{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:12Z","timestamp":1787018112828,"version":"build-2736575974"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">This study aimed to elucidate the impact of vasa vasorum on the natural progression of aortic dissection in patients with hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Full\u2010thickness ascending aortic walls from 43 participants (median age, 53\u2009years; 32.6% women) were analyzed using pathological observation and shear stress measurement. Comparisons among hypertensive dissection (AD, n=23), hypertensive control (n=12), and nonhypertensive dissection (non\u2013HT\u2010AD, n=8) groups were performed using Kruskal\u2013Wallis and repeated\u2010measures ANOVA tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Compared with the control group, a higher density of vasa vasorum was observed within the outer third of the tunica media (medial neovascularization [MN]) in the AD group (adjusted\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02). In the AD group, MN frequently coincided with the site of medial tearing, and the MN grade was higher than in the other 2 groups (overall:\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.01; non\u2013HT\u2010AD versus AD group: adjusted\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.05; control versus AD group: adjusted\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.05). Medial degeneration was observed in all of the groups. Compared with the non\u2013HT\u2010AD group, the medial degeneration grade was even lower in the AD group (adjusted\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.006). Multicenter fractures of elastic and collagen fibers were evident within the MN region in the AD group. Biomechanical testing revealed a significantly increasing translamellar discrepancy in stretch ranges inside the similar region (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001 for interaction;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      <jats:sub>column factor<\/jats:sub>\n                      &lt;0.001) in the AD group when compared with the control group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">MN and subsequent vasa vasorum rupture in the outer tunica media may represent an alternative initiating event in hypertension\u2010related aortic dissection, distinct from the classical intimal tear. However, the cross\u2010sectional nature of this study precludes definitive causal conclusions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.047349","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:31:08Z","timestamp":1780115468000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Medial Neovascularization: A Novel Mechanism of Aortic Dissection in a Hypertensive Population?"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9002-2606","authenticated-orcid":false,"given":"Yong","family":"Lin","sequence":"first","affiliation":[{"name":"Fujian Medical University Union Hospital","place":["Fuzhou, P. R. China"]},{"name":"Fujian Province University","place":["Fuzhou, P. R. China"]},{"name":"Fujian Provincial Centre for Cardiovascular Medicine","place":["Fuzhou, P. R. 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