Thoracic Aortic Aneurysm: Blood Pressure and Inflammation as Key Factors in the Development of Aneurysm Dissection

Aortic aneurism development is dependent on internal and external etiological factors that define the width of the therapeutic window available for the treatment of patients with such diagnosis. In this review, we provide a detailed overview of the most prominent of these factors. In particular, we discuss the input of elevated blood pressure to the remodeling of the aortic wall, describe the mechanisms of inflammatory remodeling of the aorta, and evaluate the cross-interaction of blood pressure, inflammation and immunity during the pathology development. Better understanding of this interaction will allow broadening the therapeutic options available for patients with aortic aneurism or preventive strategies for patients with known risk factors. To date, modulation of the immune signaling appears to be a promising point of the therapeutic intervention for the treatment of such patients. In this article, we also discuss the search for new diagnostic markers predicting changes in the width of the therapeutic window for the management of patients with aortic aneurysm.