{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T12:14:01Z","timestamp":1788956041799,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Imperial College Biomedical Research Centre","award":["P69559 and P74143"],"award-info":[{"award-number":["P69559 and P74143"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p\/>\n               <jats:sec>\n                  <jats:title>OBJECTIVES<\/jats:title>\n                  <jats:p>This study aims to characterize the material properties of ascending thoracic aortic aneurysmal tissue, using regional biomechanical assessment of both tensile and dissection propagation peel strength.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>Thirty-four aneurysm specimens (proximal thoracic aorta) were harvested en-bloc from patients undergoing surgery for aneurysm replacement. Specimens were processed into regional samples of similar shapes covering the whole aneurysm isosurface, according to a structured protocol, in both orientations (longitudinal and circumferential). Thickness mapping, uniaxial tensile and peel tests were conducted, enabling calculation of the following parameters: true stress\/strain, tangential modulus, tensile strength, peeling force and dissection energy. Two constitutive material models were used (hyperelastic models of Delfino and Ogden) to fit the data. A circumferential strip of tissue was also obtained for computational histology [regional quantification of (i) elastin, (ii) collagen and (iii) smooth muscle cells].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>The aortic wall was thinner on the outer curve (2.21, standard deviation (SD) 0.4\u2009mm vs inner curve 2.50, SD 0.12\u2009mm). Advanced patient age and higher pulse wave velocity (externally measured) were predictors of increased aortic wall thickness. Tensile strength was higher in the circumferential versus longitudinal direction when analysed according to anatomical regions. Both peel force (35.5, 22\u2009N\/m) and dissection energy (88.5, 69 J\/m2) were on average lowest at the outer curve of the aneurysm in the longitudinal orientation. Delfino and Ogden model constants varied throughout anatomical regions, with the outer curve being associated a higher \u0251 constant (Delfino) and lower \u00b51 constant (Ogden) (P\u2009&amp;lt;\u20090.05) indicating increased stiffness. Histologically, collagen abundance was significantly related to circumferential and longitudinal strength (P=\u20090.010), whilst smooth muscle cell count had no relation with any mechanical property (P &amp;gt;\u20090.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our results suggest that the outer aortic curve is more prone to dissection propagation and perhaps less prone to rupture than the inner aortic curve. This strengthens the notion of disease heterogeneity in ascending thoracic aortic aneurysms and has implications for the pathogenesis of aortic dissection.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ejcts\/ezac392","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T14:50:30Z","timestamp":1658933430000},"source":"Crossref","is-referenced-by-count":27,"title":["Regional variation in biomechanical properties of ascending thoracic aortic aneurysms"],"prefix":"10.1093","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-1294","authenticated-orcid":false,"given":"M Yousuf","family":"Salmasi","sequence":"first","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumesh","family":"Sasidharan","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Faculty of Engineering, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Frattolin","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Faculty of Engineering, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lowell","family":"Edgar","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Faculty of Engineering, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Stock","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Transplantation, Royal Brompton and Harefield Foundation Trust , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2525-5515","authenticated-orcid":false,"given":"Thanos","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Department of Surgery and Cancer, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Moore Jr","sequence":"additional","affiliation":[{"name":"Department of Bioengineering, Faculty of Engineering, Imperial College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"2022120817034505800_ezac392-B1","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1038\/nrcardio.2009.191","article-title":"Cellular and molecular mechanisms of thoracic aortic aneurysms","volume":"6","author":"El-Hamamsy","year":"2009","journal-title":"Nat Rev Cardiol"},{"key":"2022120817034505800_ezac392-B2","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1161\/CIRCULATIONAHA.110.958975","article-title":"Acute aortic dissection: clinician update","volume":"122","author":"Braverman","year":"2010","journal-title":"Circulation"},{"key":"2022120817034505800_ezac392-B3","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1093\/eurheartj\/ehu281","article-title":"2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. 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