Architectural trends in the human normal and bicuspid aortic valve leaflet and its relevance to valve disease.
The bicuspid aortic valve (AV) is the most common cardiac congenital anomaly and has been found to be a significant risk factor for developing calcific AV disease. However, the mechanisms of disease development remain unclear. In this study we quantified the structure of human normal and bicuspid leaflets in the early disease stage. From these individual leaflet maps average fiber structure maps were generated using a novel spline based technique. Interestingly, we found statistically different and consistent regional structures between the normal and bicuspid valves. The regularity in the observed microstructure was a surprising finding, especially for the pathological BAV leaflets and is an essential cornerstone of any predictive mathematical models of valve disease. In contrast, we determined that isolated valve interstitial cells from BAV leaflets show the same in vitro calcification pathways as those from the normal AV leaflets. This result suggests the VICs are not intrinsically different when isolated, and that external features, such as abnormal microstructure and altered flow may be the primary contributors in the accelerated calcification experienced by BAV patients.
Center for Cardiovascular Simulation, Institute for Computational Engineering Sciences and the Department of Biomedical Engineering, The University of Texas at Austin, 201 East 24th Street, ACES 5.438, One University Station, C0200, Austin, TX, 78712-0027, USA.
Ankush
A
Aggarwal
Giovanni
G
Ferrari
Erin
E
Joyce
Michael J
MJ
Daniels
Rachana
R
Sainger
Joseph H
JH
Gorman
Robert
R
Gorman
Michael S
MS
Sacks
D000368:Aged; D001021:Aortic Valve / Q000002:abnormalities* / Q000033:anatomy & histology / Q000378:metabolism; D000082882:Bicuspid Aortic Valve Disease; D003094:Collagen / Q000378:metabolism; D004549:Elastin / Q000378:metabolism; D005260:Female; D006349:Heart Valve Diseases / Q000378:metabolism; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011509:Proteoglycans / Q000378:metabolism
D011509:Proteoglycans; D003094:Collagen; D004549:Elastin