Abdominal Aortic Aneurysm and Liver Fibrosis. Clinical Evidence and Molecular Pathomechanics

To stimulate further research, we will discuss studies linking liver fibrosis with the risk of abdominal aortic aneurysms (AAA). AAA is defined as a permanently weakened and di-lated abdominal aorta, which develops due to inflammation of the tunica media, activa-tion of the renin-angiotensin-aldosterone system, immune system activation, and coagu-lation disorders. Typically asymptomatic, AAA is often incidentally detected through imaging done for abdominal symptoms or as part of screening programs. AAA follows a variable course and has a mortality rate strongly dependent on age and sex. Risk factors for AAA include age, male sex, ethnicity, family history of AAA, lifestyle habits, arterial hypertension, dyslipidemia, and comorbid atherosclerotic cardiovascular disease. Con-versely, individuals with type 2 diabetes, female sex, and certain ethnicities are at a re-duced risk of AAA. Liver fibrosis, resulting from chronic liver diseases owing of varying etiologies, is increasingly recognized as a potential contributor to AAA development. We will specifically examine the epidemiology and risk factors associated with the link be-tween AAA and liver fibrosis. Additionally, we will discuss potential pathomechanisms that may explain this connection. Several key questions remain for future research, partic-ularly concerning targeted therapeutic interventions and the identification of novel bi-omarkers to predict disease progression.