Correlation of aortic wall shear stress with MMP-9 levels in human abdominal aortic aneurysms.
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Currently, there is no truly reliable way to evaluate the susceptibility of particular abdominal aortic aneurysms (AAA) to rupture. In order to elucidate the pathogenesis of AAA, a correlation of aortic blood flow with intraluminal thrombus (ILT) and aortic wall composition might vastly improve understanding the development, growth and rupture of AAA. We numerically simulated aortic blood flow in non-ruptured AAA, from this; high and low wall shear stress (WSS) were identified as well as thickness of ILT. Multiple sites of tissue of electively repaired AAA was harvested to analyze inflammatory cells, collagen, elastin content and MMP-9 levels. We showed that there is significant variability of MMP-9 content throughout AAA, and that areas of thick ILT had higher levels of MMP-9 and were associated with lower velocity and recirculation. This variability in proteolytic enzymes in AAA has never been shown before. This is a stepping stone in fully elucidating the pathogenesis and rupture of AAA. This information may lead to better medical targets or management of AAA in patients.