0
Journal of Biomechanical Engineering | Volume 137 | Issue 8 | research-article
Research Papers

Biomechanical Properties of Human Ascending Thoracic Aortic Dissections

[+] Author and Article Information
Anju R. Babu

Centre for Nano Science and Engineering,
Indian Institute of Science,
Bangalore 560 012, India
e-mail: anjurb@mecheng.iisc.ernet.in

Achu G. Byju

Department of Mechanical Engineering,
Indian Institute of Science,
Bangalore 560 012, India
e-mail: achugb@gmail.com

Namrata Gundiah

Department of Mechanical Engineering,
Indian Institute of Science,
Bangalore 560 012, India
e-mail: namrata@mecheng.iisc.ernet.in

1Corresponding author.

Manuscript received October 8, 2014; final manuscript received May 12, 2015; published online June 24, 2015. Assoc. Editor: Jonathan Vande Geest.

J Biomech Eng 137(8), 081013 (Aug 01, 2015) (9 pages) Paper No: BIO-14-1501; doi: 10.1115/1.4030752 History: Received October 08, 2014; Revised May 12, 2015; Online June 24, 2015
Article
References
Figures
Tables
Citing Articles

Thoracic aortic dissections are associated with a significant risk of morbidity and mortality, and currently challenge our understanding of the biomechanical factors leading to their initiation and propagation. We quantified the biaxial mechanical properties of human type A dissections (n = 16) and modeled the stress–strain data using a microstructurally motivated form of strain energy function. Our results show significantly higher stiffness for dissected tissues as compared to control aorta without arterial disease. Higher stiffness of dissected tissues did not, however, correlate with greater aortic diameter measured prior to surgery nor were there any age dependent differences in the tissue properties.
FIGURES IN THIS ARTICLE
<>
Copyright © 2015 by ASME
Your Session has timed out. Please sign back in to continue.

References

1
Hagan, P. G., Nienaber, C. A., Isselbacher, E. M., Bruckman, D., Karavite, D. J., Russman, P. L., Evangelista, A., Fattori, R., Suzuki, T., Oh, J. K., Moore, A. G., Malouf, J. F., Pape, L. A., Gaca, C., Sechtem, U., Lenferink, S., Deutsch, H. J., Diedrichs, H., Marcos y Robles, J., Llovet, A., Gilon, D., Das, S. K., Armstrong, W. F., Deeb, G. M., and Eagle, K. A., 2000, “The International Registry of Acute Aortic Dissection (IRAD): New Insights Into an Old Disease,” JAMA, J. Am. Med. Assoc., 283(7), pp. 897–903. [CrossRef]
2
Mehta, R. H., Suzuki, T., and Hagan, P. G., 2002, “Predicting Death in Patients With Acute Type A Aortic Dissection,” Circulation, 105(2), pp. 200–206. [CrossRef] [PubMed]
3
Haskett, D., Johnson, G., Zhou, A., Utzinger, U., and van de Geest, J., 2010, “Microstructural and Biomechanical Alterations of the Human Aorta as a Function of Age and Location,” Biomech. Model. Mechanobiol., 9(6), pp. 725–736. [CrossRef] [PubMed]
4
Nathan, D. P., Xu, C., Gorman, J. H., III, Fairman, R. M., Bavaria, J. E., Gorman, R. C., Chandran, K. B., and Jackson, B. M., 2011, “Pathogenesis of Acute Aortic Dissection: A Finite Element Stress Analysis,” Ann. Thorac. Surg., 91(2), pp. 458–463. [CrossRef] [PubMed]
5
Nienaber, C. A., and Eagle, K. A., 2003, “Aortic Dissection: New Frontiers in Diagnosis and Management: Part I: From Etiology to Diagnostic Strategies,” Circulation, 108(5), pp. 628–635. [CrossRef] [PubMed]
6
Hirst, A. E., Johns, V. J., and Krime, S. W., 1958, “Dissecting Aneurysm of the Aorta: A Review of 505 Cases,” Medicine, 37(3), pp. 217–279. [CrossRef] [PubMed]
7
Rajagopal, K., Bridges, C., and Rajagopal, K. R., 2007, “Towards an Understanding of the Mechanics Underlying Aortic Dissection,” Biomech. Model. Mechanobiol., 6(5), pp. 345–359. [CrossRef] [PubMed]
8
Hiratzka, L. F., Bakris, G. L., and Beckman, J. A., 2010, “2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease,” Circulation, 121(13), pp. e266–e369. [CrossRef] [PubMed]
9
Milewicz, D. M., Dietz, H. C., and Miller, D. C., 2005, “Treatment of Aortic Disease in Patients With Marfan Syndrome,” Circulation, 111, pp. e150–e157. [CrossRef] [PubMed]
10
Pisano, C., Maresi, E., Merlo, D., Balistreri, C. R., Candore, G., Caruso, M., Codispoti, M., and Ruvolo, G., 2012, “A Particular Phenotype of Ascending Aorta Aneurysms as Precursor of Type A Aortic Dissection,” Interact. Cardiovasc. Thorac. Surg., 15(5), pp. 840–846. [CrossRef] [PubMed]
11
Vorp, D. A., Schiro, B. J., Ehrlich, M. P., Juvonen, T. S., Ergin, M. A., and Griffith, B. P., 2003, “Effect of Aneurysm on the Tensile Strength and Biomechanical Behavior of the Ascending Thoracic Aorta,” Ann. Thorac. Surg., 75(4), pp. 1210–1214. [CrossRef] [PubMed]
12
Okamoto, R. J., Wagenseil, J. E., DeLong, W. R., Peterson, S. J., Kouchoukos, N. T., and Stundt, T. M., III, 2002, “Mechanical Properties of Dilated Human Ascending Aorta,” Ann. Biomed. Eng., 30(5), pp. 624–635. [CrossRef] [PubMed]
13
Labrosse, M. R., Beller, C. J., Mesana, T., and Veinot, J. P., 2009, “Mechanical Behavior of Human Aortas: Experiments, Material Constants and 3-D Finite Element Modeling Including Residual Stress,” J. Biomech., 42(8), pp. 996–1004. [CrossRef] [PubMed]
14
Choudhury, N., Bouchot, O., Rouleau, L., Tremblay, D., Cartier, R., Butany, J., Mongrainb, R., and Leask, R. L., 2009, “Local Mechanical and Structural Properties of Healthy and Diseased Human Ascending Aorta Tissue,” Cardiovasc. Pathol., 18(2), pp. 83–91. [CrossRef] [PubMed]
15
Iliopoulos, D. C., Deveja, R. P., Kritharis, E. P., Perrea, D., Sionis, G. D., Toutouzas, K., Stefanadisd, C., and Sokolis, D. P., 2009, “Regional and Directional Variations in the Mechanical Properties of Ascending Thoracic Aortic Aneurysms,” Med. Eng. Physics, 31(1), pp. 1–9. [CrossRef]
16
Raghavan, M. L., and Vorp, D. A., 2000, “Toward a Biomechanical Tool to Evaluate Rupture Potential of Abdominal Aortic Aneurysm: Identification of a Finite Strain Constitutive Model and Evaluation of Its Applicability,” J. Biomech., 33(4), pp. 475–482. [CrossRef] [PubMed]
17
Humphrey, J. D., 2002, “The Normal Arterial Wall,” Cardiovascular Solid Mechanics: Cells, Tissues and Organs, Springer, New York, pp. 249–353.
18
Agrawal, V., Kollimada, S. A., Byju, A. G., and Gundiah, N., 2013, “Regional Variations in the Nonlinearity and Anisotropy of Bovine Aortic Elastin,” Biomech. Model. Mechanobiol., 12(6), pp. 1181–1194. [CrossRef] [PubMed]
19
Holzapfel, G. A., Gasser, T. C., and Ogden, R. W., 2000, “A New Constitutive Framework for Arterial Wall Mechanics and a Comparative Study of Material Models,” J. Elasticity, 61(1–3), pp. 1–48. [CrossRef]
20
Farina, G. A., and Kwiatkowski, T., 2003, “Aortic Dissection,” Primary Care Update OB/GYNS, 10(4), pp. 161–166. [CrossRef]
21
Sokolis, D. P., Kritharis, E. P., Giagini, A. T., Lampropoulos, K. M., Papadodima, S. A., and Iliopoulos, D. C., 2012, “Biomechanical Response of Ascending Thoracic Aortic Aneurysms: Association With Structural Remodelling,” Comput. Methods Biomech. Biomed. Eng., 15(3), pp. 231–248. [CrossRef]
22
Hosoda, Y., and Minoshima, I., 1965, “Elastin Content of the Aorta and the Pulmonary Artery in the Japanese,” Angiology, 16, pp. 325–332. [CrossRef] [PubMed]
23
Tsamis, A., Krawiec, J. T., and Vorp, D. A., 2013, “Elastin and Collagen Fibre Microstructure of the Human Aorta in Ageing and Disease: A Review,” J. R. Soc., Interface, 10(83), p. 20121004. [CrossRef]
24
Faber, M., and Oller-Hou, G., 1952, “The Human Aorta. V. Collagen and Elastin in the Normal and Hypertensive Aorta,” Acta Pathol. Microbiol. Scand., 31(3), pp. 377–382. [CrossRef] [PubMed]
25
Schlatmann, T. J., and Becker, A. E., 1977, “Histologic Changes in the Normal Aging Aorta: Implications for Dissecting Aortic Aneurysm,” Am. J. Cardiol., 39(1), pp. 13–20. [CrossRef] [PubMed]
26
Andreotti, L., Bussotti, A., Cammelli, D., di Giovine, F., Sampognaro, S., Sterantino, G., Varcasia, G., and Arcangeli, P., 1985, “Aortic Connective Tissue in Ageing: A Biochemical Study,” Angiology, 36(12), pp. 872–879. [CrossRef] [PubMed]
27
Wang, X., LeMaire, S. A., Chen, L., Shen, Y. H., Gan, Y., Bartsch, H., Carter, S. A., Utama, B., Ou, H., Coselli, J. S., and Wang, X. L., 2006, “Increased Collagen Deposition and Elevated Expression of Connective Tissue Growth Factor in Human Thoracic Aortic Dissection,” Circulation, 114(Suppl. 1), pp. 200–205. [CrossRef]
28
Kroon, M., and Holzapfel, G. A., 2007, “A Model for Saccular Cerebral Aneurysm Growth by Collagen Fibre Remodelling,” J. Theor. Biol., 247(4), pp. 775–787. [CrossRef] [PubMed]
29
Watton, P. N., and Hill, N. A., 2009, “Evolving Mechanical Properties of a Model of Abdominal Aortic Aneurysm,” Biomech. Model. Mechanobiol., 8(1), pp. 25–42. [CrossRef] [PubMed]

Figures

Grahic Jump Location
Fig. 1

(a) CT image shows the ascending aorta obtained from the patient prior to surgery. The box indicates the approximate location which was dissected and mechanically tested in this study. (b) The excised tissue sample was attached to the biaxial testing instrument and stretched using various force controlled biaxial testing protocols. (c) Raw load–unload data from one representative experiment were obtained followed by tissue preconditioning and are shown for a sample subjected to loading ratio of 2C:2L and 2C: 1L in the circumferential and longitudinal directions, respectively.

+(a) CT image shows the ascending aorta obtained from the patient prior to surgery. The box indicates the approximate location which was dissected and mechanically tested in this study. (b) The excised tissue sample was attached to the biaxial testing instrument and stretched using various force controlled biaxial testing protocols. (c) Raw load–unload data from one representative experiment were obtained followed by tissue preconditioning and are shown for a sample subjected to loading ratio of 2C:2L and 2C: 1L in the circumferential and longitudinal directions, respectively.
View Large  |  Save Figure  |  Download Slide (.ppt)
(a) CT image shows the ascending aorta obtained from the patient prior to surgery. The box indicates the approximate location which was dissected and mechanically tested in this study. (b) The excised tissue sample was attached to the biaxial testing instrument and stretched using various force controlled biaxial testing protocols. (c) Raw load–unload data from one representative experiment were obtained followed by tissue preconditioning and are shown for a sample subjected to loading ratio of 2C:2L and 2C: 1L in the circumferential and longitudinal directions, respectively.
Grahic Jump Location
Fig. 6

To assess the possible differences in material properties within each group and those between the two groups: (a) Green strains were obtained at 25 kPa and 100 kPa for the circumferential and longitudinal directions and (b) tissue stiffness, measured as slope Ec to the curve at the high stretch range, was compared between groups. We do not see any differences in the tissue stiffness between the groups.

+To assess the possible differences in material properties within each group and those between the two groups: (a) Green strains were obtained at 25 kPa and 100 kPa for the circumferential and longitudinal directions and (b) tissue stiffness, measured as slope Ec to the curve at the high stretch range, was compared between groups. We do not see any differences in the tissue stiffness between the groups.
View Large  |  Save Figure  |  Download Slide (.ppt)
To assess the possible differences in material properties within each group and those between the two groups: (a) Green strains were obtained at 25 kPa and 100 kPa for the circumferential and longitudinal directions and (b) tissue stiffness, measured as slope Ec to the curve at the high stretch range, was compared between groups. We do not see any differences in the tissue stiffness between the groups.
Grahic Jump Location
Fig. 5

Slopes to the elastin-dominated (EE) and collagen-dominated (EC) regions were obtained for equibiaxial stress–strain results and are shown for a sample. Transition points (T1, T2) were determined using the intersection of these lines.

+Slopes to the elastin-dominated (EE) and collagen-dominated (EC) regions were obtained for equibiaxial stress–strain results and are shown for a sample. Transition points (T1, T2) were determined using the intersection of these lines.
View Large  |  Save Figure  |  Download Slide (.ppt)
Slopes to the elastin-dominated (EE) and collagen-dominated (EC) regions were obtained for equibiaxial stress–strain results and are shown for a sample. Transition points (T1, T2) were determined using the intersection of these lines.
Grahic Jump Location
Fig. 4

Coefficients to the SEF were used to model the data from nonequibiaxial stress–strain experiments which were not used in the fitting procedure to assess the predictive capability of the model. Comparisons between the experimental results and the model are shown for samples in the two groups. The r2 values indicate the goodness of fits and are shown for each sample.

+Coefficients to the SEF were used to model the data from nonequibiaxial stress–strain experiments which were not used in the fitting procedure to assess the predictive capability of the model. Comparisons between the experimental results and the model are shown for samples in the two groups. The r2 values indicate the goodness of fits and are shown for each sample.
View Large  |  Save Figure  |  Download Slide (.ppt)
Coefficients to the SEF were used to model the data from nonequibiaxial stress–strain experiments which were not used in the fitting procedure to assess the predictive capability of the model. Comparisons between the experimental results and the model are shown for samples in the two groups. The r2 values indicate the goodness of fits and are shown for each sample.
Grahic Jump Location
Fig. 3

Equibiaxial stress–strain results were plotted for each individual sample in groups A and B in the circumferential and longitudinal directions. These were obtained by fitting the experimental results to a microstructurally motivated form of SEF as described earlier (Table 2).

+Equibiaxial stress–strain results were plotted for each individual sample in groups A and B in the circumferential and longitudinal directions. These were obtained by fitting the experimental results to a microstructurally motivated form of SEF as described earlier (Table 2).
View Large  |  Save Figure  |  Download Slide (.ppt)
Equibiaxial stress–strain results were plotted for each individual sample in groups A and B in the circumferential and longitudinal directions. These were obtained by fitting the experimental results to a microstructurally motivated form of SEF as described earlier (Table 2).
Grahic Jump Location
Fig. 2

Cauchy stress and Green strain data were obtained from multiple biaxial experiments for: (a) TAD tissues from group A (≤50 yr) and (b) those belonging to group B (>50 yr). Individual experiments are shown for each sample using 100 g base force in the circumferential or longitudinal directions that are represented by 1C:1L in the legend.

+Cauchy stress and Green strain data were obtained from multiple biaxial experiments for: (a) TAD tissues from group A (≤50 yr) and (b) those belonging to group B (>50 yr). Individual experiments are shown for each sample using 100 g base force in the circumferential or longitudinal directions that are represented by 1C:1L in the legend.
View Large  |  Save Figure  |  Download Slide (.ppt)
Cauchy stress and Green strain data were obtained from multiple biaxial experiments for: (a) TAD tissues from group A (≤50 yr) and (b) those belonging to group B (>50 yr). Individual experiments are shown for each sample using 100 g base force in the circumferential or longitudinal directions that are represented by 1C:1L in the legend.

Tables

Errata

Discussions

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Introduction and Definitions
Handbook on Stiffness & Damping in Mechanical Design> Chapter 1
Supporting Systems/Foundations
Handbook on Stiffness & Damping in Mechanical Design> Chapter 5
mDFA Human Empirical Results
Modified Detrended Fluctuation Analysis (mDFA)
Vibration Analysis of the Seated Human Body in Vertical Direction
International Conference on Computer Technology and Development, 3rd (ICCTD 2011)
Clustered (Hierarchical) Ad Hoc Routing Protocol (CARP)
International Conference on Computer Technology and Development, 3rd (ICCTD 2011)
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In