Layer-specific biomechanical and histological properties of normal and dissected human ascending aortas

Recent studies have attempted to characterize the layer-specific mechanical and microstructural properties of the aortic tissues in either normal or pathological state to understand its structural-mechanical property relationships. However, layer-specific tissue mechanics and compositions of normal and dissected ascending aortas have not been thoroughly compared with a statistical conclusion obtained. Eighteen ascending aortic specimens were harvested from 13 patients with type A aortic dissection and 5 donors without aortic diseases, with each specimen further excised to obtain three tissue samples including an intact wall, an intima-media layer and an adventitia layer. For each tissue sample, biaxial tensile testing was performed to obtain the experimental stress-stretch ratio data, which were further fed into the Fung-type model to quantify the tissue stiffness, and Elastin Van Gieson stain and Masson's trichrome stain were employed to quantify the elastic and collagen fiber densities. Statistical analyses were performed to determine whether any significant differences exist in mechanical properties and compositions between diseased and normal aortic tissues. The tissue stiffness of intima-media samples was significant higher in diseased group than that of normal group in longitudinal direction at the stretch ratio 1.30 (p = 0.0068), while no significant differences were found in the other direction or other tissue types. Even though there was no significant difference in elastic or collagen fiber densities between two groups, the diseased group generally had lower elastic fiber density, but higher collagen fiber density for all three tissue layers. Compared to normal aortic tissues, the elastic fiber density of the intima-media layer in the dissected aortic tissue was lower, while its tissue stiffness was significantly higher, indicating the tissue stiffness of the intima-media layer could be a potential indicator for aortic dissection.