Role of Aortic Root Motion in the Pathogenesis of Aortic Dissection
- 17 February 2004
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Circulation
- Vol. 109 (6), 763-769
- https://doi.org/10.1161/01.cir.0000112569.27151.f7
Abstract
Background— The downward movement of the aortic root during the cardiac cycle may be responsible for producing the circumferential tear observed in aortic dissections. Methods and Results— Contrast injections were investigated in 40 cardiac patients, and a finite element model of the aortic root, arch, and branches of the arch was built to assess the influence of aortic root displacement and pressure on the aortic wall stress. The axial displacement of the aortic root ranged from 0 to 14 mm. It was increased in patients with aortic insufficiency (22±13% of the sino-tubular junction diameter versus 12±9%) and reduced in patients with hypokinesis of the left ventricle (10±9% of sino-tubular junction versus 17±12%). The largest stress increase due to aortic root displacement was found approximately 2 cm above the sino-tubular junction, where the longitudinal stress increased by 50% to 0.32 Nmm−2 when 8.9-mm axial displacement was applied in addition to 120-mm Hg luminal pressure. A similar result was observed when the pressure load was increased to 180 mm Hg without axial displacement. Conclusions— Both aortic root displacement and hypertension significantly increase the longitudinal stress in the ascending aorta. For patients with hypertension who are at risk of dissection, aortic root movement may be monitored as an important risk factor.Keywords
This publication has 11 references indexed in Scilit:
- Heart motion adapted cine phase-contrast flow measurements through the aortic valveMagnetic Resonance in Medicine, 1999
- Wall stress as a possible mechanism for the development of transverse intimal tears in aortic dissectionsJournal of Medical Engineering & Technology, 1999
- Residual strain effects on the stress field in a thick wall finite element model of the human carotid bifurcationJournal of Biomechanics, 1997
- Ex vivo biomechanical behavior of abdominal aortic aneurysm: Assessment using a new mathematical modelAnnals of Biomedical Engineering, 1996
- Pressure-induced mechanical stress in the carotid artery bifurcation: A possible correlation to atherosclerosisJournal of Biomechanics, 1995
- Aortic MotionJournal of Computer Assisted Tomography, 1995
- Failure properties of passive human aortic tissue. II—Biaxial tension testsJournal of Biomechanics, 1983
- Pathogenesis of dissecting aneurysm of aorta: Comparative histopathologic study of significance of medial changesThe American Journal of Cardiology, 1977
- Movement of the aortic annulusThe British Journal of Radiology, 1969
- DISSECTING ANEURYSM OF THE AORTAMedicine, 1958