Novel Methodology for Characterizing Regional Variations in the Material Properties of Murine Aortas

Aortic diameter is a poor predictor of aortic tissue failure metrics in patients with ascending aneurysms

OBJECTIVES

There is growing consensus that aortic diameter is a flawed predictor of aortic dissection risk. We hypothesized that aortic tissue metrics would be better predicted by clinical metrics other than aortic diameter. Our objectives were to (1) characterize circumferential aortic failure stress and stretch as a result of aortic size and patient demographics, and (2) identify the influence of bicuspid aortic valve on failure metrics.

METHODS

From February 2018 to January 2021, 136 aortic tissue samples were obtained from 86 adults undergoing elective ascending aorta repair. Uniaxial biomechanical testing to failure, defined as a full-thickness central tear, was performed to obtain tissue failure stress and failure stretch and compared with clinical data and preoperative computed tomography imaging. The relationships among aortic diameter, patient demographics, and failure metrics were assessed using random forest regression models.

RESULTS

Median failure stress was 1.46 (1.02-1.94) megapascals, and failure stretch was 1.36 (1.27-1.54). Regression models correlated moderately with failure stress (R2 = 0.557) and highly with failure stretch (R2 = 0.806). Failure stress decreased with increasing age, lower body mass index, thicker tissue, and tricuspid aortic valves, whereas failure stretch was most highly correlated with age. Aortic area-to-height index outperformed aortic diameter in all models.

CONCLUSIONS

Aneurysmal ascending aortic tissue failure metrics correlated with available clinical metrics. Greater tissue thickness, older age, and tricuspid aortic valve morphology outperformed aortic diameter, warranting further investigation into the role of a patient-specific multifactorial dissection risk assessment over aortic diameter as a sole marker of aortic tissue integrity.

Stereo Camera Setup for 360° Digital Image Correlation to Reveal Smart Structures of Hakea Fruits

About forty years after its first application, digital image correlation (DIC) has become an established method for measuring surface displacements and deformations of objects under stress. To date, DIC has been used in a variety of in vitro and in vivo studies to biomechanically characterise biological samples in order to reveal biomimetic principles. However, when surfaces of samples strongly deform or twist, they cannot be thoroughly traced. To overcome this challenge, different DIC setups have been developed to provide additional sensor perspectives and, thus, capture larger parts of an object's surface. Herein, we discuss current solutions for this multi-perspective DIC, and we present our own approach to a 360° DIC system based on a single stereo-camera setup. Using this setup, we are able to characterise the desiccation-driven opening mechanism of two woody Hakea fruits over their entire surfaces. Both the breaking mechanism and the actuation of the two valves in predominantly dead plant material are models for smart materials. Based on these results, an evaluation of the setup for 360° DIC regarding its use in deducing biomimetic principles is given. Furthermore, we propose a way to improve and apply the method for future measurements.

Variability in structure, morphology, and mechanical properties of the descending thoracic and infrarenal aorta around their circumference

Aortic diseases, such as aneurysms, atherosclerosis, and dissections, demonstrate a preferential development and progression around the aortic circumference, resulting in a highly heterogeneous disease state around the circumference. Differences in the aorta's structural composition and mechanical properties may be partly responsible for this phenomenon. Our goal in this study was to analyze the mechanical and structural properties of the human aorta at its lateral, anterior, posterior, and medial quadrants in two regions prone to circumferentially inhomogeneous diseases, descending Thoracic Aorta (TA) and Infrarenal Aorta (IFR). Human aortas were obtained from 10 donors (64 ± 11 years) and dissected from their loose surrounding tissue. Mechanical properties were determined in all four quadrants of TA and IFR using planar biaxial testing and fitted to three common constitutive models. The structure of tissues was assessed using Movat Pentachrome stained histology slides. We observed that the anterior quadrant exhibited the greatest thickness, followed by the lateral region, in both the TA and IFR. In TA, the posterior wall appeared as the stiffest location in most samples, while in IFR, the anterior wall was the stiffest. We observed a higher glycosaminoglycans content in the lateral and posterior regions of the IFR. We found elastin density to be similar in TA lateral, anterior, and posterior quadrants, while in IFR, the anterior region demonstrated the highest elastin density. Despite significant variations between subjects, this study highlights the distinct morphometrical, mechanical, and structural properties between the quadrants of both TA and IFR.

Biomechanical characterization of tissue types in murine dissecting aneurysms based on histology and 4D ultrasound-derived strain

Abdominal aortic aneurysm disease is the local enlargement of the aorta, typically in the infrarenal section, causing up to 200,000 deaths/year. In vivo information to characterize the individual elastic properties of the aneurysm wall in terms of rupture risk is lacking. We used a method that combines 4D ultrasound and direct deformation estimation to compute in vivo 3D Green-Lagrange strain in murine angiotensin II-induced dissecting aortic aneurysms, a commonly used mouse model. After euthanasia, histological staining of cross-sectional sections along the aorta was performed in areas where in vivo strains had previously been measured. The histological sections were segmented into intact and fragmented elastin, thrombus with and without red blood cells, and outer vessel wall including the adventitia. Meshes were then created from the individual contours based on the histological segmentations. The isolated contours of the outer wall and lumen from both imaging modalities were registered individually using a coherent point drift algorithm. 2D finite element models were generated from the meshes, and the displacements from the registration were used as displacement boundaries of the lumen and wall contours. Based on the resulting deformed contours, the strains recorded were grouped according to segmented tissue regions. Strains were highest in areas containing intact elastin without thrombus attachment. Strains in areas with intact elastin and thrombus attachment, as well as areas with disrupted elastin, were significantly lower. Strains in thrombus regions with red blood cells were significantly higher compared to thrombus regions without. We then compared this analysis to statistical distribution indices and found that the results of each aligned, elucidating the relationship between vessel strain and structural changes. This work demonstrates the possibility of advancing in vivo assessments to a microstructural level ultimately improving patient outcomes.

Effects of Age, Sex, and Extracellular Matrix Integrity on Aortic Dilatation and Rupture in a Mouse Model of Marfan Syndrome

BACKGROUND

Transmural failure of the aorta is responsible for substantial morbidity and mortality; it occurs when mechanical stress exceeds strength. The aortic root and ascending aorta are susceptible to dissection and rupture in Marfan syndrome, a connective tissue disorder characterized by a progressive reduction in elastic fiber integrity. Whereas competent elastic fibers endow the aorta with compliance and resilience, cross-linked collagen fibers confer stiffness and strength. We hypothesized that postnatal reductions in matrix cross-linking increase aortopathy when turnover rates are high.

METHODS

We combined ex vivo biaxial mechanical testing with multimodality histological examinations to quantify expected age- and sex-dependent structural vulnerability of the ascending aorta in Fbn1C1041G/+ Marfan versus wild-type mice without and with 4-week exposures to β-aminopropionitrile, an inhibitor of lysyl oxidase-mediated cross-linking of newly synthesized elastic and collagen fibers.

RESULTS

We found a strong β-aminopropionitrile-associated sexual dimorphism in aortic dilatation in Marfan mice and aortic rupture in wild-type mice, with dilatation correlating with compromised elastic fiber integrity and rupture correlating with compromised collagen fibril organization. A lower incidence of rupture of β-aminopropionitrile-exposed Marfan aortas associated with increased lysyl oxidase, suggesting a compensatory remodeling of collagen that slows disease progression in the otherwise compromised Fbn1C1041G/+ aorta.

CONCLUSIONS

Collagen fiber structure and function in the Marfan aorta are augmented, in part, by increased lysyl oxidase in female and especially male mice, which improves structural integrity, particularly via fibrils in the adventitia. Preserving or promoting collagen cross-linking may represent a therapeutic target for an otherwise vulnerable aorta.

Ex vivo biaxial load testing analysis of aortic biomechanics demonstrates variation in elastic energy distribution across the aortic zone zero

OBJECTIVES

We hypothesized that tissue characteristics vary significantly along zone zero, which may be reflected by regional differences in stored elastic energy. Our objectives were to (1) characterize the regional variation in stored elastic energy within tissues of the aortic zone zero and (2) identify the association between this variation and patient characteristics.

METHODS

From February 2018 to January 2021, 123 aortic tissue samples were obtained from the aortic root and proximal and distal ascending aortas of 65 adults undergoing elective ascending aorta replacement. Biaxial biomechanics testing was performed to obtain tissue elastic energy at the inflection point and compared with patient demographics and preoperative computed tomography imaging. Coefficient models were fit using B-spline to interrogate the relationship among elastic energy, region, and patient characteristics.

RESULTS

Mean elastic energy at inflection point was 24.3 ± 15.6 kJ/m3. Elastic energy increased significantly between the root and proximal, and root and distal ascending aorta and decreased with increasing age. Differences due to history of connective tissue disorder and bicuspid aortic valve were significant but diminished when controlled for other patient characteristics. Among covariates, age and region were found to be the most important predictors for elastic energy.

CONCLUSIONS

Aortic tissue biomechanical metrics varied across regions and with patient characteristics within the aortic zone zero. Assessment of endovascular outcomes in the ascending aorta must closely consider the region of deployment and variable tissue qualities along the length of the landing zone. Regional variation in tissue characteristics should be incorporated into existing patient-specific models of aortic mechanics.

Full-field strain mapping of healthy and pathological mouse aortas using stereo digital image correlation

The murine aorta is a complex, heterogeneous structure that undergoes large and sometimes asymmetrical deformations under loading. For analytical convenience, mechanical behavior is predominantly described using global quantities that fail to capture critical local information essential to elucidating aortopathic processes. Here, in our methodological study, we used stereo digital image correlation (StereoDIC) to measure the strain profiles of speckle-patterned healthy and elastase-infused, pathological mouse aortas submerged in a temperature-controlled liquid medium. Our unique device rotates two 15-degree stereo-angle cameras that gather sequential digital images while simultaneously performing conventional biaxial pressure-diameter and force-length testing. A StereoDIC Variable Ray Origin (VRO) camera system model is employed to correct for high-magnification image refraction through hydrating physiological media. The resultant Green-Lagrange surface strain tensor was quantified at different blood vessel inflation pressures, axial extension ratios, and after aneurysm-initiating elastase exposure. Quantified results capture large, heterogeneous, inflation-related, circumferential strains that are drastically reduced in elastase-infused tissues. Shear strains, however, were very small on the tissue's surface. Spatially averaged StereoDIC-based strains were generally more detailed than those determined using conventional edge detection techniques.

Mechanical and matrix effects of short and long-duration exposure to beta-aminopropionitrile in elastase-induced model abdominal aortic aneurysm in mice

Objective

Evaluate the mechanical and matrix effects on abdominal aortic aneurysms (AAA) during the initial aortic dilation and after prolonged exposure to beta-aminopropionitrile (BAPN) in a topical elastase AAA model.

Methods

Abdominal aortae of C57/BL6 mice were exposed to topical elastase with or without BAPN in the drinking water starting 4 days before elastase exposure. For the standard AAA model, animals were harvested at 2 weeks after active elastase (STD2) or heat-inactivated elastase (SHAM2). For the enhanced elastase model, BAPN treatment continued for either 4 days (ENH2b) or until harvest (ENH2) at 2 weeks; BAPN was continued until harvest at 8 weeks in one group (ENH8). Each group underwent assessment of aortic diameter, mechanical testing (tangent modulus and ultimate tensile strength [UTS]), and quantification of insoluble elastin and bulk collagen in both the elastase exposed aorta as well as the descending thoracic aorta.

Results

BAPN treatment did not increase aortic dilation compared with the standard model after 2 weeks (ENH2, 1.65 ± 0.23 mm; ENH2b, 1.49 ± 0.39 mm; STD2, 1.67 ± 0.29 mm; and SHAM2, 0.73 ± 0.10 mm), but did result in increased dilation after 8 weeks (4.3 ± 2.0 mm; P = .005). After 2 weeks, compared with the standard model, continuous therapy with BAPN did not have an effect on UTS (24.84 ± 7.62 N/cm2; 18.05 ± 4.95 N/cm2), tangent modulus (32.60 ± 9.83 N/cm2; 26.13 ± 9.10 N/cm2), elastin (7.41 ± 2.43%; 7.37 ± 4.00%), or collagen (4.25 ± 0.79%; 5.86 ± 1.19%) content. The brief treatment, EHN2b, resulted in increased aortic collagen content compared with STD2 (7.55 ± 2.48%; P = .006) and an increase in UTS compared with ENH2 (35.18 ± 18.60 N/cm2; P = .03). The ENH8 group had the lowest tangent modulus (3.71 ± 3.10 N/cm2; P = .005) compared with all aortas harvested at 2 weeks and a lower UTS (2.18 ± 2.18 N/cm2) compared with both the STD2 (24.84 ± 7.62 N/cm2; P = .008) and ENH2b (35.18 ± 18.60 N/cm2; P = .001) groups. No differences in the mechanical properties or matrix protein concentrations were associated with abdominal elastase exposure or BAPN treatment for the thoracic aorta. The tangent modulus was higher in the STD2 group (32.60 ± 9.83 N/cm2; P = .0456) vs the SHAM2 group (17.99 ± 5.76 N/cm2), and the UTS was lower in the ENH2 group (18.05 ± 4.95 N/cm2; P = .0292) compared with the ENH2b group (35.18 ± 18.60 N/cm2). The ENH8 group had the lowest tangent modulus (3.71 ± 3.10 N/cm2; P = .005) compared with all aortas harvested at 2 weeks and a lower UTS (2.18 ± 2.18 N/cm2) compared with both the STD2 (24.84 ± 7.62 N/cm2; P = .008) and ENH2b (35.18 ± 18.60 N/cm2; P = .001) groups. Abdominal aortic elastin in the STD2 group (7.41 ± 2.43%; P = .035) was lower compared with the SHAM2 group (15.29 ± 7.66%). Aortic collagen was lower in the STD2 group (4.25 ± 0.79%; P = .007) compared with the SHAM2 group (12.44 ± 6.02%) and higher for the ENH2b (7.55 ± 2.48%; P = .006) compared with the STD2 group.

Conclusions

Enhancing an elastase AAA model with BAPN does not affect the initial (2-week) dilation phase substantially, either mechanically or by altering the matrix content. Late mechanical and matrix effects of prolonged BAPN treatment are limited to the elastase-exposed segment of the aorta.

Clinical Relevance

This paper explores the use of short- and long-term exposure to beta-aminopropionitrile to create an enhanced topical elastase abdominal aortic aneurysm model in mice. Readouts of aneurysm severity included loss of mechanical stability and vascular extracellular matrix composition reminiscent of what is seen in the course of human disease. Additionally, we show that the thoracic aorta, unlike the findings below the renal arteries, is not damaged in our animal model.

An introduction to the Ogden model in biomechanics: benefits, implementation tools and limitations

Constitutive models are important to biomechanics for two key reasons. First, constitutive modelling is an essential component of characterizing tissues' mechanical properties for informing theoretical and computational models of biomechanical systems. Second, constitutive models can be used as a theoretical framework for extracting and comparing key quantities of interest from material characterization experiments. Over the past five decades, the Ogden model has emerged as a popular constitutive model in soft tissue biomechanics with relevance to both informing theoretical and computational models and to comparing material characterization experiments. The goal of this short review is threefold. First, we will discuss the broad relevance of the Ogden model to soft tissue biomechanics and the general characteristics of soft tissues that are suitable for approximating with the Ogden model. Second, we will highlight exemplary uses of the Ogden model in brain tissue, blood clot and other tissues. Finally, we offer a tutorial on fitting the one-term Ogden model to pure shear experimental data via both an analytical approximation of homogeneous deformation and a finite-element model of the tissue domain. Overall, we anticipate that this short review will serve as a practical introduction to the use of the Ogden model in biomechanics. This article is part of the theme issue 'The Ogden model of rubber mechanics: Fifty years of impact on nonlinear elasticity'.

An introduction to the Ogden model in biomechanics: benefits, implementation tools and limitations

Constitutive models are important to biomechanics for two key reasons. First, constitutive modelling is an essential component of characterizing tissues' mechanical properties for informing theoretical and computational models of biomechanical systems. Second, constitutive models can be used as a theoretical framework for extracting and comparing key quantities of interest from material characterization experiments. Over the past five decades, the Ogden model has emerged as a popular constitutive model in soft tissue biomechanics with relevance to both informing theoretical and computational models and to comparing material characterization experiments. The goal of this short review is threefold. First, we will discuss the broad relevance of the Ogden model to soft tissue biomechanics and the general characteristics of soft tissues that are suitable for approximating with the Ogden model. Second, we will highlight exemplary uses of the Ogden model in brain tissue, blood clot and other tissues. Finally, we offer a tutorial on fitting the one-term Ogden model to pure shear experimental data via both an analytical approximation of homogeneous deformation and a finite-element model of the tissue domain. Overall, we anticipate that this short review will serve as a practical introduction to the use of the Ogden model in biomechanics. This article is part of the theme issue 'The Ogden model of rubber mechanics: Fifty years of impact on nonlinear elasticity'.

G2Φnet: Relating genotype and biomechanical phenotype of tissues with deep learning

Many genetic mutations adversely affect the structure and function of load-bearing soft tissues, with clinical sequelae often responsible for disability or death. Parallel advances in genetics and histomechanical characterization provide significant insight into these conditions, but there remains a pressing need to integrate such information. We present a novel genotype-to-biomechanical phenotype neural network (G2Φnet) for characterizing and classifying biomechanical properties of soft tissues, which serve as important functional readouts of tissue health or disease. We illustrate the utility of our approach by inferring the nonlinear, genotype-dependent constitutive behavior of the aorta for four mouse models involving defects or deficiencies in extracellular constituents. We show that G2Φnet can infer the biomechanical response while simultaneously ascribing the associated genotype by utilizing limited, noisy, and unstructured experimental data. More broadly, G2Φnet provides a powerful method and a paradigm shift for correlating genotype and biomechanical phenotype quantitatively, promising a better understanding of their interplay in biological tissues.

Evolving Mural Defects, Dilatation, and Biomechanical Dysfunction in Angiotensin II-Induced Thoracic Aortopathies

BACKGROUND

Thoracic aortopathy associates with extracellular matrix remodeling and altered biomechanical properties. We sought to quantify the natural history of thoracic aortopathy in a common mouse model and to correlate measures of wall remodeling such as aortic dilatation or localized mural defects with evolving microstructural composition and biomechanical properties of the wall.

METHODS

We combined a high-resolution multimodality imaging approach (panoramic digital image correlation and optical coherence tomography) with histopathologic examinations and biaxial mechanical testing to correlate spatially, for the first time, macroscopic mural defects and medial degeneration within the ascending aorta with local changes in aortic wall composition and mechanical properties.

RESULTS

Findings revealed strong correlations between local decreases in elastic energy storage and increases in circumferential material stiffness with increasing proximal aortic diameter and especially mural defect size. Mural defects tended to exhibit a pronounced biomechanical dysfunction that is driven by an altered organization of collagen and elastic fibers.

CONCLUSIONS

While aneurysmal dilatation is often observed within particular segments of the aorta, dissection and rupture initiate as highly localized mechanical failures. We show that wall composition and material properties are compromised in regions of local mural defects, which further increases the dilatation and overall structural vulnerability of the wall. Identification of therapies focused on promoting robust collagen accumulation may protect the wall from these vulnerabilities and limit the incidence of dissection and rupture.

Are ovine and porcine carotid arteries equivalent animal models for experimental cardiac surgery: A quantitative histological comparison

BACKGROUND

Coronary artery bypass grafting (CABG) is a common cardiac surgery. Manufacturing small-diameter (2-5mm) vascular grafts for CABG is important for patients who lack first-choice autologous arterial, or venous conduits. Ovine and porcine common carotid arteries (CCAs) are used as large animal models for in vivo testing of newly developed tissue-engineered arterial grafts. It is unknown to what extent these models are interchangeable and whether the left and right arteries of the same subjects can be used as experimental controls. Therefore, we compared the microscopic structure of paired left and right ovine and porcine CCAs in the proximodistal direction and compared these animal model samples to samples of human coronary arteries (CAs) and human internal thoracic arteries (ITAs).

METHODS

We compared the histological composition of whole CCAs of sheep (n=22 animals) with whole porcine CCAs (n=21), segments of human CAs (n=21), and human ITAs (n=21). Using unbiased sampling and stereological methods, we quantified the fractions of elastin, total collagen, type I collagen, type III collagen, smooth muscle actin (SMA) and chondroitin sulfate (CS) A, B, and C. We also quantified the densities and distributions of nuclear profiles, nervi vasorum and vasa vasorum as well as the thickness of the intima-media and total wall thickness.

RESULTS

The differences between the paired samples of left and right CCAs in sheep were substantially greater than the differences in laterality in porcine CCAs. The right ovine CCAs had a smaller fraction of elastin (p<0.001), greater fraction of SMA (p<0.01), and greater intima-media thickness (p<0.001) than the paired left side CCAs. In pigs, the right CCAs had a greater fraction of elastin (p<0.05) and a greater density of vasa vasorum in the media (p<0.001) than the left-side CCAs. The fractions of elastin and CS decreased and the fraction of SMA increased in the proximodistal direction in both the ovine (p<0.001) and porcine (p<0.001) CCAs. Ovine CCAs had a muscular phenotype along their entire length, but porcine CCAs were elastic-type arteries in the proximal segments but muscular type arteries in middle and distal segments. The CCAs of both animals differed from the human CAs and ITAs in most parameters, but the ovine CCAs had a comparable fraction of elastin and CS to human ITAs.

CONCLUSIONS

From a histological point of view, ovine and porcine CCAs were not equivalent in most quantitative parameters to human CAs and ITAs. Left and right ovine CCAs did not have the same histological composition, which is limiting for their mutual equivalence as sham-operated controls in experiments. These differences should be taken into account when designing and interpreting experiments using these models in cardiac surgery. The complete morphometric data obtained by quantitative evaluation of arterial segments were provided to facilitate the power analysis necessary for justification of the minimum number of samples when planning further experiments. The middle or distal segments of ovine and porcine CCAs remain the most realistic and the best characterized large animal models for testing artificial arterial CABG conduits.

Uncertainty quantification in subject-specific estimation of local vessel mechanical properties

Quantitative estimation of local mechanical properties remains critically important in the ongoing effort to elucidate how blood vessels establish, maintain, or lose mechanical homeostasis. Recent advances based on panoramic digital image correlation (pDIC) have made high-fidelity 3D reconstructions of small-animal (e.g., murine) vessels possible when imaged in a variety of quasi-statically loaded configurations. While we have previously developed and validated inverse modeling approaches to translate pDIC-measured surface deformations into biomechanical metrics of interest, our workflow did not heretofore include a methodology to quantify uncertainties associated with local point estimates of mechanical properties. This limitation has compromised our ability to infer biomechanical properties on a subject-specific basis, such as whether stiffness differs significantly between multiple material locations on the same vessel or whether stiffness differs significantly between multiple vessels at a corresponding material location. In the present study, we have integrated a novel uncertainty quantification and propagation pipeline within our inverse modeling approach, relying on empirical and analytic Bayesian techniques. To demonstrate the approach, we present illustrative results for the ascending thoracic aorta from three mouse models, quantifying uncertainties in constitutive model parameters as well as circumferential and axial tangent stiffness. Our extended workflow not only allows parameter uncertainties to be systematically reported, but also facilitates both subject-specific and group-level statistical analyses of the mechanics of the vessel wall.

Biomechanical consequences of compromised elastic fiber integrity and matrix cross-linking on abdominal aortic aneurysmal enlargement

Abdominal aortic aneurysms (AAAs) are characterized histopathologically by compromised elastic fiber integrity, lost smooth muscle cells or their function, and remodeled collagen. We used a recently introduced mouse model of AAAs that combines enzymatic degradation of elastic fibers and blocking of lysyl oxidase, and thus matrix cross-linking, to study progressive dilatation of the infrarenal abdominal aorta, including development of intraluminal thrombus. We quantified changes in biomaterial properties and biomechanical functionality within the aneurysmal segment as a function of time of enlargement and degree of thrombosis. Towards this end, we combined multi-modality imaging with state-of-the art biomechanical testing and histology to quantify regional heterogeneities for the first time and we used a computational model of arterial growth and remodeling to test multiple hypotheses, suggested by the data, regarding the degree of lost elastin, accumulation of glycosaminoglycans, and rates of collagen turnover. We found that standard histopathological findings can be misleading, while combining advanced experimental and computational methods revealed that glycosaminoglycan accumulation is pathologic, not adaptive, and that heightened collagen deposition is ineffective if not cross-linked. In conclusion, loss of elastic fiber integrity can be a strong initiator of aortic aneurysms, but it is the rate and effectiveness of fibrillar collagen remodeling that dictates enlargement. STATEMENT OF SIGNIFICANCE: Precise mechanisms by which abdominal aortic aneurysms enlarge remain unclear, but a recent elastase plus β-aminopropionitrile mouse model provides new insight into disease progression. As in the human condition, the aortic degeneration and adverse remodeling are highly heterogeneous in this model. Our multi-modality experiments quantify and contrast the heterogeneities in geometry and biomaterial properties, and our computational modeling shows that standard histopathology can be misleading. Neither accumulating glycosaminoglycans nor frustrated collagen synthesis slow disease progression, thus highlighting the importance of stimulating adaptive collagen remodeling to limit lesion enlargement.

Interpretation of Experimental Data is Substantial for Constitutive Characterization of Arterial Tissue

The paper aims at evaluation of mechanical tests of soft tissues and creation of their representative stress-strain responses and respective constitutive models. Interpretation of sets of experimental results depends highly on the approach to the data analysis. Their common representation through mean and standard deviation may be misleading and give nonrealistic results. In the paper, raw data of seven studies consisting of 11 experimental data sets (concerning carotid wall and atheroma tissues) are re-analyzed to show the importance of their rigorous analysis. The sets of individual uniaxial stress-stretch curves are evaluated using three different protocols: stress-based, stretch-based, and constant-based, and the population-representative response is created by their mean or median values. Except for nearly linear responses, there are substantial differences between the resulting curves, being mostly the highest for constant-based evaluation. But also the stretch-based evaluation may change the character of the response significantly. Finally, medians of the stress-based responses are recommended as the most rigorous approach for arterial and other soft tissues with significant strain stiffening.

Evolving structure-function relations during aortic maturation and aging revealed by multiphoton microscopy

The evolving microstructure and mechanical properties that promote homeostasis in the aorta are fundamental to age-specific adaptations and disease progression. We combine ex vivo multiphoton microscopy and biaxial biomechanical phenotyping to quantify and correlate layer-specific microstructural parameters, for the primary extracellular matrix components (fibrillar collagen and elastic lamellae) and cells (endothelial, smooth muscle, and adventitial), with mechanical properties of the mouse aorta from weaning through natural aging up to one year. The aging endothelium was characterized by progressive reductions in cell density and altered cellular orientation. The media similarly showed a progressive decrease in smooth muscle cell density and alignment though with inter-lamellar widening from intermediate to older ages, suggesting cell hypertrophy, matrix accumulation, or both. Despite not changing in tissue thickness, the aging adventitia exhibited a marked thickening and straightening of collagen fiber bundles and reduction in cell density, suggestive of age-related remodeling not growth. Multiple microstructural changes correlated with age-related increases in circumferential and axial material stiffness, among other mechanical metrics. Because of the importance of aging as a risk factor for cardiovascular diseases, understanding the normal progression of structural and functional changes is essential when evaluating superimposed disease-related changes as a function of the age of onset.

Heterogeneity of Ex Vivo and In Vivo Properties along the Length of the Abdominal Aortic Aneurysm

The current clinical guidelines for the management of aortic abdominal aneurysms (AAAs) overlook the structural and mechanical heterogeneity of the aortic tissue and its role in the regional weakening that drives disease progression. This study is a comprehensive investigation of the structural and biomechanical heterogeneity of AAA tissue along the length and circumference of the aorta, by means of regional ex vivo and in vivo properties. Biaxial testing and histological analysis were performed on ex vivo human aortic specimens systematically collected during open repair surgery. Wall-shear stress and three-dimensional principal strain analysis were performed to allow for in vivo regional characterization of individual aortas. A marked effect of position along the aortic length was observed in both ex vivo and in vivo properties, with the central regions corresponding to the aneurysmal sac being significantly different from the adjacent regions. The heterogeneity along the circumference of the aorta was reflected in the ex vivo biaxial response at low strains and histological properties. Present findings uniquely show the importance of regional characterization for aortic assessment and the need to correlate heterogeneity at the tissue level with non-invasive measurements aimed at improving clinical outcomes.

Sensitivity analysis of non-local damage in soft biological tissues

Computational modeling can provide insight into understanding the damage mechanisms of soft biological tissues. Our gradient-enhanced damage model presented in a previous publication has shown advantages in considering the internal length scales and in satisfying mesh independence for simulating damage, growth and remodeling processes. Performing sensitivity analyses for this model is an essential step towards applications involving uncertain patient-specific data. In this paper, a numerical analysis approach is developed. For that we integrate two existing methods, that is, the gradient-enhanced damage model and the surrogate model-based probability analysis. To increase the computational efficiency of the Monte Carlo method in uncertainty propagation for the nonlinear hyperelastic damage analysis, the surrogate model based on Legendre polynomial series is employed to replace the direct FEM solutions, and the sparse grid collocation method (SGCM) is adopted for setting the collocation points to further reduce the computational cost in training the surrogate model. The effectiveness of the proposed approach is illustrated by two numerical examples, including an application of artery dilatation mimicking to the clinical problem of balloon angioplasty.

Patient-specific computational evaluation of stiffness distribution in ascending thoracic aortic aneurysm

Quantifying local aortic stiffness properties in vivo is acknowledged as essential to assess the severity of an ascending thoracic aortic aneurysm (ATAA). Recently, the LESI (local extensional stiffness identification) methodology has been established to quantify non-invasively local stiffness properties of ATAAs using electrocardiographic-gated computed tomography (ECG-gated CT) scans. The aim of the current study was to determine the most sensitive markers of local ATAA stiffness estimation with the hypothesis that direct measures of local ATAA stiffness could better detect the high-risk patients. A cohort of 30 patients (12 BAV and 18 TAV) referred for aortic size evaluation by ECG-gated CT were recruited. For each patient, the extensional stiffness Q was evaluated by the LESI methodology whilst computational flow analyses were also performed to derive hemodynamics markers such as the wall shear stress (WSS). A strong positive correlation was found between the extensional stiffness and the aortic pulse pressure (R = 0.644 and p < 0.001). Interestingly, a significant positive correlation was also found between the extensional stiffness and patients age for BAV ATAAs (R = 0.619 and p = 0.032), but not for TAV ATAAs (R = -0.117 and p = 0.645). No significant correlation was found between the extensional stiffness and WSS evaluated locally. There was no significant difference either in the extensional stiffness between BAV ATAAs and TAV ATAAs (Q = 3.6 ± 2.5 MPa.mm for BAV ATAAs vs Q = 5.3 ± 3.1 MPa.mm for TAV ATAAs, p = 0.094). Future work will focus on relating the extensional stiffness to the patient-specific rupture risk of ATAAs on larger cohorts to confirm the promising interest of the LESI methodology.

A Chemomechanobiological Model of the Long-Term Healing Response of Arterial Tissue to a Clamping Injury

Vascular clamping often causes injury to arterial tissue, leading to a cascade of cellular and extracellular events. A reliable in silico prediction of these processes following vascular injury could help us to increase our understanding thereof, and eventually optimize surgical techniques or drug delivery to minimize the amount of long-term damage. However, the complexity and interdependency of these events make translation into constitutive laws and their numerical implementation particularly challenging. We introduce a finite element simulation of arterial clamping taking into account acute endothelial denudation, damage to extracellular matrix, and smooth muscle cell loss. The model captures how this causes tissue inflammation and deviation from mechanical homeostasis, both triggering vascular remodeling. A number of cellular processes are modeled, aiming at restoring this homeostasis, i.e., smooth muscle cell phenotype switching, proliferation, migration, and the production of extracellular matrix. We calibrated these damage and remodeling laws by comparing our numerical results to in vivo experimental data of clamping and healing experiments. In these same experiments, the functional integrity of the tissue was assessed through myograph tests, which were also reproduced in the present study through a novel model for vasodilator and -constrictor dependent smooth muscle contraction. The simulation results show a good agreement with the in vivo experiments. The computational model was then also used to simulate healing beyond the duration of the experiments in order to exploit the benefits of computational model predictions. These results showed a significant sensitivity to model parameters related to smooth muscle cell phenotypes, highlighting the pressing need to further elucidate the biological processes of smooth muscle cell phenotypic switching in the future.

The Association Between Curvature and Rupture in a Murine Model of Abdominal Aortic Aneurysm and Dissection

BACKGROUND

Mouse models of abdominal aortic aneurysm (AAA) and dissection have proven to be invaluable in the advancement of diagnostics and therapeutics by providing a platform to decipher response variables that are elusive in human populations. One such model involves systemic Angiotensin II (Ang-II) infusion into low density-lipoprotein receptor-deficient (LDLr-/-) mice leading to intramural thrombus formation, inflammation, matrix degradation, dilation, and dissection. Despite its effectiveness, considerable experimental variability has been observed in AAAs taken from our Ang-II infused LDLr-/- mice (n=12) with obvious dissection occurring in 3 samples, outer bulge radii ranging from 0.73 to 2.12 mm, burst pressures ranging from 155 to 540 mmHg, and rupture location occurring 0.05 to 2.53 mm from the peak bulge location.

OBJECTIVE

We hypothesized that surface curvature, a fundamental measure of shape, could serve as a useful predictor of AAA failure at supra-physiological inflation pressures.

METHODS

To test this hypothesis, we fit well-known biquadratic surface patches to 360° micro-mechanical test data and used Spearman's rank correlation (rho) to identify relationships between failure metrics and curvature indices.

RESULTS

We found the strongest associations between burst pressure and the maximum value of the first principal curvature (rho=-0.591, p-val=0.061), the maximum value of Mean curvature (rho=-0.545, p-val=0.087), and local values of Mean curvature at the burst location (rho=-0.864, p-val=0.001) with only the latter significant after Bonferroni correction. Additionally, the surface profile at failure was predominantly convex and hyperbolic (saddle-shaped) as indicated by a negative sign in the Gaussian curvature. Findings reiterate the importance of shape in experimental models of AAA.

Assessing Patient-Specific Mechanical Properties of Aortic Wall and Peri-Aortic Structures From In Vivo DENSE Magnetic Resonance Imaging Using an Inverse Finite Element Method and Elastic Foundation Boundary Conditions

The establishment of in vivo, noninvasive patient-specific, and regionally resolved techniques to quantify aortic properties is key to improving clinical risk assessment and scientific understanding of vascular growth and remodeling. A promising and novel technique to reach this goal is an inverse finite element method (FEM) approach that utilizes magnetic resonance imaging (MRI)-derived displacement fields from displacement encoding with stimulated echoes (DENSE). Previous studies using DENSE MRI suggested that the infrarenal abdominal aorta (IAA) deforms heterogeneously during the cardiac cycle. We hypothesize that this heterogeneity is driven in healthy aortas by regional adventitial tethering and interaction with perivascular tissues, which can be modeled with elastic foundation boundary conditions (EFBCs) using a collection of radially oriented springs with varying stiffness with circumferential distribution. Nine healthy IAAs were modeled using previously acquired patient-specific imaging and displacement fields from steady-state free procession (SSFP) and DENSE MRI, followed by assessment of aortic wall properties and heterogeneous EFBC parameters using inverse FEM. In contrast to traction-free boundary condition, prescription of EFBC reduced the nodal displacement error by 60% and reproduced the DENSE-derived heterogeneous strain distribution. Estimated aortic wall properties were in reasonable agreement with previously reported experimental biaxial testing data. The distribution of normalized EFBC stiffness was consistent among all patients and spatially correlated to standard peri-aortic anatomical features, suggesting that EFBC could be generalized for human adults with normal anatomy. This approach is computationally inexpensive, making it ideal for clinical research and future incorporation into cardiovascular fluid-structure analyses.

Computational Study of Growth and Remodeling in Ascending Thoracic Aortic Aneurysms Considering Variations of Smooth Muscle Cell Basal Tone

In this paper, we investigate the progression of Ascending Thoracic Aortic Aneurysms (ATAA) using a computational model of Growth and Remodeling (G&R) taking into account the composite (elastin, four collagen fiber families and Smooth Muscle Cells—SMCs) and multi-layered (media and adventitia) nature of the aorta. The G&R model, which is based on the homogenized Constrained Mixture theory, is implemented as a UMAT in the Abaqus finite-element package. Each component of the mixture is assigned a strain energy density function: nearly-incompressible neo-Hookean for elastin and Fung-type for collagen and SMCs. Active SMCs tension is additionally considered, through a length-tension relationship having a classic inverted parabola shape, in order to investigate its effects on the progression of ATAA in a patient-specific model. A sensitivity analysis is performed to evaluate the potential impact of variations in the parameters of the length-tension relationships. These variations reflect in variations of SMCs normal tone during ATAA progression, with active stress contributions ranging between 30% (best case scenario) and 0% (worst case scenario) of the total wall circumferential stress. Low SMCs active stress in the worst case scenarios, in fact, affect the rates of collagen deposition by which the elastin loss is gradually compensated by collagen deposition in the simulated ATAA progression, resulting eventually in larger aneurysm diameters. The types of length-tension relationships leading to a drop of SMCs active stress in our simulations reveal a critical condition which could also result in SMCs apoptosis.

Multimodality Imaging-Based Characterization of Regional Material Properties in a Murine Model of Aortic Dissection

Chronic infusion of angiotensin-II in atheroprone (ApoE-/-) mice provides a reproducible model of dissection in the suprarenal abdominal aorta, often with a false lumen and intramural thrombus that thickens the wall. Such lesions exhibit complex morphologies, with different regions characterized by localized changes in wall composition, microstructure, and properties. We sought to quantify the multiaxial mechanical properties of murine dissecting aneurysm samples by combining in vitro extension-distension data with full-field multimodality measurements of wall strain and thickness to inform an inverse material characterization using the virtual fields method. A key advance is the use of a digital volume correlation approach that allows for characterization of properties not only along and around the lesion, but also across its wall. Specifically, deformations are measured at the adventitial surface by tracking motions of a speckle pattern using a custom panoramic digital image correlation technique while deformations throughout the wall and thrombus are inferred from optical coherence tomography. These measurements are registered and combined in 3D to reconstruct the reference geometry and compute the 3D finite strain fields in response to pressurization. Results reveal dramatic regional variations in material stiffness and strain energy, which reflect local changes in constituent area fractions obtained from histology but emphasize the complexity of lesion morphology and damage within the dissected wall. This is the first point-wise biomechanical characterization of such complex, heterogeneous arterial segments. Because matrix remodeling is critical to the formation and growth of these lesions, we submit that quantification of regional material properties will increase the understanding of pathological mechanical mechanisms underlying aortic dissection.

Null strain analysis of submerged aneurysm analogues using a novel 3D stereomicroscopy device

To measure the inhomogeneous 3D-strain fields present during inflation-extension testing of physiologically submerged micro-aneurysms, a Stereo Digital Image Correlation (StereoDIC) microscopy system is developed that revolves 15° stereo-angle cameras around a centrally-mounted target. Calibration is performed using submerged dot patterns and system accuracy verified using strain and deformation analyses for rigid body motions of speckle-patterned, micro-aneurysmal surrogates. In terms of the Green-Lagrange strain tensor and the 3D displacement fields, the results are stable even after 120 minutes, with maxima in both strain bias and strain standard deviation less than 2E-03 for all components, and micron-level displacement standard deviation.

Recent Advances in Biomechanical Characterization of Thoracic Aortic Aneurysms

Thoracic aortic aneurysm (TAA) is a focal enlargement of the thoracic aorta, but the etiology of this disease is not fully understood. Previous work suggests that various genetic syndromes, congenital defects such as bicuspid aortic valve, hypertension, and age are associated with TAA formation. Though occurrence of TAAs is rare, they can be life-threatening when dissection or rupture occurs. Prevention of these adverse events often requires surgical intervention through full aortic root replacement or implantation of endovascular stent grafts. Currently, aneurysm diameters and expansion rates are used to determine if intervention is warranted. Unfortunately, this approach oversimplifies the complex aortopathy. Improving treatment of TAAs will likely require an increased understanding of the biological and biomechanical factors contributing to the disease. Past studies have substantially contributed to our knowledge of TAAs using various ex vivo, in vivo, and computational methods to biomechanically characterize the thoracic aorta. However, any singular approach typically focuses on only material properties of the aortic wall, intra-aneurysmal hemodynamics, or in vivo vessel dynamics, neglecting combinatorial factors that influence aneurysm development and progression. In this review, we briefly summarize the current understanding of TAA causes, treatment, and progression, before discussing recent advances in biomechanical studies of TAAs and possible future directions. We identify the need for comprehensive approaches that combine multiple characterization methods to study the mechanisms contributing to focal weakening and rupture. We hope this summary and analysis will inspire future studies leading to improved prediction of thoracic aneurysm progression and rupture, improving patient diagnoses and outcomes.

Characterization of chemoelastic effects in arteries using digital volume correlation and optical coherence tomography

Understanding stress-strain relationships in arteries is important for fundamental investigations in mechanobiology. Here we demonstrate the essential role of chemoelasticity in determining the mechanical properties of arterial tissues. Stepwise stress-relaxation uniaxial tensile tests were carried out on samples of porcine thoracic aortas immersed in a hyperosmotic solution. The tissue deformations were tracked using optical coherence tomography (OCT) during the tensile tests and digital volume correlation (DVC) was used to obtain measurements of depth-resolved strains across the whole thickness of the tested aortas. The hyperosmotic solution exacerbated chemoelastic effects, and we were able to measure different manifestations of these chemoelastic effects: swelling of the media inducing a modification of its optical properties, and existence of a transverse tensile strain. For the first time ever to our best knowledge, 3D strains induced by chemoelastic effects in soft tissues were quantified thanks to the OCT-DVC method. Without doubt, chemoelasticity plays an essential role in arterial mechanobiology in vivo and future work should focus on characterizing chemoelastic effects in arterial walls under physiological and disease conditions. STATEMENT OF SIGNIFICANCE: Chemoelasticity, coupling osmotic phenomena and mechanical stresses, is essential in soft tissue mechanobiology. For the first time ever, we measure and analyze 3D strain fields induced by these chemoelastic effects thanks to the unique combination of OCT imaging and digital volume correlation.

Histological mapping of porcine carotid arteries - An animal model for the assessment of artificial conduits suitable for coronary bypass grafting in humans

BACKGROUND

Using animal models in experimental medicine requires mapping of their anatomical variability. Porcine common carotid arteries (CCA) are often preferred for the preclinical testing of vascular grafts due to their anatomical and physiological similarity to human small-diameter arteries. Comparing the microscopic structure of animal model organs to their human counterparts reveals the benefits and limitations of translational medicine.

METHODS

Using quantitative histology and stereology, we performed an extensive mapping of the regional proximodistal differences in the fractions of elastin, collagen, and smooth muscle actin as well as the intima-media and wall thicknesses among 404 segments (every 1 cm) of porcine CCAs collected from male and female pigs (n = 21). We also compared the microscopic structure of porcine CCAs with segments of human coronary arteries and one of the preferred arterial conduits used for the coronary artery bypass grafting (CABG), namely, the internal thoracic artery (ITA) (n = 21 human cadavers).

RESULTS

The results showed that the histological structure of left and right porcine CCA can be considered equivalent, provided that gross anatomical variations of the regular branching patterns are excluded. The proximal elastic carotid (51.2% elastin, 4.2% collagen, and 37.2% actin) transitioned to more muscular middle segments (23.5% elastin, 4.9% collagen, 54.3% actin) at the range of 2-3 centimeters and then to even more muscular distal segments (17.2% elastin, 4.9% collagen, 64.0% actin). The resulting morphometric data set shows the biological variability of the artery and is made available for biomechanical modeling and for performing a power analysis and calculating the minimum number of samples per group when planning further experiments with this widely used large animal model.

CONCLUSIONS

Comparison of porcine carotids with human coronary arteries and ITA revealed the benefits and the limitations of using porcine CCAs as a valid model for testing bioengineered small-diameter CABG vascular conduits. Morphometry of human coronary arteries and ITA provided more realistic data for tailoring multilayered artificial vascular prostheses and the ranges of values within which the conduits should be tested in the future. Despite their limitations, porcine CCAs remain a widely used and well-characterized large animal model that is available for a variety of experiments in vascular surgery.

Effect of Residual and Transformation Choice on Computational Aspects of Biomechanical Parameter Estimation of Soft Tissues

Several nonlinear and anisotropic constitutive models have been proposed to describe the biomechanical properties of soft tissues, and reliably estimating the unknown parameters in these models using experimental data is an important step towards developing predictive capabilities. However, the effect of parameter estimation technique on the resulting biomechanical parameters remains under-analyzed. Standard off-the-shelf techniques can produce unreliable results where the parameters are not uniquely identified and can vary with the initial guess. In this study, a thorough analysis of parameter estimation techniques on the resulting properties for four multi-parameter invariant-based constitutive models is presented. It was found that linear transformations have no effect on parameter estimation for the presented cases, and nonlinear transforms are necessary for any improvement. A distinct focus is put on the issue of non-convergence, and we propose simple modifications that not only improve the speed of convergence but also avoid convergence to a wrong solution. The proposed modifications are straightforward to implement and can avoid severe problems in the biomechanical analysis. The results also show that including the fiber angle as an unknown in the parameter estimation makes it extremely challenging, where almost all of the formulations and models fail to converge to the true solution. Therefore, until this issue is resolved, a non-mechanical—such as optical—technique for determining the fiber angle is required in conjunction with the planar biaxial test for a robust biomechanical analysis.

Measurement of in vitro cardiac deformation by means of 3D digital image correlation and ultrasound 2D speckle-tracking echocardiography

Ultrasound-based 2D speckle-tracking echocardiography (US-2D-STE) is increasingly used to assess the functionality of the heart. In particular, the analysis of cardiac strain plays an important role in the identification of several cardiovascular diseases. However, this imaging technique presents some limitations associated with its operating principle that result in low accuracy and reproducibility of the measurement. In this study, an experimental framework for multimodal strain imaging in an in vitro porcine heart was developed. Specifically, the aim of this work was to analyse displacement and strain in the heart by means of 3D digital image correlation (3D-DIC) and US-2D-STE. Over a single cardiac cycle, displacement values obtained from the two techniques were in strong correlation, although systematically larger displacements were observed with 3D-DIC. Notwithstanding an absolute comparison of the strain measurements was not possible to achieve between the two methods, maximum principal strain directions computed with 3D-DIC were consistent with the longitudinal and circumferential strain distribution measured with US-2D-STE. 3D-DIC confirmed its high repeatability in quantifying displacement and strain over multiple cardiac cycles, unlike US-2D-STE which is affected by accumulated errors over time (i.e. drift). To conclude, this study demonstrates the potential of 3D-DIC to perform dynamic measurement of displacement and strain during heart deformations and supports future applications of this method in ex vivo beating heart platforms, which replicate more fully the complex contraction of the heart.

Does the Knowledge of the Local Thickness of Human Ascending Thoracic Aneurysm Walls Improve Their Mechanical Analysis?

Ascending thoracic aortic aneurysm (ATAA) ruptures are life threatening phenomena which occur in local weaker regions of the diseased aortic wall. As ATAAs are evolving pathologies, their growth represents a significant local remodeling and degradation of the microstructural architecture and thus their mechanical properties. To address the need for deeper study of ATAAs and their failure, it is required to analyze the mechanical behavior at the sub-millimeter scale by making use of accurate geometrical and kinematical measurements during their deformation. For this purpose, we propose a novel methodology that combined an accurate tool for thickness distribution measurement of the arterial wall, digital image correlation to assess local strain fields and bulge inflation to characterize the physiological and failure response of flat unruptured human ATAA specimens. The analysis of the heterogeneity of the local thickness and local physiological stress and strain was carried out for each investigated subject. At the subject level, our results state the presence of a non-consistent relationship between the local wall thickness and the local physiological strain field and high heterogeneity of the variables. At the inter-subject level, thicknesses were studied in relation to physiological strain and stress and load at rupture. The rupture pressure was correlated with neither the average thickness nor the lowest thickness of the specimens. Our results confirm that intrinsic material strength (hence structure) differs a lot from a subject to another and even within the same subject.

Co-localization of microstructural damage and excessive mechanical strain at aortic branches in angiotensin-II-infused mice

Animal models of aortic aneurysm and dissection can enhance our limited understanding of the etiology of these lethal conditions particularly because early-stage longitudinal data are scant in humans. Yet, the pathogenesis of often-studied mouse models and the potential contribution of aortic biomechanics therein remain elusive. In this work, we combined micro-CT and synchrotron-based imaging with computational biomechanics to estimate in vivo aortic strains in the abdominal aorta of angiotensin-II-infused ApoE-deficient mice, which were compared with mouse-specific aortic microstructural damage inferred from histopathology. Targeted histology showed that the 3D distribution of micro-CT contrast agent that had been injected in vivo co-localized with precursor vascular damage in the aortic wall at 3 days of hypertension, with damage predominantly near the ostia of the celiac and superior mesenteric arteries. Computations similarly revealed higher mechanical strain in branching relative to non-branching regions, thus resulting in a positive correlation between high strain and vascular damage in branching segments that included the celiac, superior mesenteric, and right renal arteries. These results suggest a mechanically driven initiation of damage at these locations, which was supported by 3D synchrotron imaging of load-induced ex vivo delaminations of angiotensin-II-infused suprarenal abdominal aortas. That is, the major intramural delamination plane in the ex vivo tested aortas was also near side branches and specifically around the celiac artery. Our findings thus support the hypothesis of an early mechanically mediated formation of microstructural defects at aortic branching sites that subsequently propagate into a macroscopic medial tear, giving rise to aortic dissection in angiotensin-II-infused mice.

A novel vision-based system for quantitative analysis of abdominal aortic aneurysm deformation

BACKGROUND

In clinical diagnostics, combination of different imaging techniques is applied to assess spatial configuration of the abdominal aortic aneurysm (AAA) and deformation of its wall. As deformation of aneurysm wall is crucial parameter in assessing wall rupture, we aimed to develop and validate a Non-Invasive Vision-Based System (NIVBS) for the analysis of 3D elastic artificial abdominal aortic models. 3D-printed elastic AAA models from four patients were applied for the reconstruction of real hemodynamic. During experiments, the inlet boundary conditions included the injection volume and frequency of pulsation averaged from electrocardiography traces. NIVBS system was equipped with nine cameras placed at a constant distance to record wall movement from 360^o angle and a dedicated set of artificial lights providing coherent illumination. Additionally, self-prepared algorithms for image acquisition, processing, segmentation, and contour detection were used to analyze wall deformation. Finally, the shape deformation factor was applied to evaluate aorta's deformation. Experimental results were confronted with medical data from AngioCT and 2D speckle-tracking echocardiography (2DSTE).

RESULTS

Image square analyses indicated that the optimal distance between the camera's lens and the investigated object was in the range of 0.30-0.35 m. There was approximately 1.44% difference observed in aneurysm diameters between NIVBS (86.57 ± 5.86 mm) and AngioCT (87.82 ± 6.04 mm) (p = 0.7764). The accuracy of developed algorithm for the reconstruction of the AAA deformation was equal to 98.56%. Bland-Altman analysis showed that the difference between clinical data (2DSTE) and predicted wall deformation (NIVBS) for all patients was 0.00 mm (confidence interval equal to 0.12 mm) for aneurysm size, 0.01 mm (confidence interval equal to 0.13 mm) and 0.00 mm (confidence interval equal to 0.09 mm) for the anterior and posterior side, as well as 0.01 mm (confidence interval equal to 0.18 mm) and 0.01 mm (confidence interval equal to 0.11 mm) for the left and right side. The optimal range of camera's lens did not affect acquired values.

CONCLUSIONS

The NIVBS with proposed algorithm that reconstructs the pressure from surrounding organs is appropriate to analyze the AAAs in water environment. Moreover, NIVBS allowed detailed quantitative analysis of aneurysm sac wall deformation.

A coupled approach for identification of nonlinear and compressible material models for soft tissue based on different experimental setups - Exemplified and detailed for lung parenchyma

In this paper, a coupled inverse analysis is proposed to identify nonlinear compressible hyperelastic material models described by two sets of experiments. While the overall approach is applicable for different materials, here it will be presented for viable lung parenchyma. Characterizing the material properties of lung parenchyma is essential to describe and predict the mechanical behavior of the respiratory system in health and disease. During breathing and mechanical ventilation, lung parenchyma is mainly subjected to volumetric deformations along with isochoric and asymmetric deformations that occur especially in diseased heterogeneous lungs. Notwithstanding, most studies examine lung tissue in predominantly isochoric tension tests. In this paper, we investigate the volumetric material behavior as well as the isochoric deformations in two sets of experiments: namely, volume-pressure-change experiments (performed with 287 samples of 26 rats) and uniaxial tension tests (performed with 30 samples of 5 rats). Based on these sets of experiments, we propose a coupled inverse analysis, which simultaneously incorporates both measurement sets to optimize the material parameters. Accordingly, we determine a suitable material model using the experimental results of both sets of experiments in one coupled identification process. The identified strain energy function with the corresponding material parameters [Formula: see text] is validated to model both sets of experiments precisely. Hence, this constitutive model describes the complex volumetric and isochoric nonlinear material behavior of lung parenchyma. This derived material model can be used for nonlinear finite element simulations of lung parenchyma and will help to quantify the stresses and strains of lung tissue during spontaneous and artificial breathing; thus, allowing new insights into lung function and biology.

Local variations in material and structural properties characterize murine thoracic aortic aneurysm mechanics

We recently developed an approach to characterize local nonlinear, anisotropic mechanical properties of murine arteries by combining biaxial extension-distension testing, panoramic digital image correlation, and an inverse method based on the principle of virtual power. This experimental-computational approach was illustrated for the normal murine abdominal aorta assuming uniform wall thickness. Here, however, we extend our prior approach by adding an optical coherence tomography (OCT) imaging system that permits local reconstructions of wall thickness. This multimodality approach is then used to characterize spatial variations of material and structural properties in ascending thoracic aortic aneurysms (aTAA) from two genetically modified mouse models (fibrillin-1 and fibulin-4 deficient) and to compare them with those from angiotensin II-infused apolipoprotein E-deficient and wild-type control ascending aortas. Local values of stored elastic energy and biaxial material stiffness, computed from spatial distributions of the best fit material parameters, varied significantly with circumferential position (inner vs. outer curvature, ventral vs. dorsal sides) across genotypes and treatments. Importantly, these data reveal an inverse relationship between material stiffness and wall thickness that underlies a general linear relationship between stiffness and wall stress across aTAAs. OCT images also revealed sites of advanced medial degeneration, which were captured by the inverse material characterization. Quantification of histological data further provided high-resolution local correlations among multiple mechanical metrics and wall microstructure. This is the first time that such structural defects and local properties have been characterized mechanically, which can better inform computational models of aortopathy that seek to predict where dissection or rupture may initiate.

Mechanical characterization of arteries affected by fetal growth restriction in guinea pigs (Cavia porcellus)

Fetal growth restriction (FGR) is a perinatal condition associated with a low birth weight that results mainly from maternal and placental constrains. Newborns affected by this condition are more likely to develop in the long term cardiovascular diseases whose origins would be in an altered vascular structure and function defined during fetal development. Thus, this study presents the modeling and numerical simulation of systemic vessels from guinea pig fetuses affected by FGR. We aimed to characterize the biomechanical properties of the arterial wall of FGR-derived the aorta, carotid, and femoral arteries by performing ring tensile and ring opening tests and, based on these data, to simulate the biomechanical behavior of FGR vessels under physiological conditions. The material parameters were first obtained from the experimental data of the ring tensile test. Then, the residual stresses were determined from the ring opening test and taken as initial stresses in the simulation of the ring tensile test. These two coupled steps are iteratively considered in a nonlinear least-squares algorithm to obtain the final material parameters. Then, the stress distribution changes along the arterial wall under physiological pressure were quantified using the adjusted material parameters. Overall, the obtained results provide a realistic approximation of the residual stresses and the changes in the mechanical behavior under physiological conditions.

A review of techniques for visualising soft tissue microstructure deformation and quantifying strain Ex Vivo

Many biological tissues have a complex hierarchical structure allowing them to function under demanding physiological loading conditions. Structural changes caused by ageing or disease can lead to loss of mechanical function. Therefore, it is necessary to characterise tissue structure to understand normal tissue function and the progression of disease. Ideally intact native tissues should be imaged in 3D and under physiological loading conditions. The current published in situ imaging methodologies demonstrate a compromise between imaging limitations and maintaining the samples native mechanical function. This review gives an overview of in situ imaging techniques used to visualise microstructural deformation of soft tissue, including three case studies of different tissues (tendon, intervertebral disc and artery). Some of the imaging techniques restricted analysis to observational mechanics or discrete strain measurement from invasive markers. Full-field local surface strain measurement has been achieved using digital image correlation. Volumetric strain fields have successfully been quantified from in situ X-ray microtomography (micro-CT) studies of bone using digital volume correlation but not in soft tissue due to low X-ray transmission contrast. With the latest developments in micro-CT showing in-line phase contrast capability to resolve native soft tissue microstructure, there is potential for future soft tissue mechanics research where 3D local strain can be quantified. These methods will provide information on the local 3D micromechanical environment experienced by cells in healthy, aged and diseased tissues. It is hoped that future applications of in situ imaging techniques will impact positively on the design and testing of potential tissue replacements or regenerative therapies. LAY DESCRIPTION: The soft tissues in our bodies, such as tendons, intervertebral discs and arteries, have evolved to have complicated structures which deform and bear load during normal function. Small changes in these structures can occur with age and disease which then leads to loss of function. Therefore, it is important to image tissue microstructure in 3D and under functional conditions. This paper gives an overview of imaging techniques used to record the deformation of soft tissue microstructures. Commonly there are compromises between obtaining the best imaging result and retaining the samples native structure and function. For example, invasive markers and dissecting samples damages the tissues natural structure, and staining or clearing (making the tissue more transparent) can distort tissue structure. Structural deformation has been quantified from 2D imaging techniques (digital image correlation) to create surface strain maps which help identify local tissue mechanics. When extended to 3D (digital volume correlation), deformation measurement has been limited to bone samples using X-ray micro-CT. Recently it has been possible to image the 3D structure of soft tissue using X-ray micro-CT meaning that there is potential for internal soft tissue mechanics to be mapped in 3D. Future application of micro-CT and digital volume correlation will be important for soft tissue mechanics studies particularly to understand normal function, progression of disease and in the design of tissue replacements.

Computational predictions of damage propagation preceding dissection of ascending thoracic aortic aneurysms

Dissections of ascending thoracic aortic aneurysms (ATAAs) cause significant morbidity and mortality worldwide. They occur when a tear in the intima-media of the aorta permits the penetration of the blood and the subsequent delamination and separation of the wall in 2 layers, forming a false channel. To predict computationally the risk of tear formation, stress analyses should be performed layer-specifically and they should consider internal or residual stresses that exist in the tissue. In the present paper, we propose a novel layer-specific damage model based on the constrained mixture theory, which intrinsically takes into account these internal stresses and can predict appropriately the tear formation. The model is implemented in finite-element commercial software Abaqus coupled with user material subroutine. Its capability is tested by applying it to the simulation of different exemplary situations, going from in vitro bulge inflation experiments on aortic samples to in vivo overpressurizing of patient-specific ATAAs. The simulations reveal that damage correctly starts from the intimal layer (luminal side) and propagates across the media as a tear but never hits the adventitia. This scenario is typically the first stage of development of an acute dissection, which is predicted for pressures of about 2.5 times the diastolic pressure by the model after calibrating the parameters against experimental data performed on collected ATAA samples. Further validations on a larger cohort of patients should hopefully confirm the potential of the model in predicting patient-specific damage evolution and possible risk of dissection during aneurysm growth for clinical applications.

A Pointwise Method for Identifying Biomechanical Heterogeneity of the Human Gallbladder

Identifying the heterogeneous biomechanical property of human gallbladder (GB) walls from non-invasive measurements can have clinical significance in patient-specific modeling and acalculous biliary pain diagnosis. In this article, a pointwise method was proposed to measure the heterogeneity of ten samples of human GB during refilling. Three different points, two on the equator of GB body 90° apart and one on the apex of GB fundus, were chosen to represent the typical regions of interest. The stretches at these points were estimated from ultrasound images of the GB during the bile emptying phase based on an analytical model. The model was validated against the experimental data of a lamb GB. The material parameters at the different points were determined inversely by making use of a structure-based anisotropic constitutive model. This anisotropic model yielded much better accuracy when compared to a number of phenomenologically-based constitutive laws, as demonstrated by its significantly reduced least-square errors in stress curve fitting. The results confirmed that the human GB wall material was heterogeneous, particularly toward the apex region. Our study also suggested that non-uniform wall thickness of the GB was important in determining the material parameters, in particular, on the parameters associated with the properties of the matrix and the longitudinal fibers—the difference could be as large as 20–30% compared to that of the uniform thickness model.

Correlation of Wall Microstructure and Heterogeneous Distributions of Strain in Evolving Murine Abdominal Aortic Aneurysms

A primary deficiency in predicting the progression and rupture-risk of abdominal aortic aneurysms (AAAs) is an inability to assign patient-specific, heterogeneous biomechanical properties to the remodelling aortic wall. Toward this end, we investigated possible correlations between three quantities having the potential for non-invasive measurement (diameter, wall thickness, and strain) and local wall microstructure within evolving experimental AAAs. AAAs were initiated in male C57BL/6J mice via in situ adventitial application of elastase and allowed to progress for 1-4 weeks. Regional in vitro Green strain was assessed using custom panoramic digital image correlation and compared to local geometry and histology. Diameter correlated mildly with elastin grade and collagen, when considering all circumferential locations and remodeling times. Normalized wall thickness correlated strongly with normalized collagen area fraction, though with outliers in highly cellular regions. Circumferential Green strain correlated strongly with elastin grade when measured over the range of 20-140 mmHg, though the correlation weakened across a physiologic range of 80-120 mmHg. Axial strain correlated strongly between in vitro and physiologic ranges of pressures. Circumferential heterogeneities render diameter a poor predictor of underlying regional microstructure. Thickness may indicate collagen content, though corrections are needed in regions of increased cellularity. In vitro circumferential strain predicts local functional elastin over large ranges of pressure, but there is a need to extend this correlation to clinically relevant pressures. Axial strain in the aneurysmal shoulder region may reflect the elastic integrity within the apical region of the lesion and should be explored as an indicator of disease severity.

A hidden structural vulnerability in the thrombospondin-2 deficient aorta increases the propensity to intramural delamination

Mice lacking thrombospondin-2 (TSP2) represent an animal model of impaired collagen fibrillogenesis. Collagen constitutes ~1/3 of the wall of the normal murine descending thoracic aorta (DTA) and is thought to confer mechanical strength at high pressures. Microstructural analysis of the DTA from TSP2-null mice revealed irregular and disorganized collagen fibrils in the adventitia and at the interface between the media and adventitia. Yet, biaxial mechanical tests performed under physiologic loading conditions showed that most mechanical metrics, including stress and stiffness, were not different between mutant and control DTAs at 20- and 40-weeks of age, thus suggesting that the absence of TSP2 is well compensated under normal conditions. A detailed bilayered analysis of the wall mechanics predicted, however, that the adventitia of TSP2-null DTAs fails to engage at high pressures, which could render the media vulnerable to mechanical damage. Failure tests confirmed that the pressure at which the DTA ruptures is significantly lower in 20-week-old TSP2-null mice compared to age-matched controls (640±37 vs. 1120±45mmHg). Moreover, half of the 20-week-old and all 40-week-old mutant DTAs failed by delamination, not rupture. This delamination occurred at the interface between the media and the adventitia, with separation planes often observed at ~45 degrees with respect to the circumferential/axial directions. Combined with the observed microstructural anomalies, our theoretical-experimental biomechanical results suggest that TSP2-null DTAs are more susceptible to material failure when exposed to high pressures and this vulnerability may result from a reduced resistance to shear loading at the medial/adventitial border.

Microscopic full-field three-dimensional strain measurement during the mechanical testing of additively manufactured porous biomaterials

A custom-designed micro-digital image correlation system was used to track the evolution of the full-surface three-dimensional strain field of Ti6Al4V additively manufactured lattice samples under mechanical loading. The high-magnification capabilities of the method allowed to resolve the strain distribution down to the strut level and disclosed a highly heterogeneous mechanical response of the lattice structure with local strain concentrations well above the nominal global strain level. In particular, we quantified that strain heterogeneity appears at a very early stage of the deformation process and increases with load, showing a strain accumulation pattern with a clear correlation to the later onset of the fracture. The obtained results suggest that the unique opportunities offered by the proposed experimental method, in conjunction with analytical and computational models, could serve to provide novel important information for the rational design of additively manufactured porous biomaterials.