Circulating biomarkers associated with aortic diameter in male and female thoracic aortic disease patients: a cross-sectional study

Abstract

Abstract Background As thoracic aortic disease (TAD) is generally asymptomatic, biomarkers are needed to provide insight into early progression. Purpose We aimed to examine the association between circulating blood biomarkers and the maximal thoracic aortic diameter (TADmax). Methods In this cross-sectional study, consecutive adult patients with a thoracic aortic diameter ≥ 40 mm and/or genetically proven hereditary TAD (HTAD) visiting our specialized outpatient clinic between 2017-2020, were prospectively included. Venous blood sampling and computed tomography angiography and/or transthoracic echocardiography of the aorta were performed. Linear regression analyses were performed and estimates were presented as mean difference in TADmax in mm per doubling of standardized biomarker level. Results In total 158 patients were included (median age 61 [50.3-68.8] years, 37.3% female). HTAD diagnosis was confirmed in 36/158 (22.7%) patients. TADmax was 43.9 ± 5.2 mm in males versus 41.9 ± 5.1 in females, p=0.030. In unadjusted analysis, significant associations with TADmax were found for interleukin-6 (IL-6) (1.15 (95%CI 0.33-1.96), p=0.006), growth-differentiation factor-15 (GDF-15) (1.01 (95%CI 0.18-1.84), p=0.018), microfibrillar-associated protein 4 (MFAP4) (-0.88 (95%CI -1.71—0.05), p=0.039) and triiodothyronine (T3) (-2.00 (95%CI -3.01—0.99), p<0.001). The association fherer MFAP4 was stronger in females (p=0.020) and for homocysteine an inverse association was observed when compared to males (p=0.008). When adjusted for age, sex, hyperlipidaemia and HTAD, total cholesterol (1.10 (95%CI 0.27-1.93), p=0.010) and T3 (-1.20 (95%CI -2.14—0.25), p=0.014) were significantly associated with TADmax. Conclusions Circulating biomarkers indicative of inflammation, lipid metabolism and thyroid function, might be associated with thoracic aortic disease severity. Possible distinct biomarker patterns for males and females warrant further investigation.Figure 1Table 1