Advanced glycation end-products as a potential target for treatment of cardiovascular disease

Mechanical and structural changes in human thoracic aortas with age

Aortic mechanical and structural characteristics have profound effects on pathophysiology, but many aspects of physiologic stress-stretch state and intramural changes due to aging remain poorly understood in human tissues. While difficult to assess in vivo due to residual stresses and pre-stretch, physiologic stress-stretch characteristics can be calculated using experimentally-measured mechanical properties and constitutive modeling. Mechanical properties of 76 human descending thoracic aortas (TA) from 13 to 78-year-old donors (mean age 51±18 years) were measured using multi-ratio planar biaxial extension. Constitutive parameters were derived for aortas in 7 age groups, and the physiologic stress-stretch state was calculated. Intramural characteristics were quantified from histological images and related to aortic morphometry and mechanics. TA stiffness increased with age, and aortas became more nonlinear and anisotropic. Systolic and diastolic elastic energy available for pulsation decreased with age from 30 to 8 kPa and from 18 to 5 kPa, respectively. Cardiac cycle circumferential stretch dropped from 1.14 to 1.04, and circumferential and longitudinal physiologic stresses decreased with age from 90 to 72 kPa and from 90 to 17 kPa, respectively. Aortic wall thickness and radii increased with age, while the density of elastin in the tunica media decreased. The number of elastic lamellae and circumferential physiologic stress per lamellae unit remained constant with age at 102±10 and 0.85±0.04 kPa, respectively. Characterization of mechanical, physiological, and structural features in human aortas of different ages can help understand aortic pathology, inform the development of animal models that simulate human aging, and assist with designing devices for open and endovascular aortic repairs. STATEMENT OF SIGNIFICANCE: This manuscript describes mechanical and structural changes occurring in human thoracic aortas with age, and presents material parameters for 4 commonly used constitutive models. Presented data can help better understand aortic pathology, inform the development of animal models that simulate human aging, and assist with designing devices for open and endovascular aortic repairs.

A constituent-based model of age-related changes in conduit arteries

In the present report, a constituent-based theoretical model of age-related changes in geometry and mechanical properties of conduit arteries is proposed. The model was based on the premise that given the time course of the load on an artery and the accumulation of advanced glycation end-products in the arterial tissue, the initial geometric dimensions and properties of the arterial tissue can be predicted by a solution of a boundary value problem for the governing equations that follow from finite elasticity, structure-based constitutive modeling within the constrained mixture theory, continuum damage theory, and global growth approach for stress-induced structure-based remodeling. An illustrative example of the age-related changes in geometry, structure, composition, and mechanical properties of a human thoracic aorta is considered. Model predictions were in good qualitative agreement with available experimental data in the literature. Limitations and perspectives for refining the model are discussed.

Characterization of arterial wall mechanical behavior and stresses from human clinical data

This paper demonstrates the feasibility of material identification and wall stress computation for human common carotid arteries based on non-invasive in vivo clinical data: dynamical intraluminal pressure measured by applanation tonometry, and medial diameter and intimal-medial thickness measured by high-resolution ultrasound echotracking. The mechanical behavior was quantified assuming an axially pre-stretched, thick-walled, cylindrical artery subjected to dynamical blood pressure and perivascular constraints. The wall was further assumed to be three-dimensional and to consist of a nonlinear, hyperelastic, anisotropic, incompressible material with smooth muscle activity and residual stresses. Mechanical contributions by individual constituents--an elastin-dominated matrix, collagen fibers, and vascular smooth muscle--were accounted for using a previously proposed microstructurally motivated constitutive relation. The in vivo boundary value problem was solved semi-analytically to compute the inner pressure during a mean cardiac cycle. Using a nonlinear least-squares method, optimal model parameters were determined by minimizing differences between computed and measured inner pressures over a mean cardiac cycle. The fit-to-data from two healthy patients was very good and the predicted radial, circumferential, and axial stretch and stress fields were sensible. Hence, the proposed approach was able to identify complex geometric and material parameters directly from non-invasive in vivo human data.

Structural strain energy function applied to the ageing of the human aorta

Stiffening of the aorta with progressing age leads to decrease of aortic compliance and thus to an increase of pulse pressure amplitude. Using a strain energy function (SEF) which takes into account the composition of the arterial wall, we have studied the evolution of key structural components of the human thoracic aorta using data obtained from the literature. The SEF takes into account the wavy nature of collagen, which upon gradual inflation of the blood vessel is assumed to straighten out and become engaged in bearing load. The engagement of the individual fibers is assumed to be distributed log-logistically. The use of a SEF enables the consideration of axial stretch (lambda(z)) and residual strain (opening angle) in the biomechanical analysis. Both lambda(z) and opening angle are known to change with age. Results obtained from applying the SEF to the measurements of aortic pressure-diameter curves indicate that the changes in aortic biomechanics with progressing age are not to be sought in the elastic constants of elastin and collagen or their volume fractions of the aortic wall but moreover in alterations of the collagen mesh arrangement and the waviness of the collagen fibers. In old subjects, the collagen fiber ensemble engages in load bearing much more abruptly than in young subjects. Reasons for this change in collagen fiber dynamics may include fiber waviness remodeling or cross-linkage by advanced glycation end-products (AGE). The abruptness of collagen fiber engagement is also the model parameter that is most responsible for the decreased compliance at progressed ages.

A strain energy function for arteries accounting for wall composition and structure

Identification of a Strain Energy Function (SEF) is used when describing the complex mechanical properties of soft biological tissues such as the arterial wall. Classic SEFs, such as the one proposed by Chuong and Fung (J. Biomech. Eng. 105(3) (1983) 268), have been mostly phenomenological and neglect the particularities of the wall structure. A more structural model was proposed by Holzapfel et al. (J. Elasticity 61 (2000) 1-48.) when they included the characteristic angle at which the collagen fibers are helically wrapped, resulting in an excellent SEF for applications such as finite element modeling. We have expanded upon the idea of structural SEFs by including not only the wavy nature of the collagen but also the fraction of both elastin and collagen contained in the media, which can be determined by histology. The waviness of the collagen is assumed to be distributed log-logistically. In order to evaluate this novel SEF, we have used it to fit experimental data from inflation-extension tests performed on rat carotids. We have compared the results of the fit to the SEFs of Choung and Fung and Holzapfel et al. The novel SEF is found to behave similarly to that of Holzapfel et al., both succeed in describing the typical S-shaped pressure-radius curves with comparable quality of fit. The parameters of the novel SEF obtained from the fitting, bearing the physical meaning of the elastic modulus of collagen, the elastic modulus of elastin, the collagen waviness, and the collagen fiber angle, were compared to experimental data and discussed.