Abstract
Atherosclerosis is a major risk factor for cardiovascular disease. However, mechanisms of interaction of atherosclerotic plaque development and local stiffness of the lamellar structure of the arterial wall are not well established. In the current study, the local Young’s modulus of the wall and plaque components were determined for three different groups of healthy, mildly diseased and advanced atherosclerotic human abdominal aortas. Histological staining was performed to highlight the atherosclerotic plaque components and lamellar structure of the aortic media, consisting of concentric layers of elastin and interlamellar zones. The force spectroscopy mode of the atomic force microscopy was utilized to determine Young’s moduli of aortic wall lamellae and plaque components at the micron level. The high variability of Young’s moduli (E) at different locations of the atherosclerotic plaque such as the fibrous cap (E = 15.5± 2.6 kPa), calcification zone (E = 103.7±19.5 kPa), and lipid pool (E = 3.5±1.2 kPa) were observed. Reduction of elastin lamellae stiffness (18.6%), as well as stiffening of interlamellar zones (50%), were detected in the diseased portion of the medial layer of abdominal aortic wall compared to the healthy artery. Additionally, significant differences in the stiffness of both elastin lamellae and interlamellar zones were observed between the diseased wall and disease-free wall in incomplete plaques. Our results elucidate the alternation of the stiffness of different lamellae in the human abdominal aortic wall with atherosclerotic plaque development and may provide new insight on the remodeling of the aortic wall during the progression of atherosclerosis.
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Acknowledgments
Authors thank Dr. Davood Kazemi-Saleh and Dr. Zahra Pourjafar at Baghiatallah Hospital for providing tissue specimens. Authors also thank Dr. Amirnader Emami Razavi at Tehran University of Medical Sciences for assistance in the preparation of samples for AFM test and determination of different components of atherosclerotic plaques and arterial wall layers in specimens.
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Alireza Rezvani-Sharif, Mohammad Tafazzoli-Shadpour and Alberto Avolio declare that they have no conflict of interest.
Ethical Approval
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5). Informed consent was obtained from all patients for being included in the study. No animal studies were carried out by the authors for this article.
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Associate Editor Wei Sun and Ajit P. Yoganathan oversaw the review of this article.
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Rezvani-Sharif, A., Tafazzoli-Shadpour, M. & Avolio, A. Mechanical Characterization of the Lamellar Structure of Human Abdominal Aorta in the Development of Atherosclerosis: An Atomic Force Microscopy Study. Cardiovasc Eng Tech 10, 181–192 (2019). https://doi.org/10.1007/s13239-018-0370-1
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DOI: https://doi.org/10.1007/s13239-018-0370-1