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从生物力学特性到形态学变异：探索主动脉瓣尖度与升主动脉瘤之间的相互作用

From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm.

作者信息

Brecs Ivars, Skuja Sandra, Kasyanov Vladimir, Groma Valerija, Kalejs Martins, Svirskis Simons, Ozolanta Iveta, Stradins Peteris

机构信息

Faculty of Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia.

Centre of Cardiac Surgery, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia.

出版信息

J Clin Med. 2024 Jul 19;13(14):4225. doi: 10.3390/jcm13144225.

DOI:10.3390/jcm13144225
PMID:39064264
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11277922/
Abstract

: 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. : Clinical characteristics, laboratory indices, and imaging data from 26 adult patients operated on for aneurysms (BAV-A: = 12; TAV-A: = 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. : 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 ( < 0.001 vs. TAV and controls). TAV-A exhibited increased collagen density ( = 0.025), thickening between media and adventitia layers, and disorganized fibers ( = 0.036). BAV-A patients had elevated adipocyte deposits and immune cell infiltration. : 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.

摘要

本研究探讨升主动脉瘤（ATAAs）的生物力学和结构特征，重点关注二叶式主动脉瓣动脉瘤（BAV-As）和三叶式主动脉瓣动脉瘤（TAV-As）与未扩张主动脉之间的差异，以确定ATAAs的特定特征。分析了26例接受动脉瘤手术的成年患者（BAV-A：n = 12；TAV-A：n = 14）和13例对照的临床特征、实验室指标及影像学数据。评估了生物力学参数（最大主动脉直径、应变和应力）和结构分析（胶原纤维组织、密度、断裂、脂肪细胞沉积和免疫细胞浸润）。观察到生物力学参数存在显著差异。最大应变中位数分别为40.0%（对照）、63.4%（BAV-A）和45.3%（TAV-A）；最大应力中位数分别为0.59 MPa（对照）、0.78 MPa（BAV-A）和0.48 MPa（TAV-A）。BAV-A显示出更高的切向模量和更小的直径，伴有大量胶原断裂（与TAV和对照相比，P < 0.001）。TAV-A表现出胶原密度增加（P = 0.025）、中膜和外膜层增厚以及纤维排列紊乱（P = 0.036）。BAV-A患者脂肪细胞沉积和免疫细胞浸润增加。本研究强调了与不同瓣膜解剖结构相关的不同病理特征。BAV-A的特征是直径较小、生物力学应力较高以及显著的胶原退变，强调了制定针对性临床策略以有效管理胸主动脉瘤的必要性。

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A study on the ultimate mechanical properties of middle-aged and elderly human aorta based on uniaxial tensile test.
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