Connective tissue growth factor expression is decreased in acute ascending aortic dissections and increased in degenerative ascending aortic aneurysms

Abstract

Purpose. Both aortic aneurysms and aortic dissections exhibit abnormal extracellular matrix properties. Connective tissue growth factor (CTGF) can induce connective tissue cell proliferation and extracellular matrix synthesis. The role of CTGF in thoracic aortic disease has never been investigated. We sought to compare the expression of CTGF in degenerative ascending aortic aneurysms and ascending aortic dissection. Methods. Intraoperative samples of ascending aorta were obtained from 47 patients: 16 patients had ascending aortic aneurysms with medial degeneration, 10 had acute aortic dissection, 9 had aneurysms due to chronic dissection. Control ascending aorta was obtained from organ donors and heart transplant recipients ( n = 10). Patients with Marfan syndrome were excluded from this study. CTGF mRNA expression within aortic wall was semiquantitatively determined by real-time RT-PCR using GAPDH as the internal standard. Results. There was a significant increase in CTGF mRNA in degenerative aneurysms compared to control tissue ( P = 0.04). Conversely, patients with acute dissection had decreased CTGF mRNA expression compared with nondissection aneurysms ( P = 0.019) and controls ( P = 0.06). The increase in CTGF expression in chronic dissections compared to acute dissections approached statistical significance ( P = 0.075). Conclusions. The altered tissue levels of CTGF in aneurysms and dissections suggest possibly different molecular pathology in these aortic disorders. Further investigation regarding the role of CTGF in thoracic aortic disease is warranted.