Biomechanical factors in the biology of aortic wall and aortic valve diseases

被引:166
作者
Back, Magnus [1 ,2 ]
Gasser, T. Christian [3 ]
Michel, Jean-Baptiste [4 ,5 ]
Caligiuri, Giuseppina [4 ,6 ]
机构
[1] Karolinska Inst, Dept Med, Ctr Mol Med, Stockholm, Sweden
[2] Karolinska Univ Hosp, Dept Cardiol, SE-17176 Stockholm, Sweden
[3] Royal Inst Technol KTH, Sch Engn Sci, Dept Solid Mech, Stockholm, Sweden
[4] INSERM, U698, Paris, France
[5] Univ Paris 07, Paris, France
[6] Hop Xavier Bichat, Dept Cardiol, Paris, France
基金
瑞典研究理事会;
关键词
Abdominal aortic aneurysm; Aortic stenosis; Inflammation; Thoracic aortic aneurysm; SMOOTH-MUSCLE-CELLS; INTRALUMINAL THROMBUS; ENDOTHELIAL-CELLS; MECHANICAL-PROPERTIES; INTERSTITIAL-CELLS; ABDOMINAL-AORTA; UP-REGULATION; SHEAR-STRESS; BLOOD-FLOW; ANEURYSMS;
D O I
10.1093/cvr/cvt040
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The biomechanical factors that result from the haemodynamic load on the cardiovascular system are a common denominator of several vascular pathologies. Thickening and calcification of the aortic valve will lead to reduced opening and the development of left ventricular outflow obstruction, referred to as aortic valve stenosis. The most common pathology of the aorta is the formation of an aneurysm, morphologically defined as a progressive dilatation of a vessel segment by more than 50% of its normal diameter. The aortic valve is exposed to both haemodynamic forces and structural leaflet deformation as it opens and closes with each heartbeat to assure unidirectional flow from the left ventricle to the aorta. The arterial pressure is translated into tension-dominated mechanical wall stress in the aorta. In addition, stress and strain are related through the aortic stiffness. Furthermore, blood flow over the valvular and vascular endothelial layer induces wall shear stress. Several pathophysiological processes of aortic valve stenosis and aortic aneurysms, such as macromolecule transport, gene expression alterations, cell death pathways, calcification, inflammation, and neoangiogenesis directly depend on biomechanical factors.
引用
收藏
页码:232 / 241
页数:10
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