (n = 69 pairs). Biomarker information was determined in 46 measurements in 18 patients. The relation between AAA diameter and wall stress was determined and the AAA's were divided into three equally sized groups (relative low, medium and high stress). Growth rate and biomarker concentrations were compared between these groups. Additionally, correlation coefficients were computed between absolute wall stress, AAA growth and biomarker concentrations.ResultsA relative low AAA wall stress was associated with a lower aneurysm growth rate. Growth rate was also positively related to MMP-9 plasma concentration (r = 0.32). The average MMP-9 and CRP concentrations increased with increasing degrees of relative wall stress, although the absolute and relative wall stress did not correlate with any of the biomarkers.ConclusionAlthough lower relative wall stress was associated to a lower AAA growth rate, no relation was found between biomarker concentrations and wall stress. Future research may focus on more and extensive biomarker measurements in relation to AAA wall stress.
Original languageEnglish
Pages (from-to)410-416
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume39
Issue number4
DOIs
Publication statusPublished - 2010

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Abdominal Aortic Aneurysm
Biomarkers
Growth
Matrix Metalloproteinases
Aneurysm
alpha 1-Antitrypsin
Finite Element Analysis
Matrix Metalloproteinase 1
Tissue Inhibitor of Metalloproteinase-1
Matrix Metalloproteinase 9
C-Reactive Protein
Up-Regulation
Down-Regulation

Cite this

Speelman, L. ; Hellenthal, F.A.M.V.I. ; Pulinx, B. ; Bosboom, E.M.H. ; Breeuwer, M. ; Sambeek, M.R. ; Vosse, van de, F.N. ; Jacobs, M.J.H.M. ; Wodzig, W.K.W.H. ; Schurink, G.W.H. / The influence of wall stress on AAA growth and biomarkers. In: European Journal of Vascular and Endovascular Surgery. 2010 ; Vol. 39, No. 4. pp. 410-416.
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title = "The influence of wall stress on AAA growth and biomarkers",
abstract = "Objectives: This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or downregulation of specific circulating biomarkers. Levels of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1, C-reactive protein and alpha 1-antitrypsin were therefore evaluated.MethodsThirty-seven patients (maximum AAA diameter 41–55 mm) with two, three or four consecutive computed tomography angiography (CTA) scans were prospectively included. Diameter growth rate in mm/year was determined between each pair of two sequential CTA scans. AAA wall stress was computed by finite element analysis, based on the first of the two sequential CTA scans only (n = 69 pairs). Biomarker information was determined in 46 measurements in 18 patients. The relation between AAA diameter and wall stress was determined and the AAA's were divided into three equally sized groups (relative low, medium and high stress). Growth rate and biomarker concentrations were compared between these groups. Additionally, correlation coefficients were computed between absolute wall stress, AAA growth and biomarker concentrations.ResultsA relative low AAA wall stress was associated with a lower aneurysm growth rate. Growth rate was also positively related to MMP-9 plasma concentration (r = 0.32). The average MMP-9 and CRP concentrations increased with increasing degrees of relative wall stress, although the absolute and relative wall stress did not correlate with any of the biomarkers.ConclusionAlthough lower relative wall stress was associated to a lower AAA growth rate, no relation was found between biomarker concentrations and wall stress. Future research may focus on more and extensive biomarker measurements in relation to AAA wall stress.",
author = "L. Speelman and F.A.M.V.I. Hellenthal and B. Pulinx and E.M.H. Bosboom and M. Breeuwer and M.R. Sambeek and {Vosse, van de}, F.N. and M.J.H.M. Jacobs and W.K.W.H. Wodzig and G.W.H. Schurink",
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The influence of wall stress on AAA growth and biomarkers. / Speelman, L.; Hellenthal, F.A.M.V.I.; Pulinx, B.; Bosboom, E.M.H.; Breeuwer, M.; Sambeek, M.R.; Vosse, van de, F.N.; Jacobs, M.J.H.M.; Wodzig, W.K.W.H.; Schurink, G.W.H.

In: European Journal of Vascular and Endovascular Surgery, Vol. 39, No. 4, 2010, p. 410-416.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The influence of wall stress on AAA growth and biomarkers

AU - Speelman, L.

AU - Hellenthal, F.A.M.V.I.

AU - Pulinx, B.

AU - Bosboom, E.M.H.

AU - Breeuwer, M.

AU - Sambeek, M.R.

AU - Vosse, van de, F.N.

AU - Jacobs, M.J.H.M.

AU - Wodzig, W.K.W.H.

AU - Schurink, G.W.H.

PY - 2010

Y1 - 2010

N2 - Objectives: This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or downregulation of specific circulating biomarkers. Levels of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1, C-reactive protein and alpha 1-antitrypsin were therefore evaluated.MethodsThirty-seven patients (maximum AAA diameter 41–55 mm) with two, three or four consecutive computed tomography angiography (CTA) scans were prospectively included. Diameter growth rate in mm/year was determined between each pair of two sequential CTA scans. AAA wall stress was computed by finite element analysis, based on the first of the two sequential CTA scans only (n = 69 pairs). Biomarker information was determined in 46 measurements in 18 patients. The relation between AAA diameter and wall stress was determined and the AAA's were divided into three equally sized groups (relative low, medium and high stress). Growth rate and biomarker concentrations were compared between these groups. Additionally, correlation coefficients were computed between absolute wall stress, AAA growth and biomarker concentrations.ResultsA relative low AAA wall stress was associated with a lower aneurysm growth rate. Growth rate was also positively related to MMP-9 plasma concentration (r = 0.32). The average MMP-9 and CRP concentrations increased with increasing degrees of relative wall stress, although the absolute and relative wall stress did not correlate with any of the biomarkers.ConclusionAlthough lower relative wall stress was associated to a lower AAA growth rate, no relation was found between biomarker concentrations and wall stress. Future research may focus on more and extensive biomarker measurements in relation to AAA wall stress.

AB - Objectives: This study investigated the relation between abdominal aortic aneurysm (AAA) wall stress, AAA growth rate and biomarker concentrations. With increasing wall stress, more damage may be caused to the AAA wall, possibly leading to progression of the aneurysm and reflection in up- or downregulation of specific circulating biomarkers. Levels of matrix metalloproteinase-9, tissue inhibitor of matrix metalloproteinase-1, C-reactive protein and alpha 1-antitrypsin were therefore evaluated.MethodsThirty-seven patients (maximum AAA diameter 41–55 mm) with two, three or four consecutive computed tomography angiography (CTA) scans were prospectively included. Diameter growth rate in mm/year was determined between each pair of two sequential CTA scans. AAA wall stress was computed by finite element analysis, based on the first of the two sequential CTA scans only (n = 69 pairs). Biomarker information was determined in 46 measurements in 18 patients. The relation between AAA diameter and wall stress was determined and the AAA's were divided into three equally sized groups (relative low, medium and high stress). Growth rate and biomarker concentrations were compared between these groups. Additionally, correlation coefficients were computed between absolute wall stress, AAA growth and biomarker concentrations.ResultsA relative low AAA wall stress was associated with a lower aneurysm growth rate. Growth rate was also positively related to MMP-9 plasma concentration (r = 0.32). The average MMP-9 and CRP concentrations increased with increasing degrees of relative wall stress, although the absolute and relative wall stress did not correlate with any of the biomarkers.ConclusionAlthough lower relative wall stress was associated to a lower AAA growth rate, no relation was found between biomarker concentrations and wall stress. Future research may focus on more and extensive biomarker measurements in relation to AAA wall stress.

U2 - 10.1016/j.ejvs.2009.12.021

DO - 10.1016/j.ejvs.2009.12.021

M3 - Article

C2 - 20060752

VL - 39

SP - 410

EP - 416

JO - European Journal of Vascular and Endovascular Surgery

JF - European Journal of Vascular and Endovascular Surgery

SN - 1078-5884

IS - 4

ER -