Progress in aorta and peripheral cardiovascular disease research

Abstract

Although coronavirus disease 2019 seems to be the leading topic in research number of outstanding studies have been published in the field of aorta and peripheral vascular diseases likely affecting our clinical practice in the near future. This review article highlights key research on vascular diseases published in 2020. Some studies have shed light in the pathophysiology of aortic aneurysm and dissection suggesting a potential role for kinase inhibitors as new therapeutic options. A first proteogenomic study on fibromuscular dysplasia (FMD) revealed a promising novel disease gene and provided proof-of-concept for a protein/lipid-based FMD blood test. The role of NADPH oxidases in vascular physiology, and particularly endothelial cell differentiation, is highlighted with potential for cell therapy development. Imaging of vulnerable plaque has been an intense field of research. Features of plaque vulnerability on magnetic resonance imaging as an under-recognized cause of stroke are discussed. Major clinical trials on lower extremity peripheral artery disease have shown added benefit of dual antithrombotic (aspirin plus rivaroxaban) treatment.

Keywords: Antithrombotics; Aorta; COVID; Peripheral artery disease; Venous thromboembolism.

Figure 1

GITR-mediated atherogenesis (reproduced with permission from Shami et al.⁶). GITR, glucocorticoid-induced tumour necrosis factor receptor family-related protein.

Figure 2

Forest plot of risk of adverse events with more intense vs. less intense antithrombotic therapy in patients with lower extremity artery disease. The 95% CIs are denoted by lines (modified from Savarese et al.¹⁹). CI, confidence interval; CV, cardiovascular.

Figure 3

Potential endothelial dysregulation by SARS-CoV-2 (reproduced with permission from Evans et al.³⁹). ACE2, angiotensin-converting enzyme 2 receptor; ROS, reactive oxygen species.