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(Circulation. 2008;117:130.)
© 2008 American Heart Association, Inc.

Editor's Note

Editor’s Note

Gilbert R. Upchurch, Jr, MD

Series Editor, Aortic Diseases

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Diseases of the aorta are the 14th leading cause of death in the United States. This complex group of diseases (aneurysms, dissections, and occlusive disease) affects multiple vascular beds, from the aortic valve to the terminal aorta and iliac arteries. Because of this fact, the clinical management of aortic diseases is performed by a variety of healthcare providers.

The incidence and prevalence of aortic disease are increasing as society ages and contributing risk factors go untreated. Thus, these diseases are not rare and, if they are left untreated, patients with aortic disease die. In addition, there are no proven specific or targeted drug therapies to treat aortic disease.

Universal are a significantly higher prevalence in men and a graded increased prevalence with advancing age. The inciting events that lead to aortic disease are not well understood; however, some common themes include: (1) proteolytic derangements in the aortic wall, (2) transmural vessel wall inflammation, (3) immune responses, including a strong genetic link, and (4) altered biomechanical wall stresses along the length of the aorta.

Unfortunately, aortic disease is often clinically silent until patients present with catastrophic aortic rupture or malperfusion of end organs, such as the intestines or kidneys. Alternatively, aortic disease may be discovered serendipitously when healthcare providers perform tests for other disease processes. Discovery of aortic disease before aortic rupture is critical, as there is a huge disparity in mortality rates between patients who undergo aortic repair in the elective setting and those who undergo repair in an emergency . . . [Full Text of this Article]