scholarly journals Avalanches and power law behavior in aortic dissection propagation

2020 ◽  
Vol 6 (21) ◽  
pp. eaaz1173 ◽  
Author(s):  
Xunjie Yu ◽  
Béla Suki ◽  
Yanhang Zhang
Keyword(s):  
Cardiovascular Disease ◽  
Extracellular Matrix ◽  
Aortic Dissection ◽  
Power Law ◽  
Model Prediction ◽  
Strain Energy ◽  
Quantitative Agreement ◽  
High Morbidity ◽  
Failure Mechanics ◽  
Microscopic Features

Aortic dissection is a devastating cardiovascular disease known for its rapid propagation and high morbidity and mortality. The mechanisms underlying the propagation of aortic dissection are not well understood. Our study reports the discovery of avalanche-like failure of the aorta during dissection propagation that results from the local buildup of strain energy followed by a cascade failure of inhomogeneously distributed interlamellar collagen fibers. An innovative computational model was developed that successfully describes the failure mechanics of dissection propagation. Our study provides the first quantitative agreement between experiment and model prediction of the dissection propagation within the complex extracellular matrix (ECM). Our results may lead to the possibility of predicting such catastrophic events based on microscopic features of the ECM.

scholarly journals Aortic Aneurysm and Dissection in Pregnancy: Report of a Rare Case in a Marfan with Bicuspid Aortic Valve

2020 ◽  
Vol 5 (04) ◽  
pp. 331-334
Author(s):  
Paolo Masiello ◽  
Rocco Leone ◽  
Rossella Maria Benvenga ◽  
Severino Iesu
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Aortic Arch ◽  
Bicuspid Aortic Valve ◽  
Rare Case ◽  
Unplanned Pregnancy ◽  
Type A ◽  
Cardiac Biomarkers ◽  
High Morbidity ◽  
Type A Aortic Dissection

Abstract Background Type A aortic dissection is an emergency with high morbidity and mortality when surgery is not performed. Few cases are described in the literature about aortic dissection during pregnancy. A correlation between pregnancy and aortic dissection is mainly reported in patients with family history and connective tissue disorders, such as Marfan’s syndrome (MS), Loeys–Dietz’s syndrome, and Ehlers–Danlos’s syndromes, and patients with bicuspid aortic valve (BAV); exceptional cases are also described in patients without risk factors. Case presentation A 22-year-old young woman with MS, ascending aorta dilation, and BAV became pregnant. During labor, she experienced a short-term chest pain with spontaneous resolution. The electrocardiogram (ECG) and cardiac biomarkers were negative for acute coronary artery disease, but no transthoracic echocardiogram (TTE) was performed. A caesarean section was performed without complications. After 1 month, a routine TTE showed a chronic ascending aortic dissection involving the aortic arch and supra-aortic vessels. Due to a normally functioning aortic valve, the David operation was performed (sparing aortic valve) with the replacement of the aortic arch and supra-aortic vessels. Conclusions Aortic dissection is a rare cardiovascular complication that can occur during pregnancy and is associated with very high-risk mortality. We have reported a rare case of undiagnosed type A aortic dissection involving the aortic arch during unplanned pregnancy in patients with BAV and MS, subsequently treated with the David surgery and replacement of ascending aortic arch and supra-aortic vessels. A closer clinical and instrumental follow-up is necessary in this particular group of patients at risk. Awareness of all physicians involved is mandatory.

scholarly journals Engineering cardiac microphysiological systems to model pathological extracellular matrix remodeling

2018 ◽  
Vol 315 (4) ◽  
pp. H771-H789 ◽  
Author(s):  
Nethika R. Ariyasinghe ◽  
Davi M. Lyra-Leite ◽  
Megan L. McCain
Keyword(s):  
Cardiovascular Disease ◽  
Extracellular Matrix ◽  
Myocardial Function ◽  
Myocardial Cell ◽  
Three Dimensions ◽  
Model Systems ◽  
Matrix Remodeling ◽  
Ecm Remodeling ◽  
Microphysiological Systems

Many cardiovascular diseases are associated with pathological remodeling of the extracellular matrix (ECM) in the myocardium. ECM remodeling is a complex, multifactorial process that often contributes to declines in myocardial function and progression toward heart failure. However, the direct effects of the many forms of ECM remodeling on myocardial cell and tissue function remain elusive, in part because conventional model systems used to investigate these relationships lack robust experimental control over the ECM. To address these shortcomings, microphysiological systems are now being developed and implemented to establish direct relationships between distinct features in the ECM and myocardial function with unprecedented control and resolution in vitro. In this review, we will first highlight the most prominent characteristics of ECM remodeling in cardiovascular disease and describe how these features can be mimicked with synthetic and natural biomaterials that offer independent control over multiple ECM-related parameters, such as rigidity and composition. We will then detail innovative microfabrication techniques that enable precise regulation of cellular architecture in two and three dimensions. We will also describe new approaches for quantifying multiple aspects of myocardial function in vitro, such as contractility, action potential propagation, and metabolism. Together, these collective technologies implemented as cardiac microphysiological systems will continue to uncover important relationships between pathological ECM remodeling and myocardial cell and tissue function, leading to new fundamental insights into cardiovascular disease, improved human disease models, and novel therapeutic approaches.

Aortic Aneurysm

2018 ◽  
Author(s):  
Christine E Lee ◽  
Leily Naraghi ◽  
Beatrice Hoffmann
Keyword(s):  
Aortic Aneurysm ◽  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Aortic Disease ◽  
Magnetic Resonance Images ◽  
Aortic Aneurysms ◽  
High Morbidity ◽  
Aortic Diseases ◽  
Decision Algorithm ◽  
Type B Dissection

Aortic diseases are relatively rare but are associated with high morbidity and mortality. Emergency physicians (EPs) should consider aortic disease in all patients with pain in the torso, particularly those with other diverse or seemingly unconnected complaints. This review summarizes the pathophysiology, stabilization and assessment, diagnosis and treatment, and disposition and outcomes for patients with abdominal aortic aneurysms (AAAs), thoracic aortic aneurysms (TAAs), and aortic dissection. Figures show a transverse image of an AAAs with a transmural hematoma, a three-dimensional computed tomographic angiogram (CTA) rendering of a thoracic aneurysm associated with a bicuspid aortic valve in the typical ascending aortic location, a chest x-ray film demonstrating prominent and blurred aortic knob due to TAA, acute aortic dissection subtypes, an electrocardiogram and transesophageal echocardiography of a patient with acute ascending aortic dissection, magnetic resonance images of a patient with dissection of the proximal descending aorta, CT representations of a type A dissection involving a dilated ascending aorta and a type B dissection involving the descending thoracic aorta, and a decision algorithm for evaluation and treatment of a suspected aortic dissection. Tables list normal aortic dimensions by CTA and echocardiography, average annual rate of expansion and rupture of AAA based on current diameter, and the etiology of TAA. Key words: AAA, aorta, aortic dissection, ascending aortic dissection, descending aortic dissection, intimal tear, intramural hematoma, thoracic aortic aneurysm

scholarly journals Cell-derived biomimetic nanoparticles as a novel drug delivery system for atherosclerosis: predecessors and perspectives

2020 ◽  
Vol 7 (4) ◽  
pp. 349-358
Author(s):  
Long Yang ◽  
Guangchao Zang ◽  
Jingwen Li ◽  
Xinyue Li ◽  
Yuanzhu Li ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Drug Delivery ◽  
Precision Medicine ◽  
Blood Circulation ◽  
Drug Delivery Systems ◽  
High Morbidity ◽  
Whole Cells ◽  
Biomimetic Nanoparticles ◽  
Novel Drug Delivery System ◽  
Novel Drug

Abstract Atherosclerosis is a key mechanism underlying the pathogenesis of cardiovascular disease, which is associated with high morbidity and mortality. In the field of precision medicine for the treatment of atherosclerosis, nanoparticle (NP)-mediated drug delivery systems have great potential, owing to their ability to release treatment locally. Cell-derived biomimetic NPs have attracted extensive attention at present due to their excellent targeting to atherosclerotic inflammatory sites, low immunogenicity and long blood circulation time. Here, we review the utility of cell-derived biomimetic NPs, including whole cells, cell membranes and extracellular vesicles, in the treatment of atherosclerosis.

Statins and menopausal health

2002 ◽  
Vol 8 (4) ◽  
pp. 141-146 ◽  
Author(s):  
Alfred O Mueck ◽  
Harald Seeger
Keyword(s):  
Cardiovascular Disease ◽  
Vascular Tissue ◽  
Hormone Replacement ◽  
Lipid Lowering ◽  
High Morbidity ◽  
Vascular Effects ◽  
Important Conclusion ◽  
Beneficial Effects ◽  
Specific Effects ◽  
Smooth Muscle Proliferation

Cardiovascular disease is associated with high morbidity and mortality. Cholesterol-lowering statins can reduce health risks both in men and women. While this benefit has thus far been attributed to the lipid-lowering effects of these drugs, the importance of their direct actions on vascular tissue is gaining more recognition. Furthermore, recent studies suggest that statins might also be effective in preventing osteoporosis and Alzheimer's disease. Equally interesting are experimental results showing that statins may inhibit growth of certain malignancies such as the breast. When statins are combined with hormone replacement therapy (HRT), even greater beneficial effects on the lipid profile can be obtained. To our knowledge we have investigated for the first time direct vascular effects by combining statins with HRT. We were able to identify significant beneficial effects on endothelial function and vascular smooth muscle proliferation. In the context of current discussions on the benefits and risks of HRT in treating patients with pre-existing cardiovascular disease, it appears particularly important that interventional studies should be conducted to evaluate the therapeutic relevance of statin/HRT combinations. At present, this is the most important conclusion drawn from the data collected thus far on the combination of these two drug types. There is some evidence suggesting drug-specific effects, particularly adverse reactions and statin interactions, which should be considered when using this combination therapy.

scholarly journals Calculation of a beam on an inhomogeneous basis

2018 ◽  
Vol 251 ◽  
pp. 04023
Author(s):  
Nikolaj Atarov
Keyword(s):  
Numerical Calculation ◽  
Power Law ◽  
Modulus Of Elasticity ◽  
Strain Energy ◽  
Deformation Modulus ◽  
Bending Moment ◽  
System Of Differential Equations ◽  
Total Potential ◽  
Modulus Of Deformation ◽  
Symmetric Load

The questions of analytical calculating the beam on the base with the modulus of deformation (modulus of elasticity), which is changed by thickness of the layer by power law, was deals in the article. The purpose of work was receiving finite expressions for reactive pressure of the basе on a beam and internal efforts in a beam when using model of the base with two characteristics (coefficient of subgrade resistance). A system of differential equations second-order with respect to the displacements of points the surface of a layer with a continuously changing modulus of elasticity was obtained based on the minimum of the total potential strain energy. The calculation of the rigid beam on the base on the action of the symmetric load was performed and the formulas for the reactive pressures of the base were got. Numerical calculation is executed and the analysis of influence of change of the module of deformation of a layer by the amount of reactive pressure and the bending moment in a beam was given. It is shown that with increase in the module of deformation on layer thickness the basе with two characteristics on nature of work is approaching vinklerovsky.

Role of proteolysis in development of murine adipose tissue

2008 ◽  
Vol 99 (02) ◽  
pp. 290-294 ◽  
Author(s):  
Valerie Christiaens ◽  
Ilse Scroyen ◽  
H. Roger Lijnen
Keyword(s):  
Cardiovascular Disease ◽  
Extracellular Matrix ◽  
Adipose Tissue ◽  
Transgenic Mice ◽  
Matrix Metalloproteinase ◽  
Proteolytic Activity ◽  
Mortality And Morbidity ◽  
Common Disorder

SummaryObesity is a common disorder, and related diseases such as diabetes, atherosclerosis, hypertension, cardiovascular disease and cancer are a major cause of mortality and morbidity inWesterntype societies. Development of obesity is associated with extensive modifications in adipose tissue involving adipogenesis, angiogenesis and extracellular matrix proteolysis. The fibrinolytic (plasminogen/plasmin) and matrix metalloproteinase (MMP) systems cooperate in these processes. A nutritionally induced obesity model in transgenic mice has been used extensively to study the role of the fibrinolytic and MMP systems in the development of obesity. These studies support a role of both systems in adipogenesis and obesity, and suggest that modulation of proteolytic activity may affect development of adipose tissue.

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