{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:51:47Z","timestamp":1787169107589,"version":"build-2736575974"},"reference-count":53,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["MA 2432\/6-3"],"award-info":[{"award-number":["MA 2432\/6-3"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Commun Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A plethora of medical conditions, ranging from torn ligaments to aneurysmic blood vessels, are caused by failure of mechanically stressed biological tissues until rupture. Clearly prediction of the potential loci of tissue failure prior to rupture is highly desirable for prophylactic measures, preferentially in sufficiently early stages of the disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Mechanical heterogeneities are identified from local mechanical strains obtained from image sequences recorded during uniaxial tensile testing of reconstituted collagen (both, in experiments and finite element model (FEM) calculations) and horse aorta explants, respectively, as well as of the pulsating aorta using magnetic resonance imaging (MRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Within this work we present a comprehensive study on the biomechanical concept that percolated local mechanical strain heterogeneities can serve as valid indicators to predict the loci of tissue rupture already from straining behavior within the elastic regime. While we first experimentally validate the predictive capabilities of our strain percolation analysis for reconstituted rat tail collagen fibers and horse aorta explants, we unveil the structural origins of mechanical heterogeneities on the network level using FEM calculations based on digitized confocal laser scanning microscopy (CLSM) measurements. To demonstrate the diagnostic capabilities, we successfully predict potential occurrence and location of an aortic aneurysm in a patient with documented Marfan syndrome from MRI video sequences recorded of the pulsating aorta six years prior to surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Detection of local mechanical heterogeneities and their percolation behavior bears predictive capabilities for tissue failure before it actually has occurred and thus promises large potential for diagnostics and therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s43856-025-00897-5","type":"journal-article","created":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T10:57:25Z","timestamp":1748084245000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Prediction of tissue rupture from percolation of local strain heterogeneities for diagnostics"],"prefix":"10.1038","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5517-8282","authenticated-orcid":false,"given":"Friedrich","family":"Sch\u00fctte","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5355-6817","authenticated-orcid":false,"given":"Sabrina","family":"Friebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8986-4873","authenticated-orcid":false,"given":"Denny","family":"B\u00f6ttcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1046-1364","authenticated-orcid":false,"given":"Michael Andrew","family":"Borger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7985-9448","authenticated-orcid":false,"given":"Madlen","family":"Uhlemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0969-8738","authenticated-orcid":false,"given":"Stefan G.","family":"Mayr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"897_CR1","doi-asserted-by":"publisher","first-page":"20151081","DOI":"10.1098\/rsif.2015.1081","volume":"13","author":"E Comellas","year":"2016","unstructured":"Comellas, E., Gasser, T. C., Bellomo, F. J. & Oller, S. A homeostatic-driven turnover remodelling constitutive model for healing in soft tissues. J. R. Soc. Interface 13, 20151081 (2016).","journal-title":"J. R. Soc. Interface"},{"key":"897_CR2","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-019-08723-y","volume":"10","author":"K Bircher","year":"2019","unstructured":"Bircher, K., Z\u00fcndel, M., Pensalfini, M., Ehret, A. E. & Mazza, E. Tear resistance of soft collagenous tissues. Nat. Commun. 10, 792 (2019).","journal-title":"Nat. Commun."},{"key":"897_CR3","doi-asserted-by":"publisher","first-page":"704","DOI":"10.1016\/j.fertnstert.2020.01.037","volume":"113","author":"O Donnez","year":"2020","unstructured":"Donnez, O. Cesarean scar defects: management of an iatrogenic pathology whose prevalence has dramatically increased. Fertil. Steril. 113, 704\u2013716 (2020).","journal-title":"Fertil. Steril."},{"key":"897_CR4","doi-asserted-by":"publisher","first-page":"1613","DOI":"10.1016\/j.jvs.2015.01.040","volume":"63","author":"AJ Boyd","year":"2016","unstructured":"Boyd, A. J., Kuhn, D. C., Lozowy, R. J. & Kulbisky, G. P. Low wall shear stress predominates at sites of abdominal aortic aneurysm rupture. J. Vasc. Surg. 63, 1613\u20131619 (2016).","journal-title":"J. Vasc. Surg."},{"key":"897_CR5","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1038\/s41569-020-00472-6","volume":"18","author":"E Bossone","year":"2021","unstructured":"Bossone, E. & Eagle, K. A. Epidemiology and management of aortic disease: aortic aneurysms and acute aortic syndromes. Nat. Rev. Cardiol. 18, 331\u2013348 (2021).","journal-title":"Nat. Rev. Cardiol."},{"key":"897_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1053\/j.semtcvs.2021.02.029","volume":"34","author":"R Gouveia e Melo","year":"2022","unstructured":"Gouveia e Melo, R. et al. Incidence and prevalence of thoracic aortic aneurysms: a systematic review and meta-analysis of population-based studies. Semin. Thorac. Cardiovasc. Surg. 34, 1\u201316 (2022).","journal-title":"Semin. Thorac. Cardiovasc. Surg."},{"key":"897_CR7","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1002\/bjs.8840","volume":"99","author":"T Kr\u00fcger","year":"2012","unstructured":"Kr\u00fcger, T. et al. Acute aortic dissection type a. J. Br. Surg. 99, 1331\u20131344 (2012).","journal-title":"J. Br. Surg."},{"key":"897_CR8","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1108\/02644401011008531","volume":"27","author":"R Layman","year":"2010","unstructured":"Layman, R., Missoum, S. & Vande Geest, J. Simulation and probabilistic failure prediction of grafts for aortic aneurysm. Eng. Comput. 27, 84\u2013105 (2010).","journal-title":"Eng. Comput."},{"key":"897_CR9","first-page":"13","volume":"7","author":"S Baek","year":"2020","unstructured":"Baek, S. A deep learning approach to predict abdominal aortic aneurysm expansion using longitudinal data. Front. Phys. 7, 13 (2020).","journal-title":"Front. Phys."},{"key":"897_CR10","doi-asserted-by":"crossref","unstructured":"Jana, S., Hu, M., Shen, M. & Kassiri, Z. Extracellular matrix, regional heterogeneity of the aorta, and aortic aneurysm. Exp. Mol. Med. 51, 1\u201315 (2019).","DOI":"10.1038\/s12276-019-0286-3"},{"key":"897_CR11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-017-1302-z","volume":"17","author":"G Astatikie","year":"2017","unstructured":"Astatikie, G., Limenih, M. A. & Kebede, M. Maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture. BMC Pregnancy Childbirth 17, 1\u20139 (2017).","journal-title":"BMC Pregnancy Childbirth"},{"key":"897_CR12","doi-asserted-by":"crossref","unstructured":"Von Forell, G. A., Hyoung, P. S. & Bowden, A. E. Failure modes and fracture toughness in partially torn ligaments and tendons. J. Mech. Behav. Biomed. Mater. 8, 77\u201384 (2014).","DOI":"10.1016\/j.jmbbm.2014.03.020"},{"key":"897_CR13","doi-asserted-by":"publisher","DOI":"10.1038\/ncomms7649","volume":"6","author":"W Yang","year":"2015","unstructured":"Yang, W. et al. On the tear resistance of skin. Nat. Commun. 6, 6649 (2015).","journal-title":"Nat. Commun."},{"key":"897_CR14","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/0002-9378(90)91059-L","volume":"163","author":"C Chazotte","year":"1990","unstructured":"Chazotte, C. & Cohen, W. R. Catastrophic complications of previous cesarean section. Am. J. Obstet. Gynecol. 163, 738\u2013742 (1990).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"897_CR15","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1016\/0002-9378(93)90032-E","volume":"169","author":"AS Leung","year":"1993","unstructured":"Leung, A. S., Leung, E. K. & Paul, R. H. Uterine rupture after previous cesarean delivery: maternal and fetal consequences. Am. J. Obstet. Gynecol. 169, 945\u2013950 (1993).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"897_CR16","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1016\/j.arthro.2005.12.021","volume":"22","author":"FA Barber","year":"2006","unstructured":"Barber, F. A., Herbert, M. A. & Coons, D. A. Tendon augmentation grafts: biomechanical failure loads and failure patterns. Arthroscopy 22, 534\u2013538 (2006).","journal-title":"Arthroscopy"},{"key":"897_CR17","doi-asserted-by":"publisher","first-page":"081010","DOI":"10.1115\/1.4027730","volume":"136","author":"IR Grosse","year":"2014","unstructured":"Grosse, I. R., Huang, L., Davis, J. L. & Cullinane, D. A multilevel hierarchical finite element model for capillary failure in soft tissue. J. Biomech. Eng. 136, 081010 (2014).","journal-title":"J. Biomech. Eng."},{"key":"897_CR18","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/s10237-016-0814-1","volume":"16","author":"M Rausch","year":"2017","unstructured":"Rausch, M., Karniadakis, G. & Humphrey, J. Modeling soft tissue damage and failure using a combined particle\/continuum approach. Biomech. Model. Mechanobiol. 16, 249\u2013261 (2017).","journal-title":"Biomech. Model. Mechanobiol."},{"key":"897_CR19","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-29111-z","volume":"13","author":"DQ Nesbitt","year":"2023","unstructured":"Nesbitt, D. Q., Burruel, D. E., Henderson, B. S. & Lujan, T. J. Finite element modeling of meniscal tears using continuum damage mechanics and digital image correlation. Sci. Rep. 13, 4039 (2023).","journal-title":"Sci. Rep."},{"key":"897_CR20","doi-asserted-by":"publisher","first-page":"2056","DOI":"10.1007\/s10439-023-03233-x","volume":"51","author":"VD Sree","year":"2023","unstructured":"Sree, V. D., Toaquiza-Tubon, J. D., Payne, J., Solorio, L. & Tepole, A. B. Damage and fracture mechanics of porcine subcutaneous tissue under tensile loading. Ann. Biomed. Eng. 51, 2056\u20132069 (2023).","journal-title":"Ann. Biomed. Eng."},{"key":"897_CR21","doi-asserted-by":"crossref","unstructured":"Zimmerman, B. K., Maas, S. A., Weiss, J. A. & Ateshian, G. A. Modeling fatigue failure of cartilage and fibrous biological tissues using constrained reactive mixture theory. J. Biomech. Eng. 146, 121001 (2024).","DOI":"10.1115\/1.4066219"},{"key":"897_CR22","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1136\/bjsm.2005.018416","volume":"39","author":"R Kayser","year":"2005","unstructured":"Kayser, R., Mahlfeld, K. & Heyde, C. E. Partial rupture of the proximal achilles tendon: a differential diagnostic problem in ultrasound imaging. Br. J. Sports Med. 39, 838\u2013842 (2005).","journal-title":"Br. J. Sports Med."},{"key":"897_CR23","doi-asserted-by":"publisher","first-page":"104284","DOI":"10.1016\/j.jmbbm.2020.104284","volume":"115","author":"X He","year":"2021","unstructured":"He, X., Avril, S. & Lu, J. Prediction of local strength of ascending thoracic aortic aneurysms. J. Mech. Behav. Biomed. Mater. 115, 104284 (2021).","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"897_CR24","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-018-0287-7","volume":"6","author":"T Fukui","year":"2018","unstructured":"Fukui, T. Management of acute aortic dissection and thoracic aortic rupture. J. Intensive Care 6, 15 (2018).","journal-title":"J. Intensive Care"},{"key":"897_CR25","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1038\/s41586-020-2612-2","volume":"584","author":"O Chaudhuri","year":"2020","unstructured":"Chaudhuri, O., Cooper-White, J., Janmey, P. A., Mooney, D. J. & Shenoy, V. B. Effects of extracellular matrix viscoelasticity on cellular behaviour. Nature 584, 535\u2013546 (2020).","journal-title":"Nature"},{"key":"897_CR26","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1016\/j.jmbbm.2011.09.018","volume":"6","author":"D Taylor","year":"2012","unstructured":"Taylor, D., O\u2019Mara, N., Ryan, E., Takaza, M. & Simms, C. The fracture toughness of soft tissues. J. Mech. Behav. Biomed. Mater. 6, 139\u2013147 (2012).","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"897_CR27","doi-asserted-by":"publisher","first-page":"101008","DOI":"10.1115\/1.4043520","volume":"141","author":"BN Safa","year":"2019","unstructured":"Safa, B. N., Lee, A. H., Santare, M. H. & Elliott, D. M. Evaluating plastic deformation and damage as potential mechanisms for tendon inelasticity using a reactive modeling framework. J. Biomech. Eng. 141, 101008 (2019).","journal-title":"J. Biomech. Eng."},{"key":"897_CR28","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/0001-6160(79)90055-5","volume":"27","author":"A Argon","year":"1979","unstructured":"Argon, A. Plastic deformation in metallic glasses. Acta Metall. 27, 47\u201358 (1979).","journal-title":"Acta Metall."},{"key":"897_CR29","doi-asserted-by":"publisher","first-page":"7192","DOI":"10.1103\/PhysRevE.57.7192","volume":"57","author":"ML Falk","year":"1998","unstructured":"Falk, M. L. & Langer, J. S. Dynamics of viscoplastic deformation in amorphous solids. Phys. Rev. E 57, 7192\u20137205 (1998).","journal-title":"Phys. Rev. E"},{"key":"897_CR30","doi-asserted-by":"publisher","first-page":"195501","DOI":"10.1103\/PhysRevLett.97.195501","volume":"97","author":"SG Mayr","year":"2006","unstructured":"Mayr, S. G. Activation energy of shear transformation zones: a key for understanding rheology of glasses and liquids. Phys. Rev. Lett. 97, 195501 (2006).","journal-title":"Phys. Rev. Lett."},{"key":"897_CR31","doi-asserted-by":"publisher","first-page":"172203","DOI":"10.1103\/PhysRevB.73.172203","volume":"73","author":"M Zink","year":"2006","unstructured":"Zink, M., Samwer, K., Johnson, W. L. & Mayr, S. G. Plastic deformation of metallic glasses: size of shear transformation zones from molecular dynamics simulations. Phys. Rev. B 73, 172203 (2006).","journal-title":"Phys. Rev. B"},{"key":"897_CR32","doi-asserted-by":"crossref","unstructured":"Schuette, F. & Mayr, S. G. Electron beam-modified collagen type i fibers: Synthesis and characterization of mechanical response. ACS Biomater. Sci. Eng. 10, 782\u2013790 (0).","DOI":"10.1021\/acsbiomaterials.3c01072"},{"key":"897_CR33","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.actbio.2021.09.025","volume":"140","author":"N Wilharm","year":"2022","unstructured":"Wilharm, N. et al. Biomimetic crosslinking of collagen gels by energetic electrons: the role of l-lysine. Acta Biomater. 140, 219\u2013232 (2022).","journal-title":"Acta Biomater."},{"key":"897_CR34","doi-asserted-by":"crossref","unstructured":"Blaber, J., Adair, B. & Antoniou, A. Ncorr: open-source 2d digital image correlation matlab software. Exp. Mech. 55, 1105\u20131122 (2015).","DOI":"10.1007\/s11340-015-0009-1"},{"key":"897_CR35","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1016\/S0140-6736(05)67789-6","volume":"366","author":"DP Judge","year":"2005","unstructured":"Judge, D. P. & Dietz, H. C. Marfan\u2019s syndrome. Lancet 366, 1965\u20131976 (2005).","journal-title":"Lancet"},{"key":"897_CR36","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-48830-w","volume":"9","author":"N Wilharm","year":"2019","unstructured":"Wilharm, N. et al. Energetic electron assisted synthesis of highly tunable temperature-responsive collagen\/elastin gels for cyclic actuation: macroscopic switching and molecular origins. Sci. Rep. 9, 1\u20137 (2019).","journal-title":"Sci. Rep."},{"key":"897_CR37","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1111\/j.1365-2818.2008.02141.x","volume":"232","author":"AM Stein","year":"2008","unstructured":"Stein, A. M., Vader, D. A., Jawerth, L. M., Weitz, D. A. & Sander, L. M. An algorithm for extracting the network geometry of three-dimensional collagen gels. J. Microsc. 232, 463\u2013475 (2008).","journal-title":"J. Microsc."},{"key":"897_CR38","unstructured":"Stein, A. M. Fiber extraction (fire) https:\/\/github.com\/uw-loci\/fiber-extraction (2009)."},{"key":"897_CR39","unstructured":"MATLAB. Version 9.3.0 (R2017b) (The MathWorks Inc., Natick, Massachusetts, 2017)."},{"key":"897_CR40","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1080\/14786446408643663","volume":"27","author":"JC Maxwell","year":"1864","unstructured":"Maxwell, J. C. XlV. On reciprocal figures and diagrams of forces. Lond., Edinb., Dublin Philos. Mag. J. Sci. 27, 250\u2013261 (1864).","journal-title":"Lond., Edinb., Dublin Philos. Mag. J. Sci."},{"key":"897_CR41","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/0045-7825(85)90050-7","volume":"49","author":"JC Simo","year":"1985","unstructured":"Simo, J. C. A finite strain beam formulation. The three-dimensional dynamic problem. Part i. Comput. Methods Appl. Mech. Eng. 49, 55\u201370 (1985).","journal-title":"Comput. Methods Appl. Mech. Eng."},{"key":"897_CR42","unstructured":"Electricit\u00e9 de France. Finite element code Aster. Open source on https:\/\/www.code-aster.org (1989\u20132022)."},{"key":"897_CR43","unstructured":"EDF-CEA. Salome. Open source on https:\/\/www.salome-platform.org (2022)."},{"key":"897_CR44","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/0045-7825(86)90079-4","volume":"58","author":"JC Simo","year":"1986","unstructured":"Simo, J. C. & Vu-Quoc, L. A three-dimensional finite-strain rod model. Part ii: computational aspects. Comput. Methods Appl. Mech. Eng. 58, 79\u2013116 (1986).","journal-title":"Comput. Methods Appl. Mech. Eng."},{"key":"897_CR45","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1016\/0045-7825(88)90073-4","volume":"66","author":"JC Simo","year":"1988","unstructured":"Simo, J. C. & Vu-Quoc, L. On the dynamics in space of rods undergoing large motions-a geometrically exact approach. Comput. Methods Appl. Mech. Eng. 66, 125\u2013161 (1988).","journal-title":"Comput. Methods Appl. Mech. Eng."},{"key":"897_CR46","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1137\/S0895479899358194","volume":"23","author":"P Amestoy","year":"2001","unstructured":"Amestoy, P., Duff, I. S., Koster, J. & L\u2019Excellent, J.-Y. A fully asynchronous multifrontal solver using distributed dynamic scheduling. SIAM J. Matrix Anal. Appl. 23, 15\u201341 (2001).","journal-title":"SIAM J. Matrix Anal. Appl."},{"key":"897_CR47","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1145\/45054.214374","volume":"14","author":"RJ Renka","year":"1988","unstructured":"Renka, R. J. Algorithm 661: Qshep3d: quadratic shepard method for trivariate interpolation of scattered data. ACM Trans. Math. Softw. 14, 151\u2013152 (1988).","journal-title":"ACM Trans. Math. Softw."},{"key":"897_CR48","doi-asserted-by":"crossref","unstructured":"Wilharm, N., Fischer, T., Hayn, A. & Mayr, S. G. Structural breakdown of collagen type i elastin blend polymerization. Polymers 14, 4434 (2022).","DOI":"10.3390\/polym14204434"},{"key":"897_CR49","doi-asserted-by":"publisher","first-page":"1532","DOI":"10.1152\/ajplegacy.1967.213.6.1532","volume":"213","author":"Y Fung","year":"1967","unstructured":"Fung, Y. Elasticity of soft tissues in simple elongation. Am. J. Physiol. Leg. Content 213, 1532\u20131544 (1967).","journal-title":"Am. J. Physiol. Leg. Content"},{"key":"897_CR50","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1111\/evj.12110","volume":"46","author":"J Bowser","year":"2014","unstructured":"Bowser, J. et al. Tensile properties in collagen-rich tissues of quarter horses with hereditary equine regional dermal asthenia (herda). Equine Vet. J. 46, 216\u2013222 (2014).","journal-title":"Equine Vet. J."},{"key":"897_CR51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12917-015-0597-0","volume":"11","author":"V Saey","year":"2015","unstructured":"Saey, V. et al. Biomechanical and biochemical properties of the thoracic aorta in warmblood horses, friesian horses, and friesians with aortic rupture. BMC Vet. Res. 11, 1\u20137 (2015).","journal-title":"BMC Vet. Res."},{"key":"897_CR52","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1590\/S1516-31802010000600009","volume":"128","author":"S-M Yuan","year":"2010","unstructured":"Yuan, S.-M. & Jing, H. Marfan\u2019s syndrome: an overview. Sao Paulo Med. J. 128, 360\u2013366 (2010).","journal-title":"Sao Paulo Med. J."},{"key":"897_CR53","doi-asserted-by":"publisher","first-page":"e334","DOI":"10.1161\/CIR.0000000000001106","volume":"146","author":"EM Isselbacher","year":"2022","unstructured":"Isselbacher, E. M. et al. 2022 ACC\/AHA guideline for the diagnosis and management of aortic disease: a report of the American heart association\/american college of cardiology joint committee on clinical practice guidelines. Circulation 146, e334\u2013e482 (2022).","journal-title":"Circulation"}],"container-title":["Communications Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s43856-025-00897-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43856-025-00897-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s43856-025-00897-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T12:02:51Z","timestamp":1748088171000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s43856-025-00897-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["897"],"URL":"https:\/\/doi.org\/10.1038\/s43856-025-00897-5","relation":{},"ISSN":["2730-664X"],"issn-type":[{"value":"2730-664X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,24]]},"assertion":[{"value":"19 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"M.A.B. declares that his hospital receives speakers\u2019 honoraria and\/or consulting fees on his behalf from Edwards Lifesciences, Medtronic, Abbott, and Artivion. F.S., S.F., D.B., M.U., and S.G.M. declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"197"}}