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Mechanical Characterization of Ascending Aorta in Patients With and Without Aortic Dissection

2016年8月30日 更新者：Assistance Publique Hopitaux De Marseille

Mechanical Characterization of Ascending Aorta in Patients With Acute Type A Dissection and in Healthy Control Group Combined to Structural and Ultrastructural Analysis of Aortic Tissue

Acute type A aortic dissection is a frequent (3 cases per 100 000 people per year) and severe (spontaneous mortality 70%), needing an emergency surgical treatment. Surgical outcomes have improved with the development of surgical techniques, but the postoperative mortality remains high (15-30% at 30 days). Endovascular approach with the deployment of endoprosthesis sealing the proximal intimal tear is an attractive minimally invasive technique, which can represent an alternative to surgical repair especially in high risk patients.

研究概览

地位

未知

条件

干预/治疗

详细说明

Objectives: this study aims to characterize mechanical properties of ascending aorta (AA) in patients, with and without aortic dissection.

Materials and methods : comprised an in vivo and ex vivo studies performed in 2 groups of patients : (1) patients admitted for acute type A dissection and treated with surgical procedure ; (2) healthy control group selected among patients without any ascending aorta pathology and who underwent transoesophageal echocardiography for various indications.

In vivo study : Strain, distensibility, stiffness index and pressure strain elastic modulus (Ep) were calculated from aortic diameter variation in response to pressure variation. Aortic diameters were measured using transoesophageal echocardiography.

Ex vivo study : biaxial tensile testing were performed on aortic wall samples. Dissected aortic samples were collected from patients who underwent surgical repair and healthy samples from unused donors hearts and lungs. Mechanical characterization was combined to a histological and microstructural analysis of aortic wall. The latter was conducted using multiphoton microscopy to visualize elastin and collagen fibers.

Results :

In vivo study: 22 patients in healthy control group and 13 patients in dissection group were prospectively investigated.

In vitro study : Biaxial testing was performed on 4 samples of dissected aorta and 6 samples of non dissected aorta. Anisotropic and non linear behavior of aortic tissue was shown in the 2 types of samples. Dissected tissue were stiffer than the intimal flap which was in turn stiffer than non dissected tissue.

Histological data showed that in dissection group global elastin density was lower than in control. Microstructural analysis in dissection specimens revealed a higher collagen signal in the media mainly in circumferential plane, contrasting with a roughly similar intensity between the two planes in control. This higher signal reflects higher collagen fiber density and/or thicker fibers in this tunica.

Conclusion : Both in vivo and in vitro data revealed that dissected aorta was stiffer than healthy ascending aorta. These findings has consequences on the choice of futur devices dedicated to AA

研究类型

观察性的

注册 (预期的)

90

联系人和位置

本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。

学习地点

  • 法国
      • Marseille、法国、13354
        • 招聘中
        • Assistance Publique Hôpitaux de Marseille
        • 接触：
          • Mourad BOUFI
          • 电话号码：+33 0491382747
          • 邮箱：drci@ap-hm.fr

参与标准

研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。

资格标准

适合学习的年龄

46年 至 81年 (成人、年长者)

接受健康志愿者

不

有资格学习的性别

全部

取样方法

概率样本

研究人群

patients with ascending aorta dissection

描述

Inclusion Criteria:

  • Patients aged 50 to 85 years
  • The information given search,
  • Aortic dissection evolving for less than 15 days confirmed

Exclusion Criteria:

  • the acute aortic dissections against-indicated for aortic surgery (patient age, stroke or multiple organ failure)
  • Iatrogenic dissections,
  • Dissections related to congenital or hereditary disorder (abnormal connective tissue) or those occurring in subjects with a bicuspid aortic valve,
  • Intramural hematomas type A,
  • Patients under guardianship or trusteeship deprived of liberty.

学习计划

本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。

研究是如何设计的？

设计细节

  • 时间观点：预期

队列和干预

团体/队列
干预/治疗
experimental
patients with acute type A dissection
其他：measure the elastic properties of aortic wall
control
patients without any pathology of the ascending aorta, but having the same characteristics as the sick patients, in terms of age and vascular risk factors including high blood pressure
其他：measure the elastic properties of aortic wall

研究衡量的是什么？

主要结果指标

结果测量
措施说明
大体时间
measure the elastic properties of aortic wall
大体时间：one day
The distensibility, aortic strain will be measured as a function of changes of aortic diameter and pulse pressure.
one day
Measurement of aortic diameters
大体时间：one day
The measurement will be done by transesophageal echocardiography simultaneously to the cuff brachial artery pressure.
one day

合作者和调查者

在这里您可以找到参与这项研究的人员和组织。

赞助

Assistance Publique Hopitaux De Marseille

研究记录日期

这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。

研究主要日期

学习开始

2014年1月1日

初级完成 (实际的)

2016年1月1日

研究完成 (预期的)

2016年8月1日

研究注册日期

首次提交

2016年7月29日

首先提交符合 QC 标准的

2016年8月5日

首次发布 (估计)

2016年8月9日

研究记录更新

最后更新发布 (估计)

2016年8月31日

上次提交的符合 QC 标准的更新

2016年8月30日

最后验证

2016年7月1日

更多信息

与本研究相关的术语

其他研究编号

  • 2013-08

此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.

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