Ascending thoracic aortic aneurysms are associated with compositional remodeling and vessel stiffening but not weakening in age-matched subjects Dimitrios.

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Presentation transcript:

Ascending thoracic aortic aneurysms are associated with compositional remodeling and vessel stiffening but not weakening in age-matched subjects Dimitrios C. Iliopoulos, MD, PhD, Eleftherios P. Kritharis, BSc, Athina T. Giagini, MSc, Stavroula A. Papadodima, MD, PhD, Dimitrios P. Sokolis, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 137, Issue 1, Pages 101-109 (January 2009) DOI: 10.1016/j.jtcvs.2008.07.023 Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Typical stress-strain curves of a control and ascending thoracic aortic aneurysm (ATAA) specimen showing multiple aortic ruptures. The symbols σf, εf, and Mp denote failure stress, failure strain, and peak elastic modulus for the ATAA specimen. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Representative histologic sections of a control (upper panel) and ascending thoracic aortic aneurysm (ATAA) specimen (lower panel) stained with hematoxylin and eosin for examination of overall vessel wall morphology (A and D), orcein for elastin staining (B and E), and Sirius red for collagen staining (C and F). (Original magnification 4×). The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Stress-strain curves of all specimens from the anterior region with circumferential (CIRC; A) and longitudinal (LONG; B) orientation. ATAA, Ascending thoracic aortic aneurysm. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Wall thickness of ascending thoracic aortic aneurysm (ATAA; open squares) and control (filled circles) tissue specimens from the anterior, right lateral, posterior, and left lateral regions with both circumferential and longitudinal directions. Data are individual measurements with means, with horizontal continuous lines denoting ATAA specimens and dotted lines denoting control specimens. Control versus ATAA specimens: anterior region, P = .002; right lateral region, P < .001; posterior region, P = .02; left lateral region, P = .02. Regional differences were nonsignificant for ATAA and control specimens. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 5 Failure strains of ascending thoracic aortic aneurysm (ATAA; open squares) and control (filled circles) tissue specimens from the anterior, right lateral, posterior, and left lateral regions for the circumferential (CIRC; A) and longitudinal (LONG; B) directions. Data are individual measurements with means, with horizontal continuous lines denoting ATAA specimens and dotted lines denoting control specimens. Control versus ATAA specimens: CIRC—anterior region, P = .009; LONG—anterior region, P = .003; posterior region, P = .04. Regional differences: ATAA CIRC—anterior versus left lateral region, P = .001; right versus left lateral region, P = .007; posterior versus left lateral region, P = .007. ATAA LONG—anterior versus left lateral region, P = .01; right versus left lateral region, P = .002; posterior versus left lateral region, P = .007. Control CIRC and LONG: nonsignificant differences. LONG versus CIRC: nonsignificant differences for ATAA and control specimens. Other differences were nonsignificant. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 6 Failure stresses of ascending thoracic aortic aneurysm (ATAA; open squares) and control (filled circles) tissue specimens from the anterior, right lateral, posterior, and left lateral regions for the circumferential (CIRC; A) and longitudinal (LONG; B) directions. Data are individual measurements with means, with horizontal continuous lines denoting ATAA specimens and dotted lines denoting control specimens. Control versus ATAA specimens: CIRC, nonsignificant differences; LONG—left lateral region, P = .003. Regional differences: ATAA CIRC, nonsignificant differences; ATAA LONG—anterior versus right lateral region, P < .001; right lateral versus posterior region, P = .003; control CIRC: nonsignificant differences; control LONG—anterior versus right lateral region, P = .01; right versus left lateral region, P < .001. LONG versus CIRC: ATAA—anterior region, P < .001; right lateral region, P < .001; posterior region, P < .001; left lateral region, P < .001. Control—anterior region, P < .001; right lateral region, P = .008; posterior region, P < .001; left lateral region, P < .001. Other differences were nonsignificant. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 7 Peak elastic modulus of ascending thoracic aortic aneurysm (ATAA; open squares) and control (filled circles) tissue specimens from the anterior, right lateral, posterior, and left lateral regions for the circumferential (CIRC; A) and longitudinal (LONG; B) directions. Data are individual measurements with means, with horizontal continuous lines denoting ATAA specimens and dotted lines denoting control specimens. Control versus ATAA specimens: CIRC—right lateral region, P = .03; LONG—anterior region, P = .003; right lateral region, P = .02; posterior region, P = .02; left lateral region, P = .004. Regional differences: ATAA CIRC, nonsignificant differences; ATAA LONG—anterior versus right lateral region, P < .001; right lateral versus posterior region, P < .001; right versus left lateral region, P = .002; control CIRC: nonsignificant differences; control LONG—anterior versus right lateral region, P < .001; right lateral versus posterior region, P = .001; right versus left lateral region, P < .001. LONG versus CIRC: ATAA—anterior region, P < .001; right lateral region, P < .001; posterior region, P < .001; left lateral region, P < .001; control—anterior region, P < .001; right lateral region, P = .002; posterior region, P < .001; left lateral region, P < .001. Other differences were nonsignificant. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions

Figure 8 Thickness (A), failure strain (B), failure stress (C), and peak elastic modulus (D) of ascending thoracic aortic aneurysm (ATAA; open columns) and control (filled columns) tissue specimens with circumferential (CIRC) and longitudinal (LONG) directions for pooled data from all regions. Values are presented as means ± standard error of the mean. Control versus ATAA specimens: thickness, P < .001; failure strain CIRC, P = .05; failure strain LONG, P < .001; failure stress LONG, P = .004; peak elastic modulus CIRC, P = .008; peak elastic modulus LONG, P < .001. LONG versus CIRC: failure stress ATAA, P < .001; failure stress control, P < .001; peak elastic modulus ATAA, P < .001; peak elastic modulus control, P < .001. Other differences were nonsignificant. The Journal of Thoracic and Cardiovascular Surgery 2009 137, 101-109DOI: (10.1016/j.jtcvs.2008.07.023) Copyright © 2009 The American Association for Thoracic Surgery Terms and Conditions