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Biomechanical properties of the thoracic aorta in Marfan patients
Fatiesa Sulejmani1, Anastassia Pokutta-Paskaleva1, Bulat Ziganshin2
1The Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA.
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.
Insights
Marfan syndrome (MFS) aortic tissue shows age-dependent stiffening and elastin degradation. Non-MFS aneurysms are stiffer than MFS, indicating age and aneurysm presence increase aortic stiffness, not diameter.
Area of Science:
- Cardiovascular biomechanics
- Connective tissue disorders
- Aortic aneurysm research
Background:
- Marfan syndrome (MFS) is a genetic connective tissue disorder.
- MFS is linked to thoracic aortic aneurysms, increasing dissection and rupture risk.
- Limited studies exist on Marfan aneurysmal biomechanics.
Purpose of the Study:
- Investigate biomechanical and microstructural properties of MFS aneurysmal tissue.
- Compare MFS tissue to non-MFS aneurysms, healthy aorta, and porcine aorta.
- Provide insights for improved risk assessment and failure prediction in MFS.
Main Methods:
- Mechanical testing: planar biaxial tensile and uniaxial failure tests.
- Microstructural analysis: Verhoeff-Van Gieson (elastin) and PicroSirius Red (collagen) staining.
- Tissues studied: MFS (n=15), non-MFS TAA (n=8), healthy human (n=8), porcine (n=10).
Main Results:
- MFS tissue showed age-dependent, diameter-independent properties with elastin degradation.
- Non-MFS aneurysmal aorta was thicker and stiffer than MFS aorta.
- Younger MFS tissue mechanics resembled aged porcine tissue.
Conclusions:
- Aortic tissue stiffness increases with age and aneurysm presence.
- Aortic diameter is not a significant factor in mechanical property deterioration.
- MFS stiffens the thoracic aorta, but less than non-MFS aneurysms.
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