oa Pressure and Angiotensin II Influence the Mechanical Properties of Aortic Valves

Elevated cyclic pressure and angiotensin II (Ang II) both promote aortic valve collagen synthesis, an early hallmark of aortic sclerosis. In the current study, it was hypothesized that the increased collagen production induced by either elevated pressure or Ang II would increase tissue stiffness. Porcine aortic valve leaflets were randomly assigned to four groups; leaflets in group 1 were treated with 10-6M Ang II, leaflets in group 2 were exposed to 80 or 120 mmHg cyclic pressure, leaflets in group 3 were treated with Ang II and exposed to cyclic pressure and leaflets in group 4 were the control. Biaxial testing was performed after 24 and 48 hours on 10mm x 10mm samples of tissue dissected from the central region of the leaflets. Four fiducial markers arranged in an approximately 4 mm x 4 mm square were placed in the center of the extracted portion of the leaflets to track tissue strain. A membrane tension (force/unit length) was applied along each axis and increased slowly from a pre-stress tension of ~0.5 N/m to a peak tension of 60 N/m. The samples were preconditioned for ten contiguous cycles, following an equibiaxial protocol of TCC:TRR = 60:60 N/m, where TCC and TRR are the tensions applied in the circumferential and radial directions, respectively. Tissue extensibility was characterized by maximum stretch along the circumferential direction (λcc) and maximum stretch along the radial direction (λrr), at an equibiaxial tension of 60 N/m. Leaflet stiffness was greater in the circumferential direction than in the radial direction, which is consistent with previous studies. The peak stretches of native valves were calculated as 1.05±0.02 and 1.40±0.02 in the circumferential and radial directions, respectively. There was no significant difference in the stiffness of native valves compared to those exposed to 0mmHg(-Ang II) or 80mmHg(-Ang II) for 24 or 48 hours. Elevated pressure increased stiffness in both directions after 24 and 48 hours. After 24 and 48 hours Ang II significantly increased stiffness in the radial direction. The combination of Ang II and elevated pressure increased stiffness in radial direction after 24 and 48 hours. Increased stiffness may be due to remodeling of the ECM. Excessive collagen production is known to hinder valve function, eventually resulting in aortic stenosis. In conclusion, the results of the present study demonstrated that both elevated pressure and Ang II play a role in the increased stiffness of aortic valve leaflets.