Sarah M. Wells

In vivo and in vitro mechanical properties of the sheep thoracic aorta in the perinatal period and adulthood

The mammalian aorta undergoes rapid remodeling during the perinatal period and more gradual remodeling during subsequent development, but the implications of this remodeling for arterial mechanics are poorly understood. In this study in vivo and in vitro techniques were used to determine the static and viscoelastic properties of the thoracic aortas of 119-day-gestation fetal sheep (full term = 145 days), 21-day-old lambs, and adult sheep at control distending pressures and after 70% increases or 30% decreases in pressure. In the weeks surrounding birth, aortic wall tissue became substantially stiffer (static elastic modulus in vitro increased by 28%, and pressure wave velocity in vivo increased by 61%) but less viscous (pressure wave attenuation in vivo decreased by 46%, and viscoelastic phase angle in vitro decreased by 15%), whereas the wall thickness-to-radius ratio was unchanged. By contrast, modest changes in tissue viscoelasticity from neonatal to adult life were accompanied by a halving of the wall thickness-to-radius ratio from 0.19 +/- 0.01 to 0.10 +/- 0.01. The relative thinning of the vessel wall, combined with a doubling of blood pressure after birth, resulted in a 265% increase in aortic wall tensile stress over the period of study. We concluded that rapid remodeling in the perinatal period primarily alters the viscoelastic properties of aortic wall tissues, whereas more gradual postnatal remodeling largely affects vessel geometry.The mammalian aorta undergoes rapid remodeling during the perinatal period and more gradual remodeling during subsequent development, but the implications of this remodeling for arterial mechanics are poorly understood. In this study in vivo and in vitro techniques were used to determine the static and viscoelastic properties of the thoracic aortas of 119-day-gestation fetal sheep (full term = 145 days), 21-day-old lambs, and adult sheep at control distending pressures and after 70% increases or 30% decreases in pressure. In the weeks surrounding birth, aortic wall tissue became substantially stiffer (static elastic modulus in vitro increased by 28%, and pressure wave velocity in vivo increased by 61%) but less viscous (pressure wave attenuation in vivo decreased by 46%, and viscoelastic phase angle in vitro decreased by 15%), whereas the wall thickness-to-radius ratio was unchanged. By contrast, modest changes in tissue viscoelasticity from neonatal to adult life were accompanied by a halving of the wall thickness-to-radius ratio from 0.19 ± 0.01 to 0.10 ± 0.01. The relative thinning of the vessel wall, combined with a doubling of blood pressure after birth, resulted in a 265% increase in aortic wall tensile stress over the period of study. We concluded that rapid remodeling in the perinatal period primarily alters the viscoelastic properties of aortic wall tissues, whereas more gradual postnatal remodeling largely affects vessel geometry.

Pregnancy-induced remodeling of collagen architecture and content in the mitral valve.

Pregnancy produces rapid, non-pathological volume-overload in the maternal circulation due to the demands of the growing fetus. Using a bovine model for human pregnancy, previous work in our laboratory has shown remarkable pregnancy-induced changes in leaflet size and mechanics of the mitral valve. The present study sought to relate these changes to structural alterations in the collagenous leaflet matrix. Anterior mitral valve leaflets were harvested from non-pregnant heifers and pregnant cows (pregnancy stage estimated by fetal length). We measured changes in the thickness of the leaflet and its anatomic layers via Verhoeff-Van Gieson staining, and in collagen crimp (wavelength and percent collagen crimped) via picrosirius red staining and polarized microscopy. Collagen concentration was determined biochemically: hydroxyproline assay for total collagen and pepsin-acid extraction for uncrosslinked collagen. Small-angle light scattering (SALS) assessed changes in internal fiber architecture (characterized by degree of fiber alignment and preferred fiber direction). Pregnancy produced significant changes to collagen structure in the mitral valve. Fiber alignment decreased 17% with an 11.5° rotation of fiber orientation toward the radial axis. Collagen fiber crimp was dramatically lost, accompanied by a 53% thickening of the fibrosa, and a 16% increase in total collagen concentration, both suggesting that new collagen is being synthesized. Extractable collagen concentration was low, both in the non-pregnant and pregnant state, suggesting early crosslinking of newly-synthesized collagen. This study has shown that the mitral valve is strongly adaptive during pregnancy, with significant changes in size, collagen content and architecture in response to rapidly changing demands.

Physiological Remodeling of the Mitral Valve During Pregnancy

There is growing evidence that heart valves are not passive structures but can remodel with left ventricular dysfunction. To determine if these tissues remodel under nonpathological conditions, we examined the mirtal valve anterior leaflet during the volume loading and cardiac expansion of pregnancy using a bovine model. We measured leaflet dimensions, chordal attachments, and biaxial mechanical properties of leaflets collected from never-pregnant heifers and pregnant cows (pregnancy duration estimated from fetal length). Hydrothermal isometric tension (HIT) tests were performed to assess the denaturation temperature (T(d)) associated with collagen molecular stability and the load decay half-time (t(1//2)) associated with intermolecular cross-linking. Histological changes were examined using Verhoeff-van Gieson and picrosirius red staining with polarized light. We observed striking changes to the structure and material properties of the mitral anterior leaflet during pregnancy. Leaflet area was increased 33%, with a surprising increase (nearly 25%) in chordae tendinae attachments. There was a biphasic change in leaflet extensibility: it rapidly decreased by 30% and then reversed to prepregnant values by late pregnancy. The 2°C decrease in T(d) in pregnancy was indicative of collagen remodeling, whereas the 70% increase in HIT t(1/2) indicated an increase in collagen cross-linking. Finally, histological results suggested transient increases in leaflet thickness and transient decreases in collagen crimp. This remodeling may compensate for the increased loading conditions associated with pregnancy by normalizing leaflet stress and maintaining coaptation. Understanding the mechanisms of mitral valve physiological remodeling in pregnancy could contribute to alternative treatments of pathological remodeling associated with left ventricular dysfunction.

Mitral valve leaflet remodelling during pregnancy: insights into cell-mediated recovery of tissue homeostasis.

Little is known about how valvular tissues grow and remodel in response to altered loading. In this work, we used the pregnancy state to represent a non-pathological cardiac volume overload that distends the mitral valve (MV), using both extant and new experimental data and a modified form of our MV structural constitutive model. We determined that there was an initial period of permanent set-like deformation where no remodelling occurs, followed by a remodelling phase that resulted in near-complete restoration of homeostatic tissue-level behaviour. In addition, we observed that changes in the underlying MV interstitial cell (MVIC) geometry closely paralleled the tissue-level remodelling events, undergoing an initial passive perturbation followed by a gradual recovery to the pre-pregnant state. Collectively, these results suggest that valvular remodelling is actively mediated by average MVIC deformations (i.e. not cycle to cycle, but over a period of weeks). Moreover, tissue-level remodelling is likely to be accomplished by serial and parallel additions of fibrillar material to restore the mean homeostatic fibre stress and MVIC geometries. This finding has significant implications in efforts to understand and predict MV growth and remodelling following such events as myocardial infarction and surgical repair, which also place the valve under altered loading conditions.

Differential Biomechanical Development of Elastic Tissues in the Bovine Fetus

Mechanical loading conditions are important factors in the gestational development of fetal tissues. However, little is known about how mechanical loading during development modulates the structure and function of elastic tissues. We hypothesized that developing elastic tissues functionally adapt to their loading conditions. To test this hypothesis, we assessed the changes in the composition, viscoelasticity, and thermoelastic properties of elastic tissue from bovine aortas (functional during gestation) and nuchal ligaments (nonfunctional during gestation). Clear differences in the developmental timeline of elastic tissue structure and function were observed between aortic and ligament elastic tissue. Elastic tissue in the aorta developed earlier than that of the nuchal ligament, indicating a role for loading conditions in the timeline of development. Ligament elastic tissue, however, underwent rapid remodeling in late gestation—likely as a preadaptation to the sudden-onset of tensile load it experiences at birth. Finally, while the same fundamental structure–mechanical relationships were seen in both tissues, there was a clear difference in mechanical properties between the elastic tissues from the adult nuchal ligament and the adult aorta, indicating that postnatal loading conditions continue to influence tissue structure and mechanical properties, tailoring them to their functional roles in adult life.