Introduction: Many observational studies have identified aortic aneurysm (AA) as a cardiovascular complication of immune-mediated inflammatory diseases (IMIDs). However, due to the effects of various confounders, it is still uncertainty whether this association holds or whether reverse causality is involved. Here we conducted a two-sample bidirectional MR study to infer the causal relationships between the two diseases. Method: We obtained genetic association datasets from public GWAS databases in populations of European ancestry. Abiding by the assumptions of Mendelian randomization (MR), we selected valid instrumental variables from genetic variants. Different statistic methods were performed for MR analysis and sensitivity analysis, and the inverse variance weighted (IVW) method was regarded as the most efficient estimate of the causal effect in this study. Results: The IVW method found evidence that genetically predicted AA had a causal effect on rheumatoid arthritis (RA) (OR = 1.06, 95%CI = 1.01-1.12, p = 0.029), but not of RA or other IMIDs on AA. Besides, no evidence showed that AA may increase the risk of inflammatory bowel disease (IBD), Crohn’s disease (CD), ulcerative colitis (UC), systemic lupus erythematosus (SLE) and psoriasis (PSO). The sensitivity analysis confirmed the absence of heterogeneity or horizontal pleiotropy effect. Conclusion: In summary, our study discovered that genetically predicted AA may increase the risk of RA, while no evidence was found that patients with RA had an increased risk of AA. Furthermore, we confirmed no evidence of association between IBD, CD, UC, SLE, PSO and AA. This is in accordance with other reports that demonstrated the human leukocyte antigen molecule in inflammatory aortic aneurysm was a genetic risk loci. Our study provides directions for future research on genetic susceptibility to inflammatory aortic aneurysm.

Background: Three-dimensional reconstruction technology is used to measure the volume of the descending aorta and to evaluate the characteristics of the remodeling of the descending aorta with different lengths after frozen elephant trunk (FET) treatment of acute type A aortic dissection (ATAAD). Methods: Three-dimensional reconstruction of the computed tomography angiography (CTA) of 48 cases ATAAD patients preoperatively and 1-3 months postoperatively was performed to measure the total volume of the aorta lumen model, descending aorta lumen volume, abdominal arterial lumen volume, as well as the true lumen (TL) and false lumen (FL) of each segment. The postoperative volumetric ratio was subtracted from the preoperative volumetric ratio, and the final distinction was made according to our remodeling classification criteria. Result: There were 13 (76.47%) positive remodeling cases, 9 (42.86%) stable remodeling cases, and 2 (20.00%) negative remodeling cases in the long FET group. In the short FET group, there were 4 (23.53%) positive remodeling cases, 12 (57.14%) stable remodeling cases, and 8 (80.00%) negative remodeling cases. As shown above, the data was obtained from the volumetric measurement and the morphological analysis of the three-dimensional reconstruction model. Conclusion: According to our classification criteria, long FET can promote the positive remodeling of the descending aorta, and it is meaningful for three-dimensional reconstruction to be used in volume measurement and morphological research.

OBJECTIVES: The frozen elephant trunk (FET) technique has become an important tool in the treatment of acute type A aortic dissection. The aim of this study was to evaluate the effect of long FET on spinal cord injury (SCI) and distal aortic remodeling after acute type A aortic dissection based on clinical and radiological outcomes. METHODS: From January 2018 to November 2019, 158 patients [mean age 51.8 years (range 32 - 78 years), 88.6% male] with acute type A aortic dissection were treated by FET with 100 mm (n=113) or 150 mm (n=45) open hybrid stent graft prosthesis. Patients were divided into two groups according to the length of FET. The clinical and radiological outcomes of the patients were reviewed retrospectively. RESULTS: Postoperative outcomes did not differ significantly: in-hospital mortality (9.7% vs 6.7%, P=0.758) and SCI (5.3% vs 2.2%, P=0.674). Aortic remodeling, which was evaluated by aortic diameter, true lumen diameter, false lumen diameter and the rate of false lumen complete thrombosis, was more positive in long FET group in the descending thoracic aorta during the follow-up period. At the abdominal level, there was no statistically significant difference between the two groups. CONCLUSIONS: The long version of FET does not increase the risk of SCI in patients with acute type A aortic dissection. The application of long FET can achieve better results in terms of remodeling of the thoracic aorta in the short- and medium-term follow-up.