与三尖瓣主动脉瓣相比，二尖瓣主动脉瓣承受的应变增加。
Bicuspid aortic valves experience increased strain as compared to tricuspid aortic valves.
作者信息
Szeto Kai, Pastuszko Peter, del Álamo Juan C, Lasheras Juan, Nigam Vishal
机构信息
Department of Pediatrics (Cardiology), University of California San Diego, La Jolla, CA, USA.
出版信息
World J Pediatr Congenit Heart Surg. 2013 Oct;4(4):362-6. doi: 10.1177/2150135113501901.
OBJECTIVE
To determine whether the leaflets of bicuspid aortic valve (BAV) experience increased strain when compared to tricuspid aortic valve (TAV) leaflets.
BACKGROUND
The population at highest risk of aortic valve calcification (AVC) are individuals with BAVs. Currently, efforts to medically treat AVC are hampered by a limited understanding of the biomechanical forces involved in the molecular pathogenesis of AVC.
METHODS
Surgically created BAVs and control TAVs were placed into a left heart simulator. Strains were calculated by comparing the distances between points on the aortic valve (AoV) leaflet during various time points during a simulated cardiac cycle.
RESULTS
The fused leaflets of BAVs experience significantly more strain during systole when compared to TAVs. Specifically, BAVs experience 24% strain (P < .0001) in the radial direction, parallel to the direction of blood flow, as compared to TAVs. There was peak difference of 4% (P < .001) in the circumferential direction.
DISCUSSION
Based upon the data presented here, we are in the process of identifying how increased strain activates calcification-associated pathways in AoV cells. Future studies will examine whether these stretch responsive pathways can be blocked to inhibit calcification of BAVs.
目的
确定与三尖瓣主动脉瓣（TAV）瓣叶相比，二叶式主动脉瓣（BAV）瓣叶是否承受更大的应变。
背景
主动脉瓣钙化（AVC）风险最高的人群是患有BAV的个体。目前，由于对AVC分子发病机制中涉及的生物力学力了解有限，药物治疗AVC的努力受到阻碍。
方法
将手术制作的BAV和对照TAV放入左心模拟器中。通过比较模拟心动周期中各个时间点主动脉瓣（AoV）瓣叶上各点之间的距离来计算应变。
结果
与TAV相比，BAV融合瓣叶在收缩期承受的应变明显更大。具体而言，与TAV相比，BAV在与血流方向平行的径向方向上承受24%的应变（P <.0001）。在圆周方向上峰值差异为4%（P <.001）。
讨论
基于此处给出的数据，我们正在确定增加的应变如何激活AoV细胞中与钙化相关的途径。未来的研究将检查这些拉伸反应途径是否可以被阻断以抑制BAV的钙化。
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