Mechanical deterioration underlies malignant behavior of aneurysmal human ascending aorta

Koullias, George J.; Modak, Raj K.; Tranquilli, Maryann; Korkolis, Dimitris P.; Barash, Paul; Elefteriades, John A.

doi:10.1016/j.jtcvs.2005.02.052

Cited by 155 publications

(152 citation statements)

References 14 publications

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“…7,8) Engineering calculations have estimated that as the aorta enlarges, distensibility of the aortic wall decreases, so that by approximately 6 cm, the aorta becomes rigid. 9) Consistent with this suggestion is the data from cases with Marfan's syndrome, [10][11][12][13] the aortopathy associated with bicuspid aortic valves (BAV) 14,15) and familial thoracic aortic aneurysms. 16) The majority of ATAA cases, however, are not due to Marfan's syndrome, aortopathy of BAV or familial/ genetic factors, but rather are usually ascribed to 'degenerative' factors and comprise 80% of all ATAA cases.…”

Section: Introductionmentioning

confidence: 85%

Pulse Wave Velocity Involving Proximal Portions of the Aorta Correlates with the Degree of Aortic Dilatation at the Sinuses of Valsalva in Ascending Thoracic Aortic Aneurysms

Rabkin

Chan

Chow

et al. 2014

Annals of Vascular Diseases

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Objective: To determine the relationship between arterial stiffness measured in different aortic segments and the presence and extent of ascending thoracic aortic aneurysm (ATAA). Methods: Patients at a Thoracic Aortic Diseases clinic at a University teaching hospital were compared to patients attending a Cardiology outpatient Clinic at the same institution. A non-invasive measure of vascular stiffness was performed using pulse wave velocity (PWV) measurement of several vascular segments-carotidfemoral pulse wave velocity (cfPWV), heart-femoral pulse wave velocity (hfPWV) and brachial-ankle pulse wave velocity (baPWV). Aortic dimensions were measured on echocardiogram. Results: Patients with ATAA (N = 32) were 66 years and the same age as those without ATAA (N = 46). There was no significant difference between those with or without aortic aneurysm with respect to cfPWV, hfPWV or baPWV. In ATAA, there was a significant (p <0.05) inverse correlation between aortic diameter at the sinuses of Valsalva and cfPWV, as well as hfPWV, but not with baPWV. This relationship was not evident in persons without ATAA. Conclusion: Reduced aortic stiffness (increased compliance), assessed by cfPWV or hfPWV, correlates with larger aortic size of ATAA at the level of the sinuses of Valsalva but not at the ascending aorta, suggesting cfPWV may be a useful method to assess the size of ATAA at the level of the sinuses of Valsalva. Overall aortic stiffness assessed by PWV did not differentiate persons with or without an ATAA, in individuals who do not have a genetic or inheritable cause of their ATAA.

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Section: Introductionmentioning

confidence: 85%

Pulse Wave Velocity Involving Proximal Portions of the Aorta Correlates with the Degree of Aortic Dilatation at the Sinuses of Valsalva in Ascending Thoracic Aortic Aneurysms

Rabkin

Chan

Chow

et al. 2014

Annals of Vascular Diseases

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“…Significant effort has been devoted to the investigation of the mechanical properties and pathogenesis of AsAA tissue (7,13,14,(18)(19)(20)(21); however, MFS-specific studies are scarce. A number of in vivo studies on Marfan tissues investigate aortic distensibility, stiffness index, and pulse wave velocity (3,(8)(9)(10)(11)(12), consistently finding increased aortic diameter (12), decreased distensibility (8)(9)(10), and stiffness (8,9,12) in MFS patients compared to age-and gender-matched controls; however, these parameters were not correlated, as also found in our study.…”

Section: In Vivomentioning

confidence: 99%

Biomechanical properties of the thoracic aorta in Marfan patients

Sulejmani¹,

Pokutta-Paskaleva²,

Ziganshin³

et al. 2017

Ann. Cardiothorac. Surg.

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Background: Marfan syndrome (MFS), a genetic disorder of the connective tissue, has been strongly linked to dilation of the thoracic aorta, among other cardiovascular complications. As a result, MFS patients frequently suffer from aortic dissection and rupture, contributing to the high rate of mortality and morbidity among MFS patients. Despite the significant effort devoted to the investigation of mechanical and structural properties of aneurysmal tissue, studies on Marfan aneurysmal biomechanics are scarce. Ex vivo mechanical characterization of MFS aneurysmal tissue can provide a better insight into tissue strength outside the physiologic loading range and serve as a basis for improved risk assessment and failure prediction. Methods:The mechanical and microstructural properties of MFS aneurysmal thoracic aorta (MFS, n=15, 39.5±3.91 years), non-MFS aneurysmal thoracic aorta (TAA, n=8, 52.8±4.9 years), healthy human thoracic aorta (HH, n=8, 75.4±6.1 years), and porcine thoracic aorta (n=10) are investigated. Planar biaxial tensile testing and uniaxial failure testing were utilized to characterize the mechanical and failure properties of the tissue, respectively. Verhoeff-Van Gieson (VVG) and PicroSirius Red stains were utilized to visualize the elastin and collagen fiber architecture, respectively.Results: MFS tissue was found to have age-dependent but diameter-independent mechanical, structural, and morphological properties, also showing extensive elastin fiber degradation. Non-MFS thoracic aneurysmal aorta was thicker and stiffer than age-matched MFS tissue. Moreover, non-MFS thoracic aneurysmal mechanics resembled closely the mechanics of older healthy human tissue. Younger MFS tissue (<40 years) exhibited similar mechanical and structural properties to aged porcine tissue.Conclusions: Both age and aneurysmal presence were found to be factors associated with increased stiffness in aortic tissue, and aortic diameter was not a significant determinant of mechanical property deterioration. Additionally, the presence of MFS was found to induce stiffening of the thoracic aorta, although not to the extent of the non-MFS aneurysm.

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“…Regional aortic wall stiffness and size are considered to be coupled [6,12]. We previously showed that regional PWV had moderate to high specificity for predicting absence of increased in a total of 28 (14 %) segments (S1: 15 cases, S2: 6 cases, S3: 4 cases, S4: 2 cases, S5: 1 cases) ( Table 3).…”

Section: Pwv Valuesmentioning

confidence: 99%

“…It is expected that in TAA patients without Marfan syndrome, local aortic wall stiffness measured by PWV is increased. Interestingly, regional aortic wall stiffness and size are considered to be coupled [6,12]. However, the local aortic wall stiffness, measured by PWV in TAA patients, has not been reported before.…”

Section: Introductionmentioning

confidence: 99%

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Coupling between MRI-assessed regional aortic pulse wave velocity and diameters in patients with thoracic aortic aneurysm: a feasibility study

et al. 2015

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Mechanical deterioration underlies malignant behavior of aneurysmal human ascending aorta

Cited by 155 publications

References 14 publications

Pulse Wave Velocity Involving Proximal Portions of the Aorta Correlates with the Degree of Aortic Dilatation at the Sinuses of Valsalva in Ascending Thoracic Aortic Aneurysms

Pulse Wave Velocity Involving Proximal Portions of the Aorta Correlates with the Degree of Aortic Dilatation at the Sinuses of Valsalva in Ascending Thoracic Aortic Aneurysms

Biomechanical properties of the thoracic aorta in Marfan patients

Coupling between MRI-assessed regional aortic pulse wave velocity and diameters in patients with thoracic aortic aneurysm: a feasibility study

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