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From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and
Ivars Brecs1,2, Sandra Skuja3, Vladimir Kasyanov1,4
1Faculty of Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia.
Journal of Clinical Medicine
|July 27, 2024
Summary
Ascending thoracic aortic aneurysms (ATAAs) show distinct traits based on aortic valve anatomy. Bicuspid aortic valve aneurysms (BAV-As) exhibit higher stress and collagen damage compared to tricuspid aortic valve aneurysms (TAV-As).
Area of Science:
- Cardiovascular Research
- Biomedical Engineering
- Pathology
Background:
- Ascending thoracic aortic aneurysms (ATAAs) represent a significant cardiovascular risk.
- Understanding biomechanical and structural differences between bicuspid (BAV-A) and tricuspid (TAV-A) aortic valve aneurysms is crucial for risk stratification.
- Previous studies have not fully elucidated the distinct pathological features of ATAAs based on aortic valve anatomy.
Purpose of the Study:
- To investigate and compare the biomechanical and structural characteristics of ascending thoracic aortic aneurysms (ATAAs) in patients with bicuspid aortic valve aneurysms (BAV-As) versus tricuspid aortic valve aneurysms (TAV-As).
- To identify specific pathological traits associated with BAV-As and TAV-As.
- To inform tailored clinical management strategies for different types of ATAAs.
Main Methods:
- Analysis of clinical, laboratory, and imaging data from 26 adult patients with ATAAs (12 BAV-A, 14 TAV-A) and 13 controls.
- Assessment of biomechanical parameters including maximal aortic diameter, strain, and stress.
- Evaluation of structural components: collagen organization, density, fragmentation, adipocyte deposits, and immune cell infiltration.
Main Results:
- BAV-A group showed significantly higher maximal strain (63.4%) and stress (0.78 MPa) compared to controls and TAV-A.
- BAV-A demonstrated higher tangential modulus, smaller diameter, and substantial collagen fragmentation (p < 0.001).
- TAV-A exhibited increased collagen density (p = 0.025), medial-adventitial thickening, and disorganized fibers (p = 0.036), with elevated adipocyte deposits and immune cell infiltration in BAV-A.
Conclusions:
- Distinct pathological profiles exist for ATAAs based on aortic valve anatomy.
- BAV-A is characterized by higher biomechanical stress, significant collagen deterioration, and inflammatory markers.
- These findings necessitate the development of tailored clinical strategies for managing thoracic aortic aneurysms.
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