1
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Cikach FS, Germano E, Roselli EE, Svensson LG. Ascending aorta mechanics and dimensions in aortopathy – from science to application. Indian J Thorac Cardiovasc Surg 2022; 38:7-13. [PMID: 35463697 PMCID: PMC8980982 DOI: 10.1007/s12055-020-01092-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/04/2020] [Indexed: 10/22/2022] Open
Abstract
The ascending aorta has a unique microstructure and biomechanical properties that allow it to absorb energy during systole and return energy during diastole (Windkessel effect). Derangements in aortic architecture can result in changes to biomechanics and inefficiencies in function. Ultimately biomechanical failure may occur resulting in aortic dissection or rupture. By measuring aortic biomechanics with either in vivo or ex vivo methods, one may be able to predict tissue failure in patients with aortic disease such as aneurysms. An understanding of the biomechanical changes that lead to these tissue-level failures may help guide therapy, disease surveillance, surgical intervention, and aid in the development of new treatments for this deadly condition.
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2
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Carlos T, Freitas AA, Alves PM, Martins R, Gonçalves L. Aortic strain in bicuspid aortic valve: an analysis. Int J Cardiovasc Imaging 2021; 37:2399-2408. [PMID: 33818697 DOI: 10.1007/s10554-021-02215-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/03/2021] [Indexed: 11/25/2022]
Abstract
Bicuspid aortic valve (BAV) is monitored by transthoracic echocardiography and computed tomography (CT) angiography. However, it does not have any early marker of disease progression. This study evaluated speckle-tracking echocardiography (STE) aortic and left ventricular (LV) strain prognostic values, their discriminative power, and their correlation with the degree of valvular regurgitation. We conducted a retrospective analysis of a prospectively enrolled cohort of 45 diagnosed with BAV and 20 gender and age matched controls. We performed 2D-STE aortic and LV strain analysis of the selected population. The cohort was followed-up during a median period of 19.9 months (IQR 12.9-25.2), and outcomes (hospital admission for heart failure (HF), aortic valve replacement (AVR), and death) were determined. The mean patient age was 46.6 ± 15.5 years and 80 % were male. LV indexed volumes and aortic diameter were higher in BAV patients. LV global longitudinal strain (GLS) was impaired (p < 0.001) and aortic GLS was significantly augmented (p = 0.027) in BAV patients. Aortic global circumferential strain (GCS) did not vary between groups. Aortic diameter was the best parameter related to BAV (AUC 0.92) and aortic GLS was best correlated with significant AR (AUC 0.76). AVR was the only outcome observed and its only predictor was indexed LV end-diastolic volume. BAV had impaired LV-GLS values. Aortic GLS was abnormally augmented in BAV patients, which might reflect higher aortic diameters that distorted strain calculations. STE aortic strain is related to AR but does not appear to be a reliable predictor of surgery in BAV patients, at 19 months.
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Affiliation(s)
- Tomás Carlos
- Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal
| | - André Azul Freitas
- Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.,Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, Coimbra, 3000-001, Portugal
| | - Patrícia Marques Alves
- Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal. .,Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, Coimbra, 3000-001, Portugal.
| | - Rui Martins
- Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.,Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, Coimbra, 3000-001, Portugal
| | - Lino Gonçalves
- Faculty of Medicine, Universidade de Coimbra, Coimbra, Portugal.,Department of Cardiology, Centro Hospitalar e Universitário de Coimbra, Praceta Mota Pinto, Coimbra, 3000-001, Portugal
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3
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The Progress of Advanced Ultrasonography in Assessing Aortic Stiffness and the Application Discrepancy between Humans and Rodents. Diagnostics (Basel) 2021; 11:diagnostics11030454. [PMID: 33800855 PMCID: PMC8001300 DOI: 10.3390/diagnostics11030454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 12/26/2022] Open
Abstract
Aortic stiffening is a fundamental pathological alteration of atherosclerosis and other various aging-associated vascular diseases, and it is also an independent risk factor of cardiovascular morbidity and mortality. Ultrasonography is a critical non-invasive method widely used in assessing aortic structure, function, and hemodynamics in humans, playing a crucial role in predicting the pathogenesis and adverse outcomes of vascular diseases. However, its applications in rodent models remain relatively limited, hindering the progress of the research. Here, we summarized the progress of the advanced ultrasonographic techniques applied in evaluating aortic stiffness. With multiple illustrative images, we mainly characterized various ultrasound techniques in assessing aortic stiffness based on the alterations of aortic structure, hemodynamics, and tissue motion. We also discussed the discrepancy of their applications in humans and rodents and explored the potential optimized strategies in the experimental research with animal models. This updated information would help to better understand the nature of ultrasound techniques and provide a valuable prospect for their applications in assessing aortic stiffness in basic science research, particularly with small animals.
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4
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Di Giuseppe M, Farzaneh S, Zingales M, Pasta S, Avril S. Patient-specific computational evaluation of stiffness distribution in ascending thoracic aortic aneurysm. J Biomech 2021; 119:110321. [PMID: 33662747 DOI: 10.1016/j.jbiomech.2021.110321] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 01/21/2021] [Accepted: 02/03/2021] [Indexed: 12/21/2022]
Abstract
Quantifying local aortic stiffness properties in vivo is acknowledged as essential to assess the severity of an ascending thoracic aortic aneurysm (ATAA). Recently, the LESI (local extensional stiffness identification) methodology has been established to quantify non-invasively local stiffness properties of ATAAs using electrocardiographic-gated computed tomography (ECG-gated CT) scans. The aim of the current study was to determine the most sensitive markers of local ATAA stiffness estimation with the hypothesis that direct measures of local ATAA stiffness could better detect the high-risk patients. A cohort of 30 patients (12 BAV and 18 TAV) referred for aortic size evaluation by ECG-gated CT were recruited. For each patient, the extensional stiffness Q was evaluated by the LESI methodology whilst computational flow analyses were also performed to derive hemodynamics markers such as the wall shear stress (WSS). A strong positive correlation was found between the extensional stiffness and the aortic pulse pressure (R = 0.644 and p < 0.001). Interestingly, a significant positive correlation was also found between the extensional stiffness and patients age for BAV ATAAs (R = 0.619 and p = 0.032), but not for TAV ATAAs (R = -0.117 and p = 0.645). No significant correlation was found between the extensional stiffness and WSS evaluated locally. There was no significant difference either in the extensional stiffness between BAV ATAAs and TAV ATAAs (Q = 3.6 ± 2.5 MPa.mm for BAV ATAAs vs Q = 5.3 ± 3.1 MPa.mm for TAV ATAAs, p = 0.094). Future work will focus on relating the extensional stiffness to the patient-specific rupture risk of ATAAs on larger cohorts to confirm the promising interest of the LESI methodology.
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Affiliation(s)
- Marzio Di Giuseppe
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, 90128 Palermo, Italy
| | - Solmaz Farzaneh
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 SAINBIOSE, Saint-Étienne 42023, France
| | - Massimiliano Zingales
- Department of Engineering, Viale delle Scienze, Ed.8, University of Palermo, 90128 Palermo, Italy
| | - Salvatore Pasta
- Department of Engineering, Viale delle Scienze, Ed.8, University of Palermo, 90128 Palermo, Italy
| | - Stéphane Avril
- Mines Saint-Etienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 SAINBIOSE, Saint-Étienne 42023, France.
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5
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Rong LQ, Palumbo MC, Rahouma M, Lopes AJ, Devereux RB, Kim J, Girardi LN, Gaudino M, Weinsaft JW. Descending aortic strain quantification by intra-operative transesophageal echocardiography: Multimodality validation via cardiovascular magnetic resonance. Echocardiography 2020; 37:1820-1827. [PMID: 32909633 DOI: 10.1111/echo.14851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Whereas cardiac magnetic resonance (CMR) imaging provides high temporal resolution imaging of aortic distensibility (strain), transesophageal echocardiography (TEE) is widely used for intra-operative aortic imaging and provides a clinical alternative for aortic assessment. We tested intra-operative global circumferential aortic strain (GCS) measured on TEE in relation to the reference of CMR-derived strain among patients undergoing surgical graft repair of ascending aortic aneurysms. METHODS CMR (3T) was prospectively performed in patients scheduled for aortic repair. TEE was performed intra-operatively; images were co-localized with MRI. GCS on CMR and TEE was quantified independently, blinded to results of the other modality. RESULTS 25 patients (54 ± 10 year-old, 88% male) were studied, inclusive of 13 genetically mediated and 12 degenerative aneurysms: CMR and TEE were performed within 12 ± 9 days. Pulse pressure (PP)-adjusted descending aortic TEE-derived GCS strongly correlated with cine-CMR-derived GCS (r = .75, P = .002) though absolute GCS and PP-adjusted values were slightly lower (5.40 ± 1.11 vs 6.49 ± 1.43% and 11.55 ± 3.04 vs 13.99 ± 4.53%, respectively). Similarly, TEE yielded slightly lower end-diastolic area (EDA [5.1 ± 1.7 cm2 vs 5.8 ± 1.3 cm2 , P = .004]) and end-systolic area (ESA [6.1 ± 1.9 cm2 vs 6.5 ± 1.7 cm2 , P = .10]), with significant correlations between the two modalities (r = .73, .76, P < .05 for all). CONCLUSIONS This exploratory study supports feasibility of TEE for assessing aortic GCS in a surgical at-risk population, as well as magnitude of agreement between intra-operative TEE and preoperative CMR. We found that there is a significant correlation between GCS and EDA and ESA aortic areas, but that TEE-derived parameters underestimated CMR values by a small but significant amount.
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Affiliation(s)
- Lisa Q Rong
- Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Maria C Palumbo
- Department of Cardiology/Medicine, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Mohammed Rahouma
- Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Alexandra J Lopes
- Department of Anesthesiology, Weill Cornell Medicine/New York Presbyterian Hospital, New York, NY, USA
| | - Richard B Devereux
- Department of Cardiology/Medicine, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Jiwon Kim
- Department of Cardiology/Medicine, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Leonard N Girardi
- Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Mario Gaudino
- Department of Cardiothoracic Surgery, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
| | - Jonathan W Weinsaft
- Department of Cardiology/Medicine, Weill Cornell Medicine/New York Presbyterian, New York, NY, USA
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6
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Cebull HL, Rayz VL, Goergen CJ. Recent Advances in Biomechanical Characterization of Thoracic Aortic Aneurysms. Front Cardiovasc Med 2020; 7:75. [PMID: 32478096 PMCID: PMC7235347 DOI: 10.3389/fcvm.2020.00075] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/14/2020] [Indexed: 12/18/2022] Open
Abstract
Thoracic aortic aneurysm (TAA) is a focal enlargement of the thoracic aorta, but the etiology of this disease is not fully understood. Previous work suggests that various genetic syndromes, congenital defects such as bicuspid aortic valve, hypertension, and age are associated with TAA formation. Though occurrence of TAAs is rare, they can be life-threatening when dissection or rupture occurs. Prevention of these adverse events often requires surgical intervention through full aortic root replacement or implantation of endovascular stent grafts. Currently, aneurysm diameters and expansion rates are used to determine if intervention is warranted. Unfortunately, this approach oversimplifies the complex aortopathy. Improving treatment of TAAs will likely require an increased understanding of the biological and biomechanical factors contributing to the disease. Past studies have substantially contributed to our knowledge of TAAs using various ex vivo, in vivo, and computational methods to biomechanically characterize the thoracic aorta. However, any singular approach typically focuses on only material properties of the aortic wall, intra-aneurysmal hemodynamics, or in vivo vessel dynamics, neglecting combinatorial factors that influence aneurysm development and progression. In this review, we briefly summarize the current understanding of TAA causes, treatment, and progression, before discussing recent advances in biomechanical studies of TAAs and possible future directions. We identify the need for comprehensive approaches that combine multiple characterization methods to study the mechanisms contributing to focal weakening and rupture. We hope this summary and analysis will inspire future studies leading to improved prediction of thoracic aneurysm progression and rupture, improving patient diagnoses and outcomes.
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Affiliation(s)
- Hannah L Cebull
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Vitaliy L Rayz
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States
| | - Craig J Goergen
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States.,Purdue Center for Cancer Research, Purdue University, West Lafayette, IN, United States
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7
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Rong LQ, Palumbo MC, Rahouma M, Meineri M, Arguelles GR, Kim J, Lau C, Devereux RB, Pryor KO, Girardi LN, Redaelli A, Gaudino MF, Weinsaft JW. Immediate Impact of Prosthetic Graft Replacement of the Ascending Aorta on Circumferential Strain in the Descending Aorta. Eur J Vasc Endovasc Surg 2019; 58:521-528. [DOI: 10.1016/j.ejvs.2019.05.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 04/04/2019] [Accepted: 05/01/2019] [Indexed: 12/11/2022]
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8
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Abdelghani M, Nassif M, de Bruin-Bon RH, Al-Amin AM, El-Baz MS, El-Shedoudy SA, Mulder BJ, de Winter RJ, Bouma BJ. Aortic Root Geometric and Dynamic Changes After Device Closure of Interatrial Shunts. J Am Soc Echocardiogr 2019; 32:1016-1026.e5. [DOI: 10.1016/j.echo.2019.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 11/24/2022]
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9
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Cosentino F, Scardulla F, D'Acquisto L, Agnese V, Gentile G, Raffa G, Bellavia D, Pilato M, Pasta S. Computational modeling of bicuspid aortopathy: Towards personalized risk strategies. J Mol Cell Cardiol 2019; 131:122-131. [PMID: 31047985 DOI: 10.1016/j.yjmcc.2019.04.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/09/2019] [Accepted: 04/26/2019] [Indexed: 11/18/2022]
Abstract
This paper describes current advances on the application of in-silico for the understanding of bicuspid aortopathy and future perspectives of this technology on routine clinical care. This includes the impact that artificial intelligence can provide to develop computer-based clinical decision support system and that wearable sensors can offer to remotely monitor high-risk bicuspid aortic valve (BAV) patients. First, we discussed the benefit of computational modeling by providing tangible examples of in-silico software products based on computational fluid-dynamic (CFD) and finite-element method (FEM) that are currently transforming the way we diagnose and treat cardiovascular diseases. Then, we presented recent findings on computational hemodynamic and structural mechanics of BAV to highlight the potentiality of patient-specific metrics (not-based on aortic size) to support the clinical-decision making process of BAV-associated aneurysms. Examples of BAV-related personalized healthcare solutions are illustrated.
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Affiliation(s)
- Federica Cosentino
- Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Piazza delle Cliniche, n.2, 90128 Palermo, Italy; Fondazione Ri.MED, Via Bandiera n.11, 90133 Palermo, Italy
| | - Francesco Scardulla
- Department of Engineering, University of Palermo, Viale delle Scienze Ed.8, 90128 Palermo, Italy
| | - Leonardo D'Acquisto
- Department of Engineering, University of Palermo, Viale delle Scienze Ed.8, 90128 Palermo, Italy
| | - Valentina Agnese
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy
| | - Giovanni Gentile
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy
| | - Giuseppe Raffa
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy
| | - Diego Bellavia
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy
| | - Michele Pilato
- Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy
| | - Salvatore Pasta
- Fondazione Ri.MED, Via Bandiera n.11, 90133 Palermo, Italy; Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Via Tricomi n.5, 90127 Palermo, Italy.
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10
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Di Giuseppe M, Alotta G, Agnese V, Bellavia D, Raffa GM, Vetri V, Zingales M, Pasta S, Pilato M. Identification of circumferential regional heterogeneity of ascending thoracic aneurysmal aorta by biaxial mechanical testing. J Mol Cell Cardiol 2019; 130:205-215. [DOI: 10.1016/j.yjmcc.2019.04.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/08/2019] [Accepted: 04/12/2019] [Indexed: 01/02/2023]
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11
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Wang L, Wu S, Cao G, Fan Y, Dunne N, Li X. Biomechanical studies on biomaterial degradation and co-cultured cells: mechanisms, potential applications, challenges and prospects. J Mater Chem B 2019; 7:7439-7459. [DOI: 10.1039/c9tb01539f] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
This review provides a comprehensive overview of biomechanical studies on biomaterial degradation and co-cultured cells as well as valuable biomechanical ideas on how to design or optimize cell biomaterial co-culture system.
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Affiliation(s)
- Lu Wang
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Shuai Wu
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Guangxiu Cao
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
| | - Nicholas Dunne
- Centre for Medical Engineering Research
- School of Mechanical and Manufacturing Engineering
- Dublin City University
- Dublin 9
- Ireland
| | - Xiaoming Li
- Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education
- School of Biological Science and Medical Engineering
- Beihang University
- Beijing 100083
- China
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12
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Emmott A, Alzahrani H, Alreshidan M, Therrien J, Leask RL, Lachapelle K. Transesophageal echocardiographic strain imaging predicts aortic biomechanics: Beyond diameter. J Thorac Cardiovasc Surg 2018; 156:503-512.e1. [DOI: 10.1016/j.jtcvs.2018.01.107] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 02/07/2023]
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13
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Bu Z, Ma J, Fan Y, Qiao Z, Kang Y, Zheng Y, Wang W, Du Y, Zheng Z, Shen X, He B, Pu J. Ascending Aortic Strain Analysis Using 2-Dimensional Speckle Tracking Echocardiography Improves the Diagnostics for Coronary Artery Stenosis in Patients With Suspected Stable Angina Pectoris. J Am Heart Assoc 2018; 7:JAHA.118.008802. [PMID: 29982229 PMCID: PMC6064841 DOI: 10.1161/jaha.118.008802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background Arterial stiffening and atherosclerosis tend to coexist. Strain imaging, using a 2‐dimensional speckle tracking (2D‐ST) method, has been used for arterial stiffness assessment and early identification of atherosclerosis. We investigated whether the ascending aortic strain assessed by 2D‐ST echocardiography at rest can predict the presence of coronary artery disease (CAD). Methods and Results Two hundred seventy‐one consecutive patients with suspected stable angina pectoris sequentially underwent exercise treadmill testing, 2‐dimensional echocardiography, M‐mode echocardiography, 2D‐ST echocardiography, and coronary angiography. Circumferential ascending aortic strain (CAAS) and radial ascending aortic strain were assessed by 2D‐ST echocardiography. Ninety‐two patients with coronary lumen area stenosis ≥70% were categorized as having significant CAD. Global CAAS was significantly lower in patients with significant CAD (7.41±2.30% versus 11.54±4.03%; P<0.001) and remained an independent predictor of significant CAD (odds ratio, 0.64 [0.54–0.75]; P<0.001) after multivariate regression. Based on the receiver operating characteristic curve for diagnosing significant CAD, the optimal cut‐off value of global CAAS was ≤9.22% (sensitivity, 86%; specificity, 70%; area under curve=0.82; P<0.001). Global CAAS decreased with increasing severity of CAD and was significantly associated with 3‐vessel disease (odds ratio, 0.58 [0.42–0.79]; P<0.001). Diagnostics for significant CAD were remarkably better for global CAAS combined with exercise treadmill testing than for exercise treadmill testing alone (area under curve=0.88 versus 0.78; P<0.001). Conclusions Global CAAS assessed by 2D‐ST echocardiography at rest was able to predict the presence of significant CAD and identify multivessel disease. In addition, global CAAS combined with exercise treadmill testing remarkably improved the diagnostics for significant CAD.
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Affiliation(s)
- Zhaohui Bu
- Institute of Biomedical Engineering, University of Shanghai for Science and Technology, Shanghai, China.,Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Ma
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yibo Fan
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhiqing Qiao
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yu Kang
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zheng
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Wang
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yongping Du
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zheng Zheng
- Institute of Biomedical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Xuedong Shen
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Ben He
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China .,Department of Cardiology, Shanghai Chest Hospital Shanghai Jiao Tong University, Shanghai, China
| | - Jun Pu
- Department of Cardiology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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14
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Cruz C, Pinho T, Sousa C, Dias CC, Silva Cardoso J, Maciel MJ. Ascending aorta in tetralogy of Fallot: Beyond echocardiographic dimensions. Echocardiography 2018; 35:1362-1369. [DOI: 10.1111/echo.14046] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
- Cristina Cruz
- Department of Cardiology; Centro Hospitalar São João; Porto Portugal
- Faculty of Medicine; University of Porto; Porto Portugal
| | - Teresa Pinho
- Department of Cardiology; Centro Hospitalar São João; Porto Portugal
- Faculty of Medicine; University of Porto; Porto Portugal
| | - Carla Sousa
- Department of Cardiology; Centro Hospitalar São João; Porto Portugal
- Faculty of Medicine; University of Porto; Porto Portugal
| | - Cláudia Camila Dias
- Department of Community Medicine; Information and Decision in Health, Faculty of Medicine; University of Porto; Porto Portugal
| | - José Silva Cardoso
- Department of Cardiology; Centro Hospitalar São João; Porto Portugal
- Faculty of Medicine; University of Porto; Porto Portugal
| | - Maria Júlia Maciel
- Department of Cardiology; Centro Hospitalar São João; Porto Portugal
- Faculty of Medicine; University of Porto; Porto Portugal
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15
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Satriano A, Guenther Z, White JA, Merchant N, Di Martino ES, Al-Qoofi F, Lydell CP, Fine NM. Three-dimensional thoracic aorta principal strain analysis from routine ECG-gated computerized tomography: feasibility in patients undergoing transcatheter aortic valve replacement. BMC Cardiovasc Disord 2018; 18:76. [PMID: 29720088 PMCID: PMC5932860 DOI: 10.1186/s12872-018-0818-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 04/24/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Functional impairment of the aorta is a recognized complication of aortic and aortic valve disease. Aortic strain measurement provides effective quantification of mechanical aortic function, and 3-dimenional (3D) approaches may be desirable for serial evaluation. Computerized tomographic angiography (CTA) is routinely performed for various clinical indications, and offers the unique potential to study 3D aortic deformation. We sought to investigate the feasibility of performing 3D aortic strain analysis in a candidate population of patients undergoing transcatheter aortic valve replacement (TAVR). METHODS Twenty-one patients with severe aortic valve stenosis (AS) referred for TAVR underwent ECG-gated CTA and echocardiography. CTA images were analyzed using a 3D feature-tracking based technique to construct a dynamic aortic mesh model to perform peak principal strain amplitude (PPSA) analysis. Segmental strain values were correlated against clinical, hemodynamic and echocardiographic variables. Reproducibility analysis was performed. RESULTS The mean patient age was 81±6 years. Mean left ventricular ejection fraction was 52±14%, aortic valve area (AVA) 0.6±0.3 cm2 and mean AS pressure gradient (MG) 44±11 mmHg. CTA-based 3D PPSA analysis was feasible in all subjects. Mean PPSA values for the global thoracic aorta, ascending aorta, aortic arch and descending aorta segments were 6.5±3.0, 10.2±6.0, 6.1±2.9 and 3.3±1.7%, respectively. 3D PSSA values demonstrated significantly more impairment with measures of worsening AS severity, including AVA and MG for the global thoracic aorta and ascending segment (p<0.001 for all). 3D PSSA was independently associated with AVA by multivariable modelling. Coefficients of variation for intra- and inter-observer variability were 5.8 and 7.2%, respectively. CONCLUSIONS Three-dimensional aortic PPSA analysis is clinically feasible from routine ECG-gated CTA. Appropriate reductions in PSSA were identified with increasing AS hemodynamic severity. Expanded study of 3D aortic PSSA for patients with various forms of aortic disease is warranted.
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Affiliation(s)
- Alessandro Satriano
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, South Health Campus, 4448 Front Street SE, Calgary, Alberta, T3M 1M4, Canada
| | - Zachary Guenther
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada.,Department of Diagnostic Imaging, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - James A White
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada.,Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, South Health Campus, 4448 Front Street SE, Calgary, Alberta, T3M 1M4, Canada
| | - Naeem Merchant
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada.,Department of Diagnostic Imaging, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Elena S Di Martino
- Department of Civil Engineering and Centre for Bioengineering Research and Education, University of Calgary, Calgary, Alberta, Canada
| | - Faisal Al-Qoofi
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, South Health Campus, 4448 Front Street SE, Calgary, Alberta, T3M 1M4, Canada
| | - Carmen P Lydell
- Stephenson Cardiac Imaging Centre, University of Calgary, Calgary, Alberta, Canada.,Department of Diagnostic Imaging, Cummings School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nowell M Fine
- Division of Cardiology, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, University of Calgary, South Health Campus, 4448 Front Street SE, Calgary, Alberta, T3M 1M4, Canada.
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16
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Pasta S, Agnese V, Di Giuseppe M, Gentile G, Raffa GM, Bellavia D, Pilato M. In Vivo Strain Analysis of Dilated Ascending Thoracic Aorta by ECG-Gated CT Angiographic Imaging. Ann Biomed Eng 2017; 45:2911-2920. [DOI: 10.1007/s10439-017-1915-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/31/2017] [Indexed: 01/13/2023]
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17
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Teixeira R, Monteiro R, Baptista R, Pereira T, Ribeiro MA, Gonçalves A, Cardim N, Gonçalves L. Aortic arch mechanics measured with two-dimensional speckle tracking echocardiography. J Hypertens 2017; 35:1402-1410. [DOI: 10.1097/hjh.0000000000001336] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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18
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Cavaca R, Teixeira R, Vieira MJ, Gonçalves L. Estenose aórtica paradoxal – revisão sistemática. Rev Port Cardiol 2017; 36:287-305. [DOI: 10.1016/j.repc.2016.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 09/05/2016] [Accepted: 09/29/2016] [Indexed: 11/26/2022] Open
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19
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Paradoxical aortic stenosis: A systematic review. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2017. [DOI: 10.1016/j.repce.2016.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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20
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Abad C. Ascending thoracic aortic aneurysm: Usefulness of the speckle-tracking transesophageal echocardiogram. J Thorac Cardiovasc Surg 2017; 153:789-790. [PMID: 28065433 DOI: 10.1016/j.jtcvs.2016.11.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Cipriano Abad
- Cardiovascular Surgery Department, University Hospital of Gran Canaria Doctor Negrin, Las Palmas de Gran Canaria, Spain.
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21
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Chung J, Lachapelle K, Cartier R, Mongrain R, Leask RL. Loss of mechanical directional dependency of the ascending aorta with severe medial degeneration. Cardiovasc Pathol 2017; 26:45-50. [DOI: 10.1016/j.carpath.2016.11.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/08/2016] [Accepted: 11/09/2016] [Indexed: 01/15/2023] Open
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22
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Abstract
Echocardiography is the primary modality for imaging the aorta for the diagnosis and serial evaluation of pathological conditions. In this article, we review the methodology for optimal echocardiographic imaging of the various segments of the aorta and discuss abnormalities of the aorta including stenosis, dilation including aortopathy and sinus of Valsalva aneurysms, and fistulous communications involving the ascending aorta including aortoventricular tunnel and ruptured sinus of Valsalva aneurysm. We review novel echocardiographic measurements of aortic functional properties of the aorta such as elasticity and stiffness, and review the literature on the potential additive value of such measurements for structural assessment alone. Finally, we discuss the limitations of echocardiography in the precise and optimal imaging of the aorta.
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23
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Descending aortic mechanics and atrial fibrillation: a two-dimensional speckle tracking transesophageal echocardiography study. Int J Cardiovasc Imaging 2016; 33:509-519. [DOI: 10.1007/s10554-016-1028-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 11/21/2016] [Indexed: 12/20/2022]
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24
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Nguyen PH, Tuzun E, Quick CM. Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses. Am J Physiol Regul Integr Comp Physiol 2016; 311:R522-31. [PMID: 27306830 DOI: 10.1152/ajpregu.00402.2015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 06/13/2016] [Indexed: 11/22/2022]
Abstract
Aortic pulse pressure arises from the interaction of the heart, the systemic arterial system, and peripheral microcirculations. The complex interaction between hemodynamics and arterial remodeling precludes the ability to experimentally ascribe changes in aortic pulse pressure to particular adaptive responses. Therefore, the purpose of the present work was to use a human systemic arterial system model to test the hypothesis that pulse pressure homeostasis can emerge from physiological adaptation of systemic arteries to local mechanical stresses. First, we assumed a systemic arterial system that had a realistic topology consisting of 121 arterial segments. Then the relationships of pulsatile blood pressures and flows in arterial segments were characterized by standard pulse transmission equations. Finally, each arterial segment was assumed to remodel to local stresses following three simple rules: 1) increases in endothelial shear stress increases radius, 2) increases in wall circumferential stress increases wall thickness, and 3) increases in wall circumferential stress decreases wall stiffness. Simulation of adaptation by iteratively calculating pulsatile hemodynamics, mechanical stresses, and vascular remodeling led to a general behavior in response to mechanical perturbations: initial increases in pulse pressure led to increased arterial compliances, and decreases in pulse pressure led to decreased compliances. Consequently, vascular adaptation returned pulse pressures back toward baseline conditions. This behavior manifested when modeling physiological adaptive responses to changes in cardiac output, changes in peripheral resistances, and changes in local arterial radii. The present work, thus, revealed that pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses.
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Affiliation(s)
- Phuc H Nguyen
- Michael E. DeBakey Institute, Texas A&M University, College Station, Texas; and
| | - Egemen Tuzun
- Texas A&M Institute for Preclinical Studies, College Station, Texas
| | - Christopher M Quick
- Michael E. DeBakey Institute, Texas A&M University, College Station, Texas; and
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25
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Leite L, Teixeira R, Oliveira-Santos M, Barbosa A, Martins R, Castro G, Gonçalves L, Pego M. Aortic Valve Disease and Vascular Mechanics: Two-Dimensional Speckle Tracking Echocardiographic Analysis. Echocardiography 2016; 33:1121-30. [PMID: 27083146 DOI: 10.1111/echo.13236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Degenerative aortic valve disease (AVD) is a complex disorder that goes beyond valve itself, also undermining aortic wall. We aimed to assess the ascending aortic mechanics with two-dimensional speckle tracking echocardiography (2DSTE) in patients with aortic regurgitation (AR) and hypothesized a relationship with degree of AR. Aortic mechanics were then compared with those of similarly studied healthy controls and patients with aortic stenosis (AS); finally, we aimed to assess the prognostic significance of vascular mechanics in AVD. METHODS Overall, 73 patients with moderate-to-severe AR and 22 healthy subjects were enrolled, alongside a previously examined cohort (N = 45) with moderate-to-severe AS. Global circumferential ascending aortic strain (CAAS) and strain rate (CAASR) served as indices of aortic deformation; corrected CAAS was calculated as CAAS/pulse pressure (PP). Median clinical follow-up was 438 days. RESULTS In patients with severe (vs. moderate) AR, CAASR (1.53 ± 0.29/sec vs. 1.90 ± 0.62/sec, P < 0.05) and corrected CAAS (0.14 ± 0.06%/mmHg vs. 0.19 ± 0.08%/mmHg, P < 0.05) were significantly lower, whereas CAAS did not differ significantly. Measurers of aortic mechanics (CAAS, corrected CAAS, CAASR) differed significantly (all P < 0.01) in patients with AS and AR and in healthy subjects, with lower values seen in patients with AS. In follow-up, survival rate of AVD patients with baseline CAASR >0.88/sec was significantly higher (log rank, 97.4% vs. 73.0%; P = 0.03). CONCLUSIONS Quantitative measures of aortic mechanics were lower for AS patients, suggesting a more significant derangement of aortic elastic properties. In the context of AVD, vascular mechanics assessment proved useful in gauging clinical prognosis.
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Affiliation(s)
- Luís Leite
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Rogério Teixeira
- Department of Cardiology, General Unit, Coimbra Hospital and University Center, Coimbra, Portugal.,Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Manuel Oliveira-Santos
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
| | - António Barbosa
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Rui Martins
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Graça Castro
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Lino Gonçalves
- Department of Cardiology, General Unit, Coimbra Hospital and University Center, Coimbra, Portugal.,Faculty of Medicine of the University of Coimbra, Coimbra, Portugal
| | - Mariano Pego
- Department of Cardiology, University Unit, Coimbra Hospital and University Center, Coimbra, Portugal
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26
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Emmott A, Garcia J, Chung J, Lachapelle K, El-Hamamsy I, Mongrain R, Cartier R, Leask RL. Biomechanics of the Ascending Thoracic Aorta: A Clinical Perspective on Engineering Data. Can J Cardiol 2016; 32:35-47. [DOI: 10.1016/j.cjca.2015.10.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Revised: 10/17/2015] [Accepted: 10/18/2015] [Indexed: 12/14/2022] Open
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27
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Teixeira R, Vieira MJ, Gonçalves A, Cardim N, Gonçalves L. Ultrasonographic vascular mechanics to assess arterial stiffness: a review. Eur Heart J Cardiovasc Imaging 2015; 17:233-46. [DOI: 10.1093/ehjci/jev287] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 10/04/2015] [Indexed: 12/21/2022] Open
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28
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Battiston KG, Labow RS, Simmons CA, Santerre JP. Immunomodulatory polymeric scaffold enhances extracellular matrix production in cell co-cultures under dynamic mechanical stimulation. Acta Biomater 2015; 24:74-86. [PMID: 26093069 DOI: 10.1016/j.actbio.2015.05.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 12/16/2022]
Abstract
Despite the importance of immune cells in regulating the wound healing process following injury, there are few examples of synthetic biomaterials that have the capacity to push the body's immune cells toward pro-regeneration phenotypes, and fewer still that are designed with the intention of achieving this immunomodulatory character. While monocytes and their derived macrophages have been recognized as important contributors to tissue remodeling in vivo, this is primarily believed to be due to their ability to regulate other cell types. The ability of monocytes and macrophages to generate tissue products themselves, however, is currently not well appreciated within the field of tissue regeneration. Furthermore, while monocytes/macrophages are found in remodeling tissue that is subjected to mechanical loading, the effect this biomechanical strain on monocytes/macrophages and their ability to regulate tissue-specific cellular activity has not been understood due to the complexity of the many factors involved in the in vivo setting, hence necessitating the use of controlled in vitro culture platforms to investigate this phenomenon. In this study, human monocytes were co-cultured with human coronary artery smooth muscle cells (VSMCs) on a tubular (3mm ID) degradable polyurethane scaffold, with a unique combination of non-ionic polar, hydrophobic and ionic chemistry (D-PHI). The goal was to determine if such a synthetic matrix could be used in a co-culture system along with dynamic biomechanical stimulus (10% circumferential strain, 1Hz) conditions in order to direct monocytes to enhance tissue generation, and to better comprehend the different ways in which monocytes/macrophages may contribute to new tissue production. Mechanical strain and monocyte co-culture had a complementary and non-mitigating effect on VSMC growth. Co-culture samples demonstrated increased deposition of sulphated glycosaminoglycans (GAGs) and elastin, as well as increases in the release of FGF-2, a growth factor that can stimulate VSMC growth, while dynamic culture supported increases in collagen I and III as well as increased mechanical properties (elastic modulus, tensile strength) vs. static controls. Macrophage polarization toward an M1 state was not promoted by the biomaterial or culture conditions tested. Monocytes/macrophages cultured on D-PHI were also shown to produce vascular extracellular matrix components, including collagen I, collagen III, elastin, and GAGs. This study highlights the use of synthetic biomaterials having immunomodulatory character in order to promote cell and tissue growth when used in tissue engineering strategies, and identifies ECM deposition by monocytes/macrophages as an unexpected source of this new tissue. STATEMENT OF SIGNIFICANCE The ability of biomaterials to regulate macrophage activation towards a wound healing phenotype has recently been shown to support positive tissue regeneration. However, the ability of immunomodulatory biomaterials to harness monocyte/macrophage activity to support tissue engineering strategies in vitro holds enormous potential that has yet to be investigated. This study used a monocyte co-culture on a degradable polyurethane (D-PHI) to regulate the response of VSMCs in combination with biomechanical strain in a vascular tissue engineering context. Results demonstrate that immunomodulatory biomaterials, such as D-PHI, that support a desirable macrophage activation state can be combined with biomechanical strain to augment vascular tissue production in vitro, in part due to the novel and unexpected contribution of monocytes/macrophages themselves producing vascular ECM proteins.
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Affiliation(s)
- K G Battiston
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada
| | - R S Labow
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario K1H 8M5, Canada
| | - C A Simmons
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada; Faculty of Dentistry, University of Toronto, Toronto, Ontario M5G 1G6, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Ontario M5S 3G8, Canada
| | - J P Santerre
- Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Ontario M5S 3G9, Canada; Faculty of Dentistry, University of Toronto, Toronto, Ontario M5G 1G6, Canada.
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29
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Circumferential vascular strain rate to estimate vascular load in aortic stenosis: a speckle tracking echocardiography study. Int J Cardiovasc Imaging 2015; 31:681-9. [DOI: 10.1007/s10554-015-0597-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 01/17/2015] [Indexed: 10/24/2022]
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30
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Plein S, Edvardsen T, Pierard LA, Saraste A, Knuuti J, Maurer G, Lancellotti P. The year 2013 in the European Heart Journal - Cardiovascular Imaging: Part II. Eur Heart J Cardiovasc Imaging 2014; 15:837-41. [DOI: 10.1093/ehjci/jeu088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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