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Aortic aneurysm, familial thoracic 12(AAT12)

MedGen UID:
1802657
Concept ID:
C5676959
Disease or Syndrome
Synonyms: AAT12; AORTIC ANEURYSM, FAMILIAL THORACIC 12
 
Gene (location): THSD4 (15q23)
 
Monarch Initiative: MONDO:0030731
OMIM®: 619825

Definition

Familial thoracic aortic aneurysm-12 (AAT12) is characterized by dilation of the arterial wall associated with a progressive loss of its ability to withstand the wall tension generated by high intraluminal pressure, which can lead to intramural or complete acute vessel wall rupture. Some patients have dolichostenomelia (summary by Elbitar et al., 2021). For a general phenotypic description and a discussion of genetic heterogeneity of thoracic aortic aneurysm, see AAT1 (607086). [from OMIM]

Clinical features

From HPO
Aortic regurgitation
MedGen UID:
8153
Concept ID:
C0003504
Disease or Syndrome
An insufficiency of the aortic valve, leading to regurgitation (backward flow) of blood from the aorta into the left ventricle.
Bicuspid aortic valve
MedGen UID:
57436
Concept ID:
C0149630
Congenital Abnormality
Aortic valve disease-2 (AOVD2) is characterized by bicuspid aortic valve (BAV) and dilation of the ascending aorta. Calcification of the valve and the aorta has been observed, and some patients exhibit coarctation of the aorta (Tan et al., 2012; Luyckx et al., 2019; Park et al., 2019). For a general phenotypic description and a discussion of genetic heterogeneity of aortic valve disease, see AOVD1 (109730).
Ascending tubular aorta aneurysm
MedGen UID:
163631
Concept ID:
C0856747
Anatomical Abnormality
An abnormal localized widening (dilatation) of the tubular part of the ascending aorta.
Aortic root aneurysm
MedGen UID:
720712
Concept ID:
C1298820
Anatomical Abnormality
An abnormal localized widening (dilatation) of the aortic root.
Ascending aortic dissection
MedGen UID:
322966
Concept ID:
C1836653
Disease or Syndrome
A separation of the layers within the wall of the ascending aorta. Tears in the intimal layer result in the propagation of dissection (proximally or distally) secondary to blood entering the intima-media space.
Disproportionate tall stature
MedGen UID:
323048
Concept ID:
C1836996
Finding
A tall and slim body build with increased arm span to height ratio (>1.05) and a reduced upper-to-lower segment ratio (<0.85), i.e., unusually long arms and legs. The extremities as well as the hands and feet are unusually slim.
Arthritis
MedGen UID:
2043
Concept ID:
C0003864
Disease or Syndrome
Inflammation of a joint.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Pectus excavatum
MedGen UID:
781174
Concept ID:
C2051831
Finding
A defect of the chest wall characterized by a depression of the sternum, giving the chest ("pectus") a caved-in ("excavatum") appearance.
Chronic obstructive pulmonary disease
MedGen UID:
9818
Concept ID:
C0024117
Disease or Syndrome
Chronic obstructive pulmonary disease (COPD) is a common, complex disorder associated with substantial morbidity and mortality. COPD is defined by irreversible airflow obstruction due to chronic bronchitis, emphysema, and/or small airways disease. Airflow obstruction is typically determined by reductions in quantitative spirometric indices, including forced expiratory volume at 1 second (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) (Silverman et al., 2002; Celedon et al., 2004).
Spontaneous pneumothorax
MedGen UID:
57701
Concept ID:
C0149781
Disease or Syndrome
Pneumothorax occurring without traumatic injury to the chest or lung.
High palate
MedGen UID:
66814
Concept ID:
C0240635
Congenital Abnormality
Height of the palate more than 2 SD above the mean (objective) or palatal height at the level of the first permanent molar more than twice the height of the teeth (subjective).
Hypertelorism
MedGen UID:
9373
Concept ID:
C0020534
Finding
Although hypertelorism means an excessive distance between any paired organs (e.g., the nipples), the use of the word has come to be confined to ocular hypertelorism. Hypertelorism occurs as an isolated feature and is also a feature of many syndromes, e.g., Opitz G syndrome (see 300000), Greig cephalopolysyndactyly (175700), and Noonan syndrome (163950) (summary by Cohen et al., 1995).

Professional guidelines

PubMed

Dijkstra T, van den Heuvel LM, van Tintelen JP, van der Werf C, van Langen IM, Christiaans I
Eur J Hum Genet 2023 Dec;31(12):1381-1386. Epub 2023 Mar 27 doi: 10.1038/s41431-023-01334-8. PMID: 36973393Free PMC Article
Verstraeten A, Luyckx I, Loeys B
Nat Rev Cardiol 2017 Apr;14(4):197-208. Epub 2017 Jan 19 doi: 10.1038/nrcardio.2016.211. PMID: 28102232
Campens L, Renard M, Callewaert B, Coucke P, De Backer J, De Paepe A
Pol Arch Med Wewn 2013;123(12):693-700. Epub 2013 Dec 16 doi: 10.20452/pamw.2015. PMID: 24343123

Recent clinical studies

Etiology

Creamer TJ, Bramel EE, MacFarlane EG
Genes (Basel) 2021 Jan 27;12(2) doi: 10.3390/genes12020183. PMID: 33514025Free PMC Article
Shalhub S, Rah JY, Campbell R, Sweet MP, Quiroga E, Starnes BW
J Vasc Surg 2021 Jun;73(6):1906-1914.e2. Epub 2020 Nov 27 doi: 10.1016/j.jvs.2020.10.080. PMID: 33249204
Braverman AC, Mittauer E, Harris KM, Evangelista A, Pyeritz RE, Brinster D, Conklin L, Suzuki T, Fanola C, Ouzounian M, Chen E, Myrmel T, Bekeredjian R, Hutchison S, Coselli J, Gilon D, O'Gara P, Davis M, Isselbacher E, Eagle K
JAMA Cardiol 2021 Jan 1;6(1):58-66. doi: 10.1001/jamacardio.2020.4876. PMID: 33052376Free PMC Article
Luyckx I, Kumar AA, Reyniers E, Dekeyser E, Vanderstraeten K, Vandeweyer G, Wünnemann F, Preuss C, Mazzella JM, Goudot G, Messas E, Albuisson J, Jeunemaitre X, Eriksson P, Mohamed SA, Kempers M, Salemink S, Duijnhouwer A, Andelfinger G, Dietz HC, Verstraeten A, Van Laer L, Loeys BL; MIBAVA Leducq Consortium
Eur J Hum Genet 2019 Jul;27(7):1033-1043. Epub 2019 Feb 28 doi: 10.1038/s41431-019-0364-y. PMID: 30820038Free PMC Article
Verstraeten A, Luyckx I, Loeys B
Nat Rev Cardiol 2017 Apr;14(4):197-208. Epub 2017 Jan 19 doi: 10.1038/nrcardio.2016.211. PMID: 28102232

Diagnosis

Yagyu T, Noguchi T, Asano Y, Ida K, Ogata S, Nishimura K, Matsuda H
J Am Heart Assoc 2023 Apr 18;12(8):e028625. Epub 2023 Apr 12 doi: 10.1161/JAHA.122.028625. PMID: 37042257Free PMC Article
Creamer TJ, Bramel EE, MacFarlane EG
Genes (Basel) 2021 Jan 27;12(2) doi: 10.3390/genes12020183. PMID: 33514025Free PMC Article
Braverman AC, Mittauer E, Harris KM, Evangelista A, Pyeritz RE, Brinster D, Conklin L, Suzuki T, Fanola C, Ouzounian M, Chen E, Myrmel T, Bekeredjian R, Hutchison S, Coselli J, Gilon D, O'Gara P, Davis M, Isselbacher E, Eagle K
JAMA Cardiol 2021 Jan 1;6(1):58-66. doi: 10.1001/jamacardio.2020.4876. PMID: 33052376Free PMC Article
Balmforth D, Harky A, Adams B, Yap J, Shipolini A, Roberts N, Uppal R, Bashir M
Gen Thorac Cardiovasc Surg 2019 Jan;67(1):12-19. Epub 2017 Oct 28 doi: 10.1007/s11748-017-0855-0. PMID: 29080094
Verstraeten A, Luyckx I, Loeys B
Nat Rev Cardiol 2017 Apr;14(4):197-208. Epub 2017 Jan 19 doi: 10.1038/nrcardio.2016.211. PMID: 28102232

Therapy

Li H, Guo J, Jia Y, Kong W, Li W
Genes (Basel) 2021 Mar 31;12(4) doi: 10.3390/genes12040513. PMID: 33807332Free PMC Article
Jakob H, Moughal S, Bashir M
J Cardiovasc Surg (Torino) 2020 Jun;61(3):301-307. Epub 2020 Apr 27 doi: 10.23736/S0021-9509.20.11401-0. PMID: 32337941
Luyckx I, Kumar AA, Reyniers E, Dekeyser E, Vanderstraeten K, Vandeweyer G, Wünnemann F, Preuss C, Mazzella JM, Goudot G, Messas E, Albuisson J, Jeunemaitre X, Eriksson P, Mohamed SA, Kempers M, Salemink S, Duijnhouwer A, Andelfinger G, Dietz HC, Verstraeten A, Van Laer L, Loeys BL; MIBAVA Leducq Consortium
Eur J Hum Genet 2019 Jul;27(7):1033-1043. Epub 2019 Feb 28 doi: 10.1038/s41431-019-0364-y. PMID: 30820038Free PMC Article
Shalhub S, Eagle KA, Asch FM, LeMaire SA, Milewicz DM; GenTAC Investigators for the Genetically Triggered Thoracic Aortic Aneurysms and Cardiovascular Conditions (GenTAC) Consortium
J Vasc Surg 2018 Aug;68(2):364-371. Epub 2018 Mar 19 doi: 10.1016/j.jvs.2017.11.095. PMID: 29567025
El-Hamamsy I, Yacoub MH
Nat Rev Cardiol 2009 Dec;6(12):771-86. Epub 2009 Nov 3 doi: 10.1038/nrcardio.2009.191. PMID: 19884902

Prognosis

Yagyu T, Noguchi T, Asano Y, Ida K, Ogata S, Nishimura K, Matsuda H
J Am Heart Assoc 2023 Apr 18;12(8):e028625. Epub 2023 Apr 12 doi: 10.1161/JAHA.122.028625. PMID: 37042257Free PMC Article
Shalhub S, Rah JY, Campbell R, Sweet MP, Quiroga E, Starnes BW
J Vasc Surg 2021 Jun;73(6):1906-1914.e2. Epub 2020 Nov 27 doi: 10.1016/j.jvs.2020.10.080. PMID: 33249204
Braverman AC, Mittauer E, Harris KM, Evangelista A, Pyeritz RE, Brinster D, Conklin L, Suzuki T, Fanola C, Ouzounian M, Chen E, Myrmel T, Bekeredjian R, Hutchison S, Coselli J, Gilon D, O'Gara P, Davis M, Isselbacher E, Eagle K
JAMA Cardiol 2021 Jan 1;6(1):58-66. doi: 10.1001/jamacardio.2020.4876. PMID: 33052376Free PMC Article
Grotenhuis HB, Dallaire F, Verpalen IM, van den Akker MJE, Mertens L, Friedberg MK
Circ Cardiovasc Imaging 2018 Dec;11(12):e007611. doi: 10.1161/CIRCIMAGING.118.007611. PMID: 30562107
Ruddy JM, Jones JA, Ikonomidis JS
Prog Cardiovasc Dis 2013 Jul-Aug;56(1):68-73. Epub 2013 May 15 doi: 10.1016/j.pcad.2013.04.002. PMID: 23993239Free PMC Article

Clinical prediction guides

Asokan KL, Landes JR, Renders W, Muiño Mosquera L, De Backer J, Jantzen DW, Yetman AT, Teixido-Tura G, Evangelista A, Jeremy R, Jones EG, Morris S, Doan T, Ouzonian M, Braverman A, Jondeau G, Milleron O, Milewicz DM, Prakash SK; Montalcino Aortic Consortium *
J Am Heart Assoc 2024 Nov 5;13(21):e036274. Epub 2024 Oct 18 doi: 10.1161/JAHA.124.036274. PMID: 39424426
Katz AE, Yang ML, Levin MG, Tcheandjieu C, Mathis M, Hunker K, Blackburn S, Eliason JL, Coleman DM, Fendrikova-Mahlay N, Gornik HL, Karmakar M, Hill H, Xu C, Zawistowski M, Brummett CM, Zoellner S, Zhou X, O'Donnell CJ, Douglas JA, Assimes TL, Tsao PS; VA Million Veteran Program, Li JZ, Damrauer SM, Stanley JC, Ganesh SK
Circ Genom Precis Med 2022 Dec;15(6):e003496. Epub 2022 Nov 14 doi: 10.1161/CIRCGEN.121.003496. PMID: 36374587Free PMC Article
Longobardo L, Carerj S, Bitto A, Cusmà-Piccione M, Carerj ML, Calabrò MP, Di Bella G, Licordari R, Squadrito F, Khandheria BK, Zito C
Eur Heart J Cardiovasc Imaging 2021 Jun 22;22(7):808-816. doi: 10.1093/ehjci/jeaa250. PMID: 33026072
Grotenhuis HB, Dallaire F, Verpalen IM, van den Akker MJE, Mertens L, Friedberg MK
Circ Cardiovasc Imaging 2018 Dec;11(12):e007611. doi: 10.1161/CIRCIMAGING.118.007611. PMID: 30562107
Dong SB, Zheng J, Ma WG, Chen MJ, Cheng LJ, He L, Xing QH, Sun LZ
Ann Vasc Surg 2014 Nov;28(8):1909-12. Epub 2014 Aug 7 doi: 10.1016/j.avsg.2014.07.013. PMID: 25110237

Recent systematic reviews

Mariscalco G, Debiec R, Elefteriades JA, Samani NJ, Murphy GJ
J Am Heart Assoc 2018 Aug 7;7(15):e009302. doi: 10.1161/JAHA.118.009302. PMID: 30371227Free PMC Article

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