Vasoactive Agents Alter the Biomechanical Properties of Aortic Heart Valve Leaflets in a Time-Dependent Manner

Background and aim of the study: Although the vasoactive agents, angiotensin II (Ang II) and 5-hydroxytryptamine (5-HT) are implicated in aortic heart valve disease, it is unclear how these compounds alter the biomechanical properties of valve leaflet tissue. The study aim was to characterize temporal changes in the elastic modulus of tissues incubated with these compounds. Methods: Valve leaflets were excised from fresh porcine aortic heart valves. Leaflet tissue was incubated with 10(-6) M 5-HT, or 10(-6) M Ang II. The stress and elongation of the tissue in the circumferential and radial directions was measured using a stepper motor-driven micromechanical testing machine at 0.5, 6, and 24 h, followed by calculations of strain and elastic modulus of each sample. Results: Tissue samples incubated with Ang II showed a significant increase in stiffness with time in the radial direction, but not in the circumferential direction. Regression analysis showed a correlation between time and elastic modulus for the tissue (R-2 = 0.84). Conversely, leaflets incubated in 5-HT did not show any significant change in elastic modulus over time in the radial direction; however, significant increases in stiffness were observed after 24 h in the circumferential direction. A strong correlation between the elastic modulus in the circumferential direction and time was also noted (R-2 = 0.99). Conclusion: The study results showed that vasoactive agents are capable of increasing the elastic modulus of aortic valve tissue in a time-dependent manner. Furthermore, the biomechanical changes induced by vasoactive agents are direction-specific, indicating different modes of action.