多模态主动脉结构分析：从瓣膜到分叉。

Multimodal Structural Analysis of the Human Aorta: From Valve to Bifurcation.

机构信息

Department of Cardiovascular Sciences, University of Leicester and Cardiovascular Theme, NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK.

East Midlands Forensic Pathology Unit, University of Leicester, Robert Kilpatrick Building, Leicester, UK.

出版信息

Eur J Vasc Endovasc Surg. 2022 May;63(5):721-730. doi: 10.1016/j.ejvs.2022.02.005. Epub 2022 Feb 11.

DOI:10.1016/j.ejvs.2022.02.005

PMID:35346566

Abstract

OBJECTIVE

The aims of the present study were to assess the relative proportion of collagen and elastin in the arterial wall and to evaluate the collagen microstructure from the aortic root to the external iliac artery.

METHODS

Arterial wall tissue samples sampled during post-mortem examination from 16 sites in 14 individuals without aneurysm disease were fixed and stained for collagen and elastin. Stained sections were imaged and analysed to calculate collagen and elastin content as a percentage of overall tissue area. Scanning electron microscopy was used to quantify the collagen microstructure at six specific arterial regions.

RESULTS

From the aortic root to the level of the suprarenal aorta, the percentages (area fractions) of collagen (ascending, descending, and suprarenal aorta respectively with 95% confidence interval [CI] 37.5%, 31.7 - 43.2; 38.9%, 33.1 - 44.7; 44.8%, 37.4 - 52.1) and elastin (43.0%, 37.3 - 48.8; 40.3%, 34.8 - 46.1; 32.4%, 25.2 - 39.6) in the aortic wall were similar. From the suprarenal aorta to the internal iliac arteries, the percentage of collagen increased (abdominal aorta, common and internal iliac arteries and external iliac artery respectively with 95% CI 50.6%, 42.7 - 58.7; 51.2%, 45.5 - 56.9; 49.2%, 42.0 - 56.4) reaching a double percentage for elastin (23.6%, 15.7 - 31.6; 20.8%, 15.1 - 26.5; 22.2%, 14.9 - 29.5). Mean collagen fibre diameter (MFD) and average segment length (ASL) were significantly larger in the external iliac artery (MFD 6.03, 95% CI 5.95 - 6.11; ASL 22.21, 95% CI 20.80 - 23.61) than in the ascending aorta (MFD 5.81, 5.72 - 5.89; ASL 19.47, 18.07 - 20.88) and the abdominal aorta (MFD 5.92, 5.84 - 6.00; ASL 21.10, 19.69 - 22.50).

CONCLUSION

In subjects lacking aneurysmal disease, the aorta and iliac arteries are not structurally uniform along their length. There is an increase in collagen percentage and decrease in elastin percentage progressing distally along the aorta. Mean collagen fibre diameter and average segment length are larger in the external iliac artery, compared with the ascending and the abdominal aorta.

摘要

目的

本研究旨在评估动脉壁中胶原和弹性蛋白的相对比例，并从主动脉根部到髂外动脉评估胶原的微观结构。

方法

从 14 名无动脉瘤病患者的 16 个部位的尸检中采集动脉壁组织样本，进行胶原和弹性蛋白固定和染色。对染色的切片进行成像和分析，以计算胶原和弹性蛋白占组织总面积的百分比。扫描电子显微镜用于定量分析 6 个特定动脉区域的胶原微观结构。

结果

从主动脉根部到肾上主动脉水平，主动脉壁中胶原（升主动脉、降主动脉和肾上主动脉分别为 95%置信区间 [CI] 37.5%，31.7-43.2%；38.9%，33.1-44.7%；44.8%，37.4-52.1%）和弹性蛋白（43.0%，37.3-48.8%；40.3%，34.8-46.1%；32.4%，25.2-39.6%）的百分比相似。从肾上主动脉到髂内动脉，胶原的百分比增加（腹主动脉、髂总动脉和髂内动脉以及髂外动脉分别为 95%CI 50.6%，42.7-58.7%；51.2%，45.5-56.9%；49.2%，42.0-56.4%），弹性蛋白的百分比增加一倍（23.6%，15.7-31.6%；20.8%，15.1-26.5%；22.2%，14.9-29.5%）。髂外动脉的胶原纤维平均直径（MFD）和平均节段长度（ASL）显著大于升主动脉（MFD 6.03，95%CI 5.95-6.11；ASL 22.21，95%CI 20.80-23.61）和腹主动脉（MFD 5.81，5.72-5.89；ASL 19.47，18.07-20.88）。