AI Article Synopsis
- The study investigated the biomechanical and compositional changes in aortic aneurysms by comparing samples from patients with these conditions to healthy controls.
- The analysis revealed that aneurysmal aortas had decreased elastin, reduced wall thickness, and increased stiffness compared to non-aneurysmal samples, while collagen levels remained unchanged.
- The findings challenge previous beliefs about aneurysms weakening the aorta, suggesting they primarily lead to stiffness and loss of elasticity, which is crucial for understanding how aneurysms may lead to dissections.
Article Abstract
Objective: We sought to examine in age-matched subjects the biomechanical and compositional remodeling associated with ascending thoracic aortic aneurysms according to region and direction.
Methods: Whole, fresh, degenerative ascending thoracic aortic aneurysms were taken from 26 patients (age, 69 +/- 2 years; maximum aortic diameter, 5.9 +/- 0.3 cm) during elective surgical intervention, and 15 nonaneurysmal ascending thoracic aortas were obtained during autopsies (age, 66 +/- 3 years; maximum aortic diameter, 3.3 +/- 0.2 cm). These were cut into anterior, right lateral, posterior, and left lateral regions, and circumferentially and longitudinally oriented specimens were prepared. The aortic specimens were submitted to histomorphometric and biomechanical studies, including measurement of failure strain (ie, extensibility), failure stress (ie, strength), and peak elastic modulus (ie, stiffness).
Results: Wall elastin, but not collagen content, decreased in aneurysmal specimens, displaying lower wall thickness and failure strain, higher peak elastic modulus, and equal failure stress than control specimens in the majority of regions and directions. Similar differences were noted in pooled data from all regions. Regional variations in mechanical parameters were mostly found in longitudinally oriented tissue. Circumferential specimens showed higher failure stress and peak elastic modulus but equal failure strain than longitudinal specimens.
Conclusions: Our findings contradict previous studies on ascending thoracic and abdominal aortic aneurysms, suggesting that the former might not cause weakening but rather only stiffening and reduction in tissue extensibility and elastin content. Marked heterogeneity was evident in healthy and aneurysmal aortas. The present data offer insight into the pathogenesis of aneurysm dissection. Information on directional and regional variations is pertinent because dissections develop circumferentially and bulging preferentially occurs in the anterior region.
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| http://dx.doi.org/10.1016/j.jtcvs.2008.07.023 | DOI Listing |
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