Extracellular matrix fiber microarchitecture is region-specific in bicuspid aortic valve-associated ascending aortopathy

Antonio D'Amore, Julie A. Phillippi, Alkiviadis Tsamis, Antonio D'Amore, Jeffrey T. Krawiec, William R. Wagner, Ryan G. Koch, Patrick G. Chan, Simon C. Watkins, David A. Vorp, Thomas G. Gleason

    Risultato della ricerca: Articlepeer review

    23 Citazioni (Scopus)

    Abstract

    Objective Ascending thoracic aortic aneurysm (ATAA) in patients with bicuspid aortic valve (BAV) commonly dilate asymmetrically compared with patients with tricuspid aortic valve (TAV). This discrepancy in aneurysm geometry led us to hypothesize that microarchitectural differences underlie the observed asymmetric dilatation pattern. The purpose of this study was to characterize the microarchitectural distinctions of the extracellular matrix of the 2 phenotypes with a focus on the proportion of radially oriented elastin and collagen fibers in different circumferential aortic regions. Methods Aortic tissue rings were obtained just distal to the sinotubular junction from patients with BAV or TAV undergoing elective aneurysm repair. They were sectioned into three circumferentially based regions according to adjacent aortic sinus segment (left coronary sinus [L], right coronary sinus [R], or noncoronary sinus [N]). Multiphoton microscopy was used to quantify and characterize the number of radially oriented elastin and collagen fibers. Results There were fewer radially oriented fibers in medial region N and medial-intimal region R of BAV-ATAAs when compared with TAV-ATAAs (medial region N, amplitude of angular undulation of elastin = 10.67° ± 1.35° vs 15.58° ± 1.91°; P =.041; medial-intimal region R, amplitude of angular undulation of elastin = 9.83° ± 0.83° vs 14.72° ± 1.64°; P =.015). Conversely, fibers became more radially oriented in the medial-intimal region L of BAV-ATAA when compared with TAV-ATAA (amplitude of angular undulation of collagen = 18.67° ± 0.95° vs 14.56° ± 1.37°; P =.041). Conclusions The differential pattern of fiber orientation noted between L and N-R regions help explain the unique pattern of greater curvature dilatation of BAV-ATAA. The distinctions noted in matrix microarchitecture may form the basis of differing aneurysm geometries and aortic wall integrities in ATAAs arising in these different valve morphologies.
    Lingua originaleEnglish
    pagine (da-a)1718-1728
    Numero di pagine11
    RivistaJournal of Thoracic and Cardiovascular Surgery
    Volume151
    Stato di pubblicazionePublished - 2016

    All Science Journal Classification (ASJC) codes

    • Surgery
    • Pulmonary and Respiratory Medicine
    • Cardiology and Cardiovascular Medicine

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