{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:17:51Z","timestamp":1762917471752,"version":"3.38.0"},"reference-count":18,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,10,1]],"date-time":"2013-10-01T00:00:00Z","timestamp":1380585600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2013,10]]},"abstract":"<jats:sec><jats:title>Objective:<\/jats:title><jats:p> To determine whether the leaflets of bicuspid aortic valve (BAV) experience increased strain when compared to tricuspid aortic valve (TAV) leaflets. <\/jats:p><\/jats:sec><jats:sec><jats:title>Background:<\/jats:title><jats:p> The population at highest risk of aortic valve calcification (AVC) are individuals with BAVs. Currently, efforts to medically treat AVC are hampered by a limited understanding of the biomechanical forces involved in the molecular pathogenesis of AVC. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p> Surgically created BAVs and control TAVs were placed into a left heart simulator. Strains were calculated by comparing the distances between points on the aortic valve (AoV) leaflet during various time points during a simulated cardiac cycle. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p> The fused leaflets of BAVs experience significantly more strain during systole when compared to TAVs. Specifically, BAVs experience 24% strain ( P &lt; .0001) in the radial direction, parallel to the direction of blood flow, as compared to TAVs. There was peak difference of 4% ( P &lt; .001) in the circumferential direction. <\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion:<\/jats:title><jats:p> Based upon the data presented here, we are in the process of identifying how increased strain activates calcification-associated pathways in AoV cells. Future studies will examine whether these stretch responsive pathways can be blocked to inhibit calcification of BAVs. <\/jats:p><\/jats:sec>","DOI":"10.1177\/2150135113501901","type":"journal-article","created":{"date-parts":[[2013,10,10]],"date-time":"2013-10-10T19:44:37Z","timestamp":1381434277000},"page":"362-366","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Bicuspid Aortic Valves Experience Increased Strain as Compared to Tricuspid Aortic Valves"],"prefix":"10.1177","volume":"4","author":[{"given":"Kai","family":"Szeto","sequence":"first","affiliation":[{"name":"Department of Pediatrics (Cardiology), University of California San Diego, La Jolla, CA, USA"},{"name":"Department of Mechanical Engineering, University of California San Diego, La Jolla, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Pastuszko","sequence":"additional","affiliation":[{"name":"Department of Surgery (Cardiothoracic Surgery), University of California San Diego, La Jolla, CA, USA"},{"name":"Children\u2019s Mercy Hospital Kansas City, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan C. del","family":"\u00c1lamo","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of California San Diego, La Jolla, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan","family":"Lasheras","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, University of California San Diego, La Jolla, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vishal","family":"Nigam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics (Cardiology), University of California San Diego, La 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