The Involvement of Herpesviruses in the Pathogenesis of Thoracic Aortic Aneurysms: Passive Bystanders or Active Contributors?

The fundamental mechanism of thoracic aneurysm dissection involves morphological and functional reorganization of the aorta, accompanied by a reduction in the biomechanical parameters of the arterial wall. Functional zones with high receptor density are distinguished along the aorta. The autonomic reflex arc ensures the functional feasibility for a virus to penetrate the functional zones of the aorta. Numerous clinical and experimental studies demonstrated that necrotic changes specific to aneurysms develop in the middle sheath of the aorta. Therefore, necrosis of the aortic media may result from damage by the virus to the middle layer of the aorta. Further research should focus on the potential role of herpesviruses in medial vascular wall necrosis. The development of antiviral therapy for patients with aortic aneurysms will help stop medial necrosis in the aortic wall and possibly reduce mortality rates.