Temporal evolution of mechanical stimuli from vascular remodeling in response to the severity and duration of aortic coarctation in a preclinical model.

Autor: Azarnoosh J; Department of Pediatrics - Section of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA. jimmy.azarnoosh@nghs.com.; Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, USA. jimmy.azarnoosh@nghs.com., Ghorbannia A; Department of Pediatrics - Section of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA.; Herma Heart Institute, Children's Wisconsin, Milwaukee, WI, USA., Ibrahim EH; Departments of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA., Jurkiewicz H; Department of Pediatrics - Section of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA.; Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, USA., Kalvin L; Departments of Medicine - Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA., LaDisa JF Jr; Department of Pediatrics - Section of Cardiology, Medical College of Wisconsin, Milwaukee, WI, USA.; Department of Biomedical Engineering, Marquette University and the Medical College of Wisconsin, Milwaukee, WI, USA.; Departments of Medicine - Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.; Departments of Physiology, Medical College of Wisconsin, Milwaukee, WI, USA.; Herma Heart Institute, Children's Wisconsin, Milwaukee, WI, USA.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2023 May 23; Vol. 13 (1), pp. 8352. Date of Electronic Publication: 2023 May 23.
DOI: 10.1038/s41598-023-34400-8
Abstrakt: Coarctation of the aorta (CoA) is one of the most common congenital cardiovascular diseases. CoA patients frequently undergo surgical repair, but hypertension (HTN) is still common. The current treatment guideline has revealed irreversible changes in structure and function, yet revised severity guidelines have not been proposed. Our objective was to quantify temporal alterations in mechanical stimuli and changes in arterial geometry in response to the range of CoA severities and durations (i.e. age of treatment) seen clinically. Rabbits were exposed to CoA resulting in peak-to-peak blood pressure gradient (BPG pp ) severities of ≤ 10, 10-20, and ≥ 20 mmHg for a duration of ~ 1, 3, or 20 weeks using permanent, dissolvable, and rapidly dissolvable sutures. Elastic moduli and thickness were estimated from imaging and longitudinal fluid-structure interaction (FSI) simulations were conducted at different ages using geometries and boundary conditions from experimentally measured data. Mechanical stimuli were characterized including blood flow velocity patterns, wall tension, and radial strain. Experimental results show vascular alternations including thickening and stiffening proximal to the coarctation with increasing severity and/or duration of CoA. FSI simulations indicate wall tension in the proximal region increases markedly with coarctation severity. Importantly, even mild CoA induced stimuli for remodeling that exceeds values seen in adulthood if not treated early and using a BPG pp lower than the current clinical threshold. The findings are aligned with observations from other species and provide some guidance for the values of mechanical stimuli that could be used to predict the likelihood of HTN in human patients with CoA.
(© 2023. The Author(s).)
Databáze: MEDLINE
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