Ex Vivo Quantification of Calcification Stiffness in Aortic Stenosis: Biomechanical Data from Resected Human Valves.

IF 5.4 2区 医学 Q3 ENGINEERING, BIOMEDICAL
Takashi Shirakawa, Kazuo Shimamura, Koichi Maeda, Shin Yajima, Ai Kawamura, Takuji Kawamura, Daisuke Yoshioka, Shigeru Miyagawa
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Abstract

Purpose: Aortic stenosis (AS) is characterized by progressive calcification of the aortic valve. While imaging can assess the extent and localization of calcification, intraoperative findings suggest substantial variability in mechanical stiffness. Quantitative biomechanical evaluation is needed to inform optimized treatment strategies. We aimed to quantify the mechanical stiffness of calcified nodules in human AS.

Methods: We performed ex vivo compression testing on 129 calcified nodules resected from 46 patients undergoing surgical aortic valve replacement for severe AS. Stress-strain relationships were measured to characterize the mechanical behavior of the nodules, and two stiffness parameters-compression strength (CS) and compression energy (CE)-were defined. These parameters were compared with the computed tomography (CT) density of the region from which each nodule was resected.

Results: Calcified nodules exhibited wide variation in reactive stress, with maximum values in low strain regions ranging from 60 to 100-fold higher than the minimum. The stress-strain curves demonstrated three-phase pattern consisting of an initial increase, plateau phase, and steep rise in stress. The median CS increased from 0.38 MPa at 10% strain to 1.73 MPa at 50% strain, and median CE from 0.020 to 0.43 J/cm3 across the same range. The Pearson's correlation coefficients between CT density and these parameters ranged from 0.291 to 0.454.

Conclusion: Some nodules demonstrated marked reactive stress even at low strain levels, indicating strong resistance to compression with minimal deformation. This study provides reference data on the biomechanical stiffness of calcification in human AS.

主动脉狭窄钙化刚度的体外量化:来自切除人类瓣膜的生物力学数据。
目的:主动脉瓣狭窄(AS)以主动脉瓣进行性钙化为特征。虽然影像学可以评估钙化的程度和定位,但术中发现表明机械刚度存在很大差异。需要定量的生物力学评估来优化治疗策略。我们的目的是量化人类AS钙化结节的机械刚度。方法:我们对46例重度AS行主动脉瓣置换术患者切除的129个钙化结节进行了体外压缩试验。测量了应力应变关系以表征结核的力学行为,并定义了两个刚度参数-压缩强度(CS)和压缩能(CE)。将这些参数与每个结节切除区域的CT密度进行比较。结果:钙化结节反应应力变化较大,低应变区的最大值比最小值高60 ~ 100倍。应力-应变曲线表现为应力初始升高、平台阶段和急剧升高的三相模式。应变强度的中位数CS从10%应变时的0.38 MPa增加到50%应变时的1.73 MPa, CE从0.020 J/cm3增加到0.43 J/cm3。CT密度与这些参数之间的Pearson相关系数为0.291 ~ 0.454。结论:即使在低应变水平下,一些结节也表现出明显的反应应力,表明在最小变形的情况下对压缩有很强的抵抗力。本研究为人类AS钙化的生物力学刚度提供了参考数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annals of Biomedical Engineering
Annals of Biomedical Engineering 工程技术-工程:生物医学
CiteScore
7.50
自引率
15.80%
发文量
212
审稿时长
3 months
期刊介绍: Annals of Biomedical Engineering is an official journal of the Biomedical Engineering Society, publishing original articles in the major fields of bioengineering and biomedical engineering. The Annals is an interdisciplinary and international journal with the aim to highlight integrated approaches to the solutions of biological and biomedical problems.
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