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Article

From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm

1
Faculty of Medicine, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia
2
Centre of Cardiac Surgery, Pauls Stradins Clinical University Hospital, 13 Pilsonu Street, LV-1002 Riga, Latvia
3
Joint Laboratory of Electron Microscopy, Riga Stradins University, 9 Kronvalda Boulevard, LV-1010 Riga, Latvia
4
Laboratory of Biomechanics, Riga Stradins University, 5a Ratsupites Street, LV-1067 Riga, Latvia
5
Institute of Microbiology and Virology, Riga Stradins University, 5 Ratsupites Street, LV-1067 Riga, Latvia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2024, 13(14), 4225; https://doi.org/10.3390/jcm13144225
Submission received: 12 June 2024 / Revised: 11 July 2024 / Accepted: 17 July 2024 / Published: 19 July 2024
(This article belongs to the Special Issue State-of-the-Art in Aortic Surgery)

Abstract

Background: This research explores the biomechanical and structural characteristics of ascending thoracic aortic aneurysms (ATAAs), focusing on the differences between bicuspid aortic valve aneurysms (BAV-As) and tricuspid aortic valve aneurysms (TAV-As) with non-dilated aortas to identify specific traits of ATAAs. Methods: Clinical characteristics, laboratory indices, and imaging data from 26 adult patients operated on for aneurysms (BAV-A: n = 12; TAV-A: n = 14) and 13 controls were analyzed. Biomechanical parameters (maximal aortic diameter, strain, and stress) and structural analyses (collagen fiber organization, density, fragmentation, adipocyte deposits, and immune cell infiltration) were assessed. Results: Significant differences in biomechanical parameters were observed. Median maximal strain was 40.0% (control), 63.4% (BAV-A), and 45.3% (TAV-A); median maximal stress was 0.59 MPa (control), 0.78 MPa (BAV-A), and 0.48 MPa (TAV-A). BAV-A showed higher tangential modulus and smaller diameter, with substantial collagen fragmentation (p < 0.001 vs. TAV and controls). TAV-A exhibited increased collagen density (p = 0.025), thickening between media and adventitia layers, and disorganized fibers (p = 0.036). BAV-A patients had elevated adipocyte deposits and immune cell infiltration. Conclusions: This study highlights distinct pathological profiles associated with different valve anatomies. BAV-A is characterized by smaller diameters, higher biomechanical stress, and significant collagen deterioration, underscoring the necessity for tailored clinical strategies for effective management of thoracic aortic aneurysm.
Keywords: tricuspid aortic valve; bicuspid aortic valve; ascending thoracic aortic aneurysm; biomechanical properties; morphology tricuspid aortic valve; bicuspid aortic valve; ascending thoracic aortic aneurysm; biomechanical properties; morphology

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MDPI and ACS Style

Brecs, I.; Skuja, S.; Kasyanov, V.; Groma, V.; Kalejs, M.; Svirskis, S.; Ozolanta, I.; Stradins, P. From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm. J. Clin. Med. 2024, 13, 4225. https://doi.org/10.3390/jcm13144225

AMA Style

Brecs I, Skuja S, Kasyanov V, Groma V, Kalejs M, Svirskis S, Ozolanta I, Stradins P. From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm. Journal of Clinical Medicine. 2024; 13(14):4225. https://doi.org/10.3390/jcm13144225

Chicago/Turabian Style

Brecs, Ivars, Sandra Skuja, Vladimir Kasyanov, Valerija Groma, Martins Kalejs, Simons Svirskis, Iveta Ozolanta, and Peteris Stradins. 2024. "From Biomechanical Properties to Morphological Variations: Exploring the Interplay between Aortic Valve Cuspidity and Ascending Aortic Aneurysm" Journal of Clinical Medicine 13, no. 14: 4225. https://doi.org/10.3390/jcm13144225

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