Background: We sought to investigate and compare biomechanical properties and histomorphometric findings of thoracic ascending aorta aneurysm (TAA) tissue from patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in order to clarify mechanisms underlying differences in the clinical course.Methods: Circumferential sections of TAA tissue in patients with BAV (BAV-TAA) and TAV (TAV-TAA) were obtained during surgery and used for biomechanical tests and histomorphometrical analysis.Results: In BAV-TAA, we observed biomechanical higher peak stress and lower Young modulus values compared with TAV-TAA wall. The right lateral longitudinal region seemed to be the most fragile zone of the TAA wall. Mechanical stress-induced rupture of BAV-TAA tissue was sudden and uniform in all aortic wall layers, whereas a gradual and progressive aortic wall breakage was described in TAV-TAA. Histomorphometric analysis revealed higher amount of collagen but not elastin in BAV-TAA tunica media.Conclusions: The higher deformability of BAV-TAA tissue supports the hypothesis that increased wall shear stress doesn't explain the increased risk of sudden onset of rupture and dissection; other mechanisms, likely related to alteration of specific genetic pathways and epigenetic signals, could be investigated to explain differences in aortic dissection and rupture in BAV patients.

Pisano, C., D'Amico, F., Balistreri, C., Vacirca, S., Nardi, P., Alfieri, C., et al. (2020). Biomechanical properties and histomorphometric features of aortic tissue in patients with or without bicuspid aortic valve. JOURNAL OF THORACIC DISEASE, 12(5), 2304-2316 [10.21037/jtd.2020.03.122].

Biomechanical properties and histomorphometric features of aortic tissue in patients with or without bicuspid aortic valve

Pisano, C;Nardi, P;Alfieri, C;Bertoldo, F;Santo, L;Bellisario, D;Verzicco, R;Ruvolo, G;Orlandi, A
2020

Abstract

Background: We sought to investigate and compare biomechanical properties and histomorphometric findings of thoracic ascending aorta aneurysm (TAA) tissue from patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) in order to clarify mechanisms underlying differences in the clinical course.Methods: Circumferential sections of TAA tissue in patients with BAV (BAV-TAA) and TAV (TAV-TAA) were obtained during surgery and used for biomechanical tests and histomorphometrical analysis.Results: In BAV-TAA, we observed biomechanical higher peak stress and lower Young modulus values compared with TAV-TAA wall. The right lateral longitudinal region seemed to be the most fragile zone of the TAA wall. Mechanical stress-induced rupture of BAV-TAA tissue was sudden and uniform in all aortic wall layers, whereas a gradual and progressive aortic wall breakage was described in TAV-TAA. Histomorphometric analysis revealed higher amount of collagen but not elastin in BAV-TAA tunica media.Conclusions: The higher deformability of BAV-TAA tissue supports the hypothesis that increased wall shear stress doesn't explain the increased risk of sudden onset of rupture and dissection; other mechanisms, likely related to alteration of specific genetic pathways and epigenetic signals, could be investigated to explain differences in aortic dissection and rupture in BAV patients.
Pubblicato
Rilevanza internazionale
Articolo
Esperti anonimi
Settore MED/23
eng
Bicuspid aortic valve (BAV)
aortic wall
aortopathy
fluid dynamic analysis
elastic tissue fragmentation
Pisano, C., D'Amico, F., Balistreri, C., Vacirca, S., Nardi, P., Alfieri, C., et al. (2020). Biomechanical properties and histomorphometric features of aortic tissue in patients with or without bicuspid aortic valve. JOURNAL OF THORACIC DISEASE, 12(5), 2304-2316 [10.21037/jtd.2020.03.122].
Pisano, C; D'Amico, F; Balistreri, C; Vacirca, S; Nardi, P; Alfieri, C; Scioli, M; Bertoldo, F; Santo, L; Bellisario, D; Talice, M; Verzicco, R; Ruvolo, G; Orlandi, A
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/251290
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