Is there any research on if/how a slightly dilatated thoracic aorta root dilatation (caused by high blood pressure and not Marfan) can be successful reversed? If not, what is the physiological reason that a dilatated aortic root (4cm) (caused specifically by high blood) pressure cannot return back to normal size after aggressive blood pressure control?
There are numerous pathophysiological mechanisms that are gradually progressive and cause dilation of vessels like macromolecule transport, gene expression alterations, cell death pathways, calcification, inflammation. Currently there are no ways of reversing it. That is the research topic for the future I guess
Good question. And that is the beginning of something, I hope you will explore it and offer us some explanation. There is no such possibility for now, which does not mean it will not. Congratulations on an interesting question.
Dilatation of the aorta may be seen as a degenerative disease, with aging, arterial pressure, atherosclerosis and oxidative stress as the main mediators.
It can be facilitated by the genetic background. In a minority of patients, this genetic background is predominant. Such as Marfan, straight back syndrome, bicuspid aortic valve, Dietz-Loeys syndrome...
How genetic background interacts with aging, arterial stiffening, lifestyle and environment still is a fascinating research topic.
Provided that research contributes to a better prevention.
Unfortunately there is no means of reversing the dilatation which has already happened. At least we can aim to retard the rate of progression by better control of blood pressure and addressing co morbid conditions like diabetic state and dyslipidemia. Among the anti hypertensives, drugs acting on the RAAS system may be preferred. Beta blockers also probably have a role as they blunt the rate of rise of intraventricular pressure which is transmitted to the vasculature.
Certainly, an excellent area for research. Thanks.
Sobering recent results of ARB administration. In Marfan ARB's are at most equally good as beta blocking agents and add-on therapy is not beneficial. See October issue of JACC, manuscript by Teixedo-Tura and editorial by Isselbacher. Article Losartan for the Treatment of Marfan Syndrome
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