Heterogeneity of Mitral Leaflet Matrix Composition and Turnover Correlates with Regional Leaflet Strain

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• 作者：Elizabeth H. Stephens ; Patrick S. Connell…
• 关键词：Mitral valve ; Extracellular matrix ; Matrix metalloproteases ; Collagen ; Leaflet strain
• 刊名：Cardiovascular Engineering and Technology
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：6
• 期：2
• 页码：141-150
• 全文大小：982 KB
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• 作者单位：Elizabeth H. Stephens (1) (2)
  Patrick S. Connell (2)
  Monica M. Fahrenholtz (2)
  Tomasz A. Timek (3)
  George T. Daughters (4)
  Joyce J. Kuo (2)
  Aaron M. Patton (2)
  Neil B. Ingels (4) (5)
  D. Craig Miller (4) (5)
  K. Jane Grande-Allen (2) (6)
  
  1. Department of Cardiothoracic Surgery, Columbia University School of Medicine, New York, NY, USA
  2. Department of Bioengineering, Rice University, Houston, TX, USA
  3. Department of Cardiothoracic Surgery, Meijer Heart and Vascular Institute, Spectrum Health, Grand Rapids, MI, USA
  4. Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, USA
  5. Department of Cardiovascular Physiology and Biophysics, Research Institute, Palo Alto Medical Foundation, Palo Alto, CA, USA
  6. Bioengineering, Rice University, MS142, PO Box 1892, Houston, TX, 77251-1892, USA
  
• 刊物主题：Biomedical Engineering; Cardiology; Biomedicine general;
• 出版者：Springer US
• ISSN：1869-4098

文摘

To determine how extracellular matrix and contractile valvular cells contribute to the heterogeneous motion and strain across the mitral valve (MV) during the cardiac cycle, regional MV material properties, matrix composition, matrix turnover, and cell phenotype were related to regional leaflet strain. Radiopaque markers were implanted into 14 sheep to delineate the septal (SEPT), lateral (LAT), and anterior and posterior commissural leaflets (ANT-C, POST-C). Videofluoroscopy imaging was used to calculate radial and circumferential strains. Mechanical properties were assessed using uniaxial tensile testing and micropipette aspiration. Matrix composition and cell phenotypes were immunohistochemically evaluated within each leaflet region [basal leaflet (BL), mid-leaflet (ML), and free edge]. SEPT-BL segments were stiffer and stronger than other valve tissues, while LAT segments demonstrated more extensibility and strain. Collagens I and III in SEPT were greater than in LAT, although LAT showed greater collagen turnover [matrix metalloprotease (MMP)-13, lysyl oxidase] and cell activation [smooth muscle alpha-actin (SMaA), and non-muscle myosin (NMM)]. MMP13, NMM, and SMaA were strongly correlated with each other, as well as with radial and circumferential strains in both SEPT and LAT. SMaA and MMP13 in POST-C ML was greater than ANT-C, corresponding to greater radial strains in POST-C. This work directly relates leaflet strain, material properties, and matrix turnover, and suggests a role for myofibroblasts in the heterogeneity of leaflet composition and strain. New approaches to MV repair techniques and ring design should preserve this normal coupling between leaflet composition and motion.