From Biomechanical Properties to Morphological Variations : Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm
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Date
2024-07-19
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Abstract
Background: This research explores the biomechanical and structural characteristics of ascending thoracic aortic aneurysms (ATAAs), focusing on the differences between bicuspid aortic valve aneurysms (BAV-As) and tricuspid aortic valve aneurysms (TAV-As) with non-dilated aortas to identify specific traits of ATAAs. Methods: Clinical characteristics, laboratory indices, and imaging data from 26 adult patients operated on for aneurysms (BAV-A: n = 12; TAV-A: n = 14) and 13 controls were analyzed. Biomechanical parameters (maximal aortic diameter, strain, and stress) and structural analyses (collagen fiber organization, density, fragmentation, adipocyte deposits, and immune cell infiltration) were assessed. Results: Significant differences in biomechanical parameters were observed. Median maximal strain was 40.0% (control), 63.4% (BAV-A), and 45.3% (TAV-A); median maximal stress was 0.59 MPa (control), 0.78 MPa (BAV-A), and 0.48 MPa (TAV-A). BAV-A showed higher tangential modulus and smaller diameter, with substantial collagen fragmentation ( p < 0.001 vs. TAV and controls). TAV-A exhibited increased collagen density ( p = 0.025), thickening between media and adventitia layers, and disorganized fibers ( p = 0.036). BAV-A patients had elevated adipocyte deposits and immune cell infiltration. Conclusions: This study highlights distinct pathological profiles associated with different valve anatomies. BAV-A is characterized by smaller diameters, higher biomechanical stress, and significant collagen deterioration, underscoring the necessity for tailored clinical strategies for effective management of thoracic aortic aneurysm.
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Publisher Copyright: © 2024 by the authors.
Keywords
tricuspid aortic valve, bicuspid aortic valve, ascending thoracic aortic aneurysm, biomechanical properties, morphology, 3.1 Basic medicine, 3.2 Clinical medicine, 1.1. Scientific article indexed in Web of Science and/or Scopus database, General Medicine
Citation
Brečs, I, Skuja, S, Kasyanov, V, Groma, V, Kalējs, M, Svirskis, Š, Ozolanta, I & Stradiņš, P 2024, 'From Biomechanical Properties to Morphological Variations : Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm', Journal of clinical medicine, vol. 13, no. 14, 4225. https://doi.org/10.3390/jcm13144225, https://doi.org/10.3390/jcm13144225