The Etiological Heterogeneity of Bicuspid Aortopathy between Ascending and Root Morphotype

Heterogeneity of Bicuspid Aortopathy

Authors

  • Fei Li, MD Department of Structural Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Xuan Li, MD Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, USA
  • Yue-tang Wang, MD Department of Structural Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Chin
  • Cun-tao Yu, MD Department of Vascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Gang Yin, BS Department of Magnetic Resonance Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Xiu-yu Chen, MD Department of Magnetic Resonance Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Shi-hua Zhao, MD Department of Magnetic Resonance Imaging, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Wei Wang, MD Department of Structural Heart Disease, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  • Qi Gao, PhD School of Aeronautics and Astronautics, Zhejiang University, Hangzhou, China

DOI:

https://doi.org/10.1532/hsf.3333

Keywords:

Aortic Aneurysm, Wall Shear Stress, Matrix Metalloproteinases, 4D Flow CMR

Abstract

Background: Valve-related hemodynamics and intrinsically regulated matrix proteases are 2 determined pathogenetic factors associated with medial elastin degeneration in bicuspid aortopathy. This study analyzed the association between elastic fiber deterioration and the 2 pathogenetic factors in ascending and root morphotypes, aiming to elucidate the etiological heterogeneity between the 2 morphotypes.

Methods: Four-dimensional flow cardiac magnetic resonance was used to measure the regional wall shear stress (WSS) on the ascending aorta, and matrix metalloproteinase (MMP) expression was assessed by immunoblotting. After histopathology analysis of aortic tissue, we assessed whether elevated regional WSS and increased MMP expression corresponded with medial elastin thinning.

Results: Increased regional WSS corresponded with medial elastin thinning in both morphotypes. Increased expression of different MMP isoforms corresponded with medial elastin degeneration in bicuspid aortopathy. The significantly increased expression of MMP-2 corresponded with a decrease of elastic fiber thickness in the ascending morphotype (P = .046), whereas elastic fiber thinning was associated with high levels of MMP-3 expression (P = .012) in the root morphotype. No association was observed between regional WSS and MMP expression.

Conclusion: There is no difference in the effect of valve-related hemodynamics between ascending and root morphotype, and MMPs are not involved in the process of elastic fiber degeneration induced by increased WSS. The increased expression of different MMP isoforms was observed in the context of elastic fiber degeneration between the 2 morphotypes, implying that heterogeneity between them is revealed in the different intrinsic pathway of medial elastin degradation.

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Published

2020-12-22

How to Cite

Li, F., Li, X., Wang, Y.- tang, Yu, C.- tao, Yin, G., Chen, X.- yu, Zhao, S., Wang, W., & Gao, Q. (2020). The Etiological Heterogeneity of Bicuspid Aortopathy between Ascending and Root Morphotype: Heterogeneity of Bicuspid Aortopathy. The Heart Surgery Forum, 23(6), E913-E919. https://doi.org/10.1532/hsf.3333

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