In the first part of this dissertation, the phenomenon of self-sustained pressure os-cillations due to the flow past a circular, axisymmetric cavity, associated with inline gate valves, was investigated. In many engineering applications, such as flows through open gate valves, there exists potential for coupling between the vortex shedding from the up-stream edge of the cavity and a diametral mode of the acoustic pressure fluctuations. The effects of the internal pipe geometry immediately upstream and downstream of the shal-low cavity on the characteristics of partially trapped diametral acoustic modes were in-vestigated numerically and experimentally on a scaled model of a gate valve mounted in a pipeline that contained convergence-divergence sections in the vicinity of the valve. The resonant response of the system corresponded to the second acoustic diametral mode of the cavity. Excitation of the dominant acoustic mode was accompanied by pressure oscillations, and, in addition to that, as the angle of the converging-diverging section of the main pipeline in the vicinity of the cavity increased, the trapped behavior of the acoustic diametral modes diminished, and additional antinodes of the acoustic pressure wave were observed in the main pipeline. In addition to that, the effect of shallow chamfers, introduced at the upstream and/or downstream cavity edges, was investigated in the experimental system that con-tained a deep, circular, axisymmetric cavity. Through the measurements of unsteady pressure and associated acoustic mode shapes, which were calculated numerically for several representative cases of the internal cavity geometry, it was possible to identify the configuration that corresponded to the most efficient noise suppression. This arrangement also allowed calculation of the azimuthal orientation of the acoustic modes, which were classified as stationary, partially spinning or spinning. Introduction of shallow chamfers at the upstream and the downstream edges of the cavity resulted in changes of azimuthal orientation and spinning behaviour of the acoustic modes. In addition, introduction of splitter plates in the cavity led to pronounced change in the spatial orientation and the spinning behaviour of the acoustic modes. The short splitter plates changed the behaviour of the dominant acoustic modes from partially spinning to stationary, while the long split-ter plates enforced the stationary behaviour across all resonant acoustic modes. Finally, the evolution of fully turbulent, acoustically coupled shear layers that form across deep, axisymmetric cavities and the effects of geometric modifications of the cavity edges on the separated flow structure were investigated using digital particle image velocimetry (PIV). Instantaneous, time- and phase-averaged patterns of vorticity pro-vided insight into the flow physics during flow tone generation and noise suppression by the geometric modifications. In particular, the first mode of the shear layer oscillations was significantly affected by shallow chamfers located at the upstream and, to a lesser degree, the downstream edges of the cavity. In the second part of the dissertation, the performance of aortic heart valve pros-thesis was assessed in geometries of the aortic root associated with certain types of valve diseases, such as aortic valve stenosis and aortic valve insufficiency. The control case that corresponds to the aortic root of a patient without valve disease was used as a reference. By varying the aortic root geometry, it was possible to investigate corresponding changes in the levels of Reynolds shear stress and establish the possibility of platelet activation and, as a result of that, the formation of blood clots. / Graduate / 0541 / 0546 / 0548 / 0986 / alexbn024@gmail.com

Diss. Linköping : Linköpings universitet, 2005.

Η νευρολογικές διαταραχές και κυρίως η παραπληγία, αποτελούν τις πιο καταστροφικές επιπλοκές των επεμβάσεων στη θωρακο-κοιλιακή αορτή. Η διαδικασία ισχαιμίας/επαναιμάτωσης κατά τις επεμβάσεις αυτές λόγω του αποκλεισμού της αορτής, προκαλεί την ανάπτυξη τοξικών ελεύθερων ριζών οξυγόνου φαινόμενο που ορίζει το οξειδωτικό stress. Ο σκοπός της παρούσας μελέτης είναι ο καθορισμός και η ανίχνευση των ελευθέρων ριζών, αλλά και η επίδραση της Αμιφοστίνης, ενός αντιοξειδωτικού παράγοντα της κατηγορίας των θειολών. Μέθοδος: Η μέθοδος αφορά δεκαοκτώ αρσενικούς κονίκλους που υποβάλλονται σε ισχαιμία του νωτιαίου μυελού με αποκλεισμό της αορτής με τη χρήση ενδο-αορτικού ασκού. Ο ασκός προωθείται μέσω της μηριαίας αρτηρίας σε επίπεδο αμέσως κάτωθεν της αριστεράς υποκλειδίου αρτηρίας. Τα ζώα αποτελούσαν τρείς ομάδες. Η Ομάδα Ι αποτέλεσε την ομάδα ελέγχου. Στην Ομάδα ΙΙ η αορτή αποκλείσθηκε για 30΄και ακολούθησε επαναιμάτωση για 75΄. Στην Ομάδα ΙΙΙ χορηγήθηκε Αμιφοστίνη μέσω του καθετήρα αποκλεισμού κατά το δεύτερο ήμισυ της περιόδου αποκλεισμού (των 30΄). Στο τέλος της επαναιμάτωσης δείγματα νωτιαίου μυελού υποβλήθηκαν σε ανάλογη επεξεργασία για την ανίχνευση ελευθέρων ριζών οξυγόνου με τη χρήση υδροεθιδίνης και παραγώγων λιπιδικής υπεροξείδωσης με ιδιαίτερα ευαίσθητη μέθοδο φθορισμού. Αποτελέσματα: Τα αποτελέσματα των μετρήσεων έδειξαν αύξηση του υπεροξειδίου του οξυγόνου στην Ομάδα ΙΙ κατά 27.43% σχετικά με την Ομάδα Ι για να ακολουθήσει μείωση στην Ομάδα ΙΙΙ κατά 42.55% σε σχέση με την Ομάδα ΙΙ και κατά 15.25% από την Ομάδα ΙΙΙ. Η μέτρηση ενώσεων λιπιδικής υπεροξείδωσης που αντιδρούν με θειοβαρβιτουρικό οξύ (TBARSassay) έδειξε αύξηση κατά 55.3% στην Ομάδα ΙΙ σε σχέση με την Ομάδα Ι και μείωση κατά 30.3% στην Ομάδα ΙΙΙ σε σχέση με την Ομάδα ΙΙ. Η στατιστική ανάλυση και των δύο μεθόδων ανέδειξε σημαντική διαφορά με ( p<0.05). Συμπεράσματα: Ο αποκλεισμός της κατιούσας αορτής σε επίπεδο αμέσως κάτωθεν της αριστεράς υποκλειδίου αρτηρίας, προκαλεί αναμφισβήτητα ισχαιμία του νωτιαίου μυελού. Η ανάπτυξη οξειδωτικού stressως αποτέλεσμα της διαδικασίας ισχαιμία/επαναιμάτωση ανιχνεύεται μέσω των ριζών υπεροξειδίου και παραγώγων λιπιδικής υπεροξείδωσης. Η έγχυση Αμιφοστίνης προτείνεται ως αντιοξειδωτικός παράγων που μπορεί να ανιχνεύσει και να δεσμεύσει τις ελεύθερες ρίζες οξυγόνου κατά το οξειδωτικό stress που προκαλεί η ισχαιμία /επαναιμάτωση του νωτιαίου μυελού. / Paraplegia is the most devastating complication of thoraco-abdominal aortic procedures. An ischemia-reperfusion procedure is known to elevate free radicals causing oxidative stress. The aim of this study is to determine and to detect the free radical products and to examine the influence of Amifostine, a triphosphate agent, on oxidative stress of spinal cord ischemia-reperfusion in rabbits. Methods: Eighteen male, New Zealand white rabbits were anesthetized and spinal cord ischemia was induced by inflation of a coronary artery balloon catheter, advanced to descending thoracic aorta through the femoral artery. The animals were randomly divided into 3 groups. Group I functioned as control. In group II the aorta was occluded for 30 minutes and then re-perfused for 75 min. In group III, 500mg Amifostine was infused into the distal aorta during the second half-time of ischemia period. At the end of reperfusion all animals were sacrificed and spinal cord specimens were examined for superoxide radicals by an ultra sensitive fluorescent assay. Results: Superoxide radical levels ranged, in group I between 1.52 and 1.76 (1.64±0.10), in group II between 1.96 and 2.50 (2.10±0.21), and in group III (amifostine) between 1.21 and 1.60 (1.40±0.13) (p=0.00), showing a decrease of 43% in the Group of Amifostine. A lipid peroxidation marker measurement ranged, in group I between 0.28 and 0.31 (0.30±0.01), in group II between 0.427 and 0.497 (0.466±0.024), and in group III (amifostine) between 0.343 and 0.357 (0.36±0.005) (p<0.00), showing a decrease of 38% after Amifostine administration. Conclusions: Occlusion of aorta below left subclavian artery causes spinal cause ischemia without the interference of collateral perfusion. Modified use of hydrο-ethidine is a useful assay for the detection of superoxide radicals. By direct and indirect methods of measuring the oxidative stress of spinal cord after ischemia/reperfusion, it is suggested that intra-aortic Amifostine infusion significantly attenuated the spinal cord oxidative injury.

Submitted by Clebson Anjos (clebson.leandro54@gmail.com) on 2016-03-29T17:44:52Z No. of bitstreams: 1 arquivototal.pdf: 1922192 bytes, checksum: 6f50e098ac1e02adb9b434bdbc12154e (MD5) / Made available in DSpace on 2016-03-29T17:44:52Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1922192 bytes, checksum: 6f50e098ac1e02adb9b434bdbc12154e (MD5) Previous issue date: 2014-08-25 / Conselho Nacional de Pesquisa e Desenvolvimento Científico e Tecnológico - CNPq / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / TRP channels have been extensively studied in many physiological and pathological processes involved in blood pressure regulation. Carvacrol is well known to act on TRP channels in the vasculature, however there are no studies of its effects in hypertensive rats. Our aim was to evaluate the contribution of TRP channels in hypertension and evaluate the effects of carvacrol on TRP channels of SHR. In an electrophysiological approach, carvacrol (300 μM) inhibited the barium current, suggesting a reduction of calcium influx through L-type voltage-operated Ca2+ channels. We found that the mRNA expression of the following TRP channels: TRPV1 (p=0.0007), TRPV4 (p=0.0002), TRPM7 (p=0.0091) and TRPM8 (p=0.0008) are decreased and TRPC1 (p=0,02) are increased in SHR compared to control. In aortic rings preparations precontracted with 1 μM of phenylephrine, carvacrol (10-8 - 3x10-4 M) induced vasorelaxation in WKY (pD2 = 4.88  0.09, Emax = 100.73  2.24%, n = 6) and SHR (pD2 = 4.93  0.08, Emax= 110.06  2.07%, n = 6) in the presence of functional endothelium and that effect was not altered after endothelium removal in WKY (pD2 = 5.09  0.08, Emax = 99.60  0.88%, n = 6) and SHR (pD2 = 5.00  0.08, Emax = 101.23  1.96%, n = 6), proposing an endotheliumindependent mechanism. To assess the role of TRP channels, aortic rings were incubated with ruthenium red. In this assay, the vasorelaxant response was not changed in the WKY. On the other hand both potency (p<0.001) and efficacy (p<0.001) were reduced in SHR, suggesting that carvacrol could activate the subtypes TRPV in hypertensive animals. When using magnesium, equally potency (p<0.001) and pharmacological efficacy (p<0.01) were attenuated in both WKY and SHR, suggesting the involvement of TRPM7. In preparations with 2-APB, CPZ and BCTC, the vasorelaxant effect was potentiated (p<0.01) in both WKY and SHR, suggesting the participation of TRPV1, TRPM8 and TRPM7 channels in the vasorelaxant effect induced by carvacrol. Nevertheless, in the presence of capsaicin, the vasodilator effect was attenuated (p<0.001) in both WKY and SHR endorsing a possible action of carvacrol on TRPV1 and TRPV4 channel. In addition, in vivo studies showed that carvacrol produced hypotension and bradycardia in unanesthetized WKY and SHR. In order to address the cardiovascular responses in vivo, we performed experiments using ruthenium red and capsaicin to evaluate the contribution of TRP channels in this effect. Our results suggested an action of carvacrol on TRPV1 and TRPV4, confirming the in vitro assays. In conclusion, these results suggest that the expression of TRPV1, TRPV4, TRPM7 and TRPM8 was reduced and TRPC1 increased in SHR and carvacrol induced a vasorelaxant effect probably by acting on TRPV1, TRPV4, TRPC1, TRPM7 and TRPM8 in SHR. Furthermore, the in vivo effects induced by carvacrol exhibited a hypotensive and bradycardic activity and this effect, at least in part, is due to an activation of TRPV1 and TRPV4 channels in these responses. / Os canais TRP têm sido amplamente estudados, em diversos processos de regulação fisiológico e patológico no sistema cardiovascular. Carvacrol (5-isopropil-2metilfenol) é conhecido por agir na vasculatura ativando ou bloqueando canais TRP, entretanto não há relatos dos seus efeitos em ratos hipertensos. Nosso objetivo foi avaliar o envolvimento dos canais TRP na hipertensão e o papel do carvacrol nos efeitos cardiovasculares em ratos espontaneamente hipertensos. Em ensaios eletrofisiológicos carvacrol (300μM) promoveu inibição das correntes de bário, sugerindo uma inibição do influxo de cálcio por canais de Ca2+ tipo-L. Ao avaliar a expressão do RNAm dos canais TRP em SHR, observamos pela primeira vez que a expressão de TRPV1 (p=0,0007), TRPV4 (p=0,0002), TRPM7 (p=0,0091), TRPM8 (p=0,0008) foram diminuídas e TRPC1 (p=0,02) aumentada. Em anéis de aorta précontraídos com 1 μM de FEN, o carvacrol (10-8 - 3 ₓ 10-4 M) induziu vasorelaxamento em ratos wistar kyoto (WKY) (pD2 = 4,88  0,09, Emáx = 100,73  2,24%, n = 6; pD2 = 5,09 0,08, Emáx = 99,60  0,88%, n = 6) e em ratos espontaneamente hipertensos (SHR) (pD2 = 4,93  0,08, Emáx = 110,06  2,07%, n = 6) na presença e na ausência do endotélio funcional, respectivamente. Para avaliar a participação dos canais TRP, na ausência do endotélio funcional as preparações foram incubadas com vermelho de rutênio, em WKY não houve alteração da resposta, mas em animais SHR tanto sua potência (p<0,001) como sua eficácia (p<0,001) foram diminuídas, sugerindo que carvacrol pode estar agindo em TRPV nos SHR. Ao utilizar magnésio, em WKY e SHR tanto sua potência (p<0,01) quanto sua eficácia (p<0,001) farmacológica foram atenuadas, sugerindo ação sobre o canal TRPM7. Nas preparações com 2-APB, CPZ e BCTC os seus efeitos foram potencializados (p<0,01), sugerindo ação sobre os canais TRPV1, TRPC1, TRPM7 e TRPM8. Já com capsaicina, um ativador de TRPV1, esse efeito foi atenuado (p<0,001) confirmando uma possível ação do carvacrol sobre TRPV1. Nos estudos in vivo, com WKY e SHR não anestesiados, carvacrol produziu hipotensão e bradicardia, onde ao avaliar a ação dos canais TRP em ensaios com vermelho de rutênio e capsaicina pode-se sugerir uma possível ação de carvacrol sobre TRPV1 e TRPV4, diminuindo a pressão arterial, corroborando com os ensaios in vitro. Em conclusão, esses resultados sugerem que os canais TRPV1, TRPV4, TRPM8 e TRPM7 têm sua expressão diminuída e TRPC1 a expressão aumentada em animais SHR e carvacrol induz efeito vasorelaxante provavelmente agindo em TRPV1, TRPV4, TRPC1, TRPM7 e TRPM8 em SHR. Além disso, os efeitos induzidos por carvacrol in vivo mostraram uma atividade hipotensora e bradicárdica e uma possível influencia dos canais TRPV1 e TRPV4 nessas respostas.

INTRODUÇÃO: A lesão medular isquêmica continua sendo uma complicação devastadora das intervenções cirúrgicas na aorta torácica descendente e aorta toracoabdominal. Relatos das diferenças de desfechos clínicos neurológicos entre os gêneros após lesões cerebrais isquêmicas e traumáticas têm levantado o interesse nas influências hormonais, bem como gerado outros estudos buscando a comprovação dos efeitos neuroprotetores do estradiol e da progesterona. Nossa hipótese foi a de que a administração aguda de 17beta-estradiol ou de progesterona seria capaz de prevenir ou atenuar a lesão medular isquêmica causada pela oclusão transitória da aorta torácica descendente proximal. OBJETIVO: Analisar os efeitos na medula espinhal da administração aguda de 17?-estradiol ou de progesterona em modelo experimental de isquemia-reperfusão medular por oclusão transitória da aorta torácica descente proximal de ratos machos. MÉTODOS: Ratos machos, da linhagem wistar, foram divididos aleatoriamente em 3 grupos para a administração de 280ug/Kg de 17beta-estradiol (n=12) ou de 4mg/Kg de progesterona (n=8) ou do veículo de infusão (grupo controle) (n=12), 30 minutos antes da oclusão transitória da aorta torácica descendente por 12 minutos. A confirmação da oclusão efetiva aórtica deu-se por meio da monitorização contínua da pressão arterial média distal com o uso de cateter colocado na artéria caudal dos animais (mantida em 10mmHg). A oclusão da aorta torácica descendente deu-se por meio do posicionamento de um cateter de Fogarty no. 2, passado no sentido caudal, via dissecção da artéria carótida comum esquerda do animal. A função locomotora dos animais foi avaliada no 1o, 3o, 5o, 7o, e 14o dia pós-operatório. No 14o dia pós-operatório, os animais, após anestesia profunda, foram sacrificados e tiveram suas medulas espinhais retiradas para análise histológica e imunohistoquímica. RESULTADOS: Houve comprometimento significativo da função locomotora inicialmente nos 3 grupos de estudo, com recuperação parcial da mesma ao longo do período de observação, não havendo diferença entre os grupos durante o período de observação. A análise histológica da substância cinzenta evidenciou escassos neurônios viáveis e importante vacuolização celular nos 3 grupos de estudo no 14o dia. A análise imunohistoquímica da substância cinzenta medular com anticorpos anti-Bcl2 e anti-anexina V foi similar nos 3 grupos. Houve marcação positiva de necrose celular com o iodeto de propídio, sendo a mesma semelhante nos 3 grupos estudados. CONCLUSÃO: A administração aguda de estradiol ou de progesterona, 30 minutos antes da oclusão transitória da aorta descendente proximal de ratos machos não foi capaz de prevenir ou atenuar a lesão medular isquêmica, até o 14o dia de observação, do ponto vista funcional ou histológico / BACKGROUND: Spinal cord ischemic injury remains a dreadful complication following thoracic and thoracoabdominal aortic interventions. Reports on gender-related neurological outcomes after ischemic and traumatic brain injuries have raised interest in hormonal influences, and have generated studies into neuroprotective effects of estrogen and progesterone. We hypothesized that the acute pre-operative administration of estradiol or of progesterone would prevent or attenuate spinal cord ischemic injury induced by transitory occlusion of the proximal descending thoracic aorta. OBJECTIVE: Evaluate the spinal cord effects of the acute administration of 17beta-estradiol or of progesterone in a spinal cord ischemia-reperfusion model. METHODS: Male rats were divided to receive 280ug/Kg of 17beta-estradiol (n=12) or 4mg/Kg of progesterone (n=8) or vehicle (control group) (n=12) 30 minutes before transitory occlusion of the proximal descending thoracic aorta, mean distal arterial blood pressure was maintained at 10mmHg during 12 minutes. Hind limb motor function was assessed at 1, 3, 5, 7 and 14 days after reperfusion. At the 14th day, a segment of the thoracolumbar spinal cord was harvested and prepared to histological and imunohistochemical analyses. RESULTS: There was an important hind limb motor function impairment initially in the 3 study groups, with partial improvement along time, but no difference was detected between groups during de observational period. Gray matter analysis showed scarce viable neurons and a marked cellular vacuolation in all three groups, but the number of viable neurons per section areas was not different between study groups at day 14th. Immunostaining of the spinal cord gray matter with antibodies anti-Bcl2 and anti-annexin V was similar among the 3 study groups. There was positive staining for the necrotic marker propidium iodide, with all groups presenting a similar staining pattern. CONCLUSION: We found that a single-dose administration of estradiol or of progesterone, 30 minutes before transitory occlusion of the proximal descending thoracic aorta of male rats, was not able to prevent spinal cord ischemic injury through analysis of functional and histological outcomes at 14 days of observation

Introdução: O presente estudo visa elucidar a apresentação anatômica da vasculatura medular em exame angiotomográfico e suas diferenças entre pacientes aortopatas e não aortopatas na população brasileira. Objetivos: Determinar as características da artéria de Adamkiewicz (AKA) e artéria espinhal anterior (ASA) por método não invasivo. Secundariamente, determinaremos a distribuição anatômica da AKA na população brasileira e a influência de determinadas aortopatias e comorbidades na identificação da AKA. Casuística: Cento e quinze angiotomografias elegíveis realizadas no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo foram avaliadas e separadas entre pacientes aortopatas e não aortopatas. Trinta e dois (52,5%) homens e 29 mulheres constituíram o grupo não aortopata e 30 (56,6%) homens e 23 mulheres constituíram o grupo de aortopatas. Método: Análise prospectiva de angiotomografias realizadas em aparelho de 320 detectores através de software open-source OsiriX e identificação da AKA e ASA por reconstrução multiplanar tridimensional. Dados clínicos e sociodemográficos foram estratificados. Resultados: A AKA foi identificada em 78,7% dos integrantes do grupo não aortopata e em 40,7% dos pacientes aortopatas (p =< 0,0001). A ASA foi identificada em 80,3% dos integrantes do grupo não aortopata e em 46,3% dos pacientes aortopatas (p=0,0001). Em 53 (73,6%) casos a AKA originou-se do lado esquerdo. Discussão: A angiotomografia é exame de rotina no pré-operatório de doenças aórticas. O presente trabalho apresentou detecção da AKA em grupo não aortopata equiparável com a literatura, apesar do aumento de detectores no aparelho de tomografia e a identificação da AKA em grupo aortopata pouco abaixo da literatura, mas significativamente diferente do grupo não aortopata: maior proporção de identificação da AKA e ASA em pacientes não aortopatas. Houve diferença na distribuição da AKA em comparação com a literatura. Conclusão: A detecção da AKA e ASA pelo método proposto é factível, porém não ocorre na totalidade dos pacientes. A AKA e ASA são mais identificáveis em pacientes não aortopatas e sua distribuição na população estudada não se assemelha à literatura. A origem da AKA é mais frequente entre T10 e T12 à esquerda / Introduction: This study investigated differences in spinal vasculature between healthy and diseased aortas among Brazilian population. Objective: The study aimed to identify and describe the spinal vascular anatomy, evaluate Anterior Spinal Artery (ASA) and Adamkiewicz artery (AKA) characteristics using non-invasive multidetector computed tomography (CT), as well as examine differences between groups with and without aortic disease. The secondary aim was to evaluate anatomic distribution of AKA level and side and the influence of clinical factors in its detection. Methods: CT scans of 115 patients from Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo were evaluated in terms of detection rate and AKA level and side. The results were also compared with data compiled from a review of the English language literature on this topic. We analysed 320-detector CT scans using OsiriX open source software. Furthermore, we identified the AKA and ASA using tridimensional multiplannar reconstruction. Clinical and demographics data were retrieved. Results: AKA identification showed higher detection rate in patients with healthy aortas (78.7%) compared to diseased aortas (40.7%) p < 0.0001. ASA was identified in 80.3% of the healthy aortas patients and 46.3% of the diseased aortas patients (p=0.0001). In 53 (76.6%) cases, the AKA originated from a left intercostal artery. Discussion: CT scan is a routine preoperative exam for aorta diseases. We observed a detection rate similar to that reported in previous literature on healthy aortas, in spite of the CT having more detectors. Furthermore, AKA identification in aorta diseased group was below literature, but statistically different from the healthy aorta group, higher AKA and ASA identification was found in healthy aorta group. The results indicated significant difference between previous literatures and our study in AKA detection. Conclusions: AKA detection using proposed method is feasible but is not detected in all patients. AKA and ASA have a higher detection rate in patients with a healthy aorta. The proposed method and data compiled from the literature did not show similar AKA level distribution. AKA originated more frequently from the left side between T10 and T12

Objective: To quantify and compare histopathological differences regarding atherosclerosis and granular media calcinosis (GMC) of ascending aortic aneurysms (AAA), which are associated with aortic stenosis (AS) or aortic regurgitation (AR). Additionally, a subanalysis of patients with bicuspid or tricuspid aortic valve (BAV or TAV), which were contained within the AS and AR group, was conducted. Patients and Methods: From 01/2012 till 12/2015 84 ascending aortic tissue samples were obtained and divided into their convex and concave half during aortic surgery. Aortic surgery was indicated due to AAA in association to AS (AS-AAA group: n = 43) or AR (AR-AAA group: n = 41). Both groups contained 19 patients with TAV. Convex and concave halves of all samples were stained with three different histologic dyes: hematoxylin-eosin (HE) was used as general stain for atherosclerosis, von-Kossa (vKossa) stain and alizarin-red (Ared) stain were used as calcinosis specific dyes. HE stained samples were analyzed using a semi-quantitative score, while calcinosis quantification was carried out by a binary, pixel guided contrast analysis via computer software. Results: In the AR-AAA group, atherosclerosis was two and a half times more often detectable in the concave halves of the tissue samples as in the AS-AAA group (AR-AAA concave: 15 (36%) vs. AS-AAA concave: 6 (13%), p ≤ 0,01). Regarding GMC, tissue samples from AS-AAAs showed a 4,2-4,5% higher mean GMC deposit than their AR-AAA counterparts (p ≤ 0,001). Furthermore, BAV patients within the AS-AAA group showed a 2,1-2,4% higher mean deposit of GMC than their TAV peers (p ≤ 0,002). These finding of higher GMC deposition was consistent for BAV patients contained in the AAA-AR group. Conclusion: AR-AAA are, in comparison with AS-AAA, more prone to develop atherosclerosis. Atherosclerosis will most likely present at the concave curvature of the ascending aorta. AS-AAAs present significant higher mean GMC deposits than AR-AAAs. Combined with a bicuspid morphology of the aortic valve, GMC deposition in AAAs is elevated in comparison to AAAs with TAV morphology. Therefore AS-AAAs with BAV have the highest tendency to develop heavy GMC deposition, compromising the biomechanical structure of the aortic wall.

No description available.

Little is known about the interaction between diabetes and sex in vasculature. This study was designed to investigate whether there were sex differences in rat aortic endothelial function in diabetes, and to examine the potential roles of superoxide and nitric oxide (NO) in this sex-specific effect. Two diabetic animal models were used: streptozotocin (STZ)-induced type 1 diabetic rats (at early and intermediate stages of disease) and Zucker type 2 diabetic fatty (ZDF) rats. Endothelium-dependent vasodilation (EDV) to acetylcholine (ACh) was measured in aortic rings pre-contracted with phenylephrine (PE) before and after pretreatment with MnTmPYP (10 mM), a superoxide scavenger, or apocynin (100 μM), a NADPH oxidase (Nox) inhibitor. Constrictor response curves (CRC) to PE (10 -8 to 10 -5 M) were also generated before and after pretreatment with L-NAME (200 μM), an endothelial nitric oxide synthase (eNOS) inhibitor, in the presence of indomethacin. In addition, the level of Nox (a potent source of superoxide) and eNOS mRNA expression were determined using real-time RT-PCR. STZ-induced diabetes impaired EDV to ACh to a greater extent in female than male aortae both at early and intermediate stage of disease (1- and 8- week, respectively). Incubation of aortic rings with L-NAME potentiated PE responses in all groups, but aortae from control females showed a greater potentiation of the PE response after NOS inhibition compared with others. STZ-diabetes reduced the extent of PE potentiation after L-NAME and the aortic eNOS mRNA expression in females to the same levels as seen in males. In addition, pre-incubation with MnTMPyP enhanced sensitivity to ACh only in diabetic females one week after STZ induction. Similarly, the levels of Nox1 mRNA expression were enhanced in STZ-induced diabetic females. Type 2 diabetes significantly impaired EDV in aortic rings from females; however, it potentiated the relaxation in male rats. Moreover, type 2 diabetes enhanced the extent of PE potentiation after blocking NOS with L-NAME in females. Pre-incubation of aortic rings with apocynin increased EDV only in diabetic female group. Accordingly, the levels of Nox1, Nox4 and eNOS mRNA expression were substantially enhanced in aorta of female ZDF rats compared to those in lean animals. In a conclusion, our data suggest that an elevation of superoxide and alteration of NO production may in part contribute to the predisposition of the female aorta to injury in diabetes.

[pt] A estenose aórtica é um dos mais graves problemas decorrentes de doenças valvares. O implante da prótese valvar aórtica por cateterismo (TAVI) vem se tornando o tratamento mais indicado aos pacientes de alto risco ou inoperáveis. A estenose aórtica grave pode ser uma condição de risco à vida quando não tratada. Devido à natureza do procedimento TAVI, é esperada uma variabilidade no ângulo de inclinação da válvula implantada. O presente trabalho investigou a influência das variações de inclinação e orientação do jato transvalvar sobre o escoamento em aorta ascendente. A compreensão dos padrões hemodinâmicos do fluxo sanguíneo em aorta ascendente é importante porque eles estão intimamente relacionados ao desenvolvimento de doenças cardiovasculares. Para este fim, um modelo vascular com geometria anatômica de paciente específico foi produzido a partir de imagens de tomografia computadorizada, gerando um protótipo impresso em 3D e resina de silicone transparente. Uma configuração especial foi projetada para permitir medições tridimensionais do fluxo em diferentes seções transversais do modelo aórtico. A técnica de velocimetria por imagens estereoscópicas de partículas foi implementada para produzir informações estatísticas acerca do fluxo turbulento, tais como, campos tridimensionais de velocidade média, de energia cinética turbulenta e correlações entre os componentes de flutuação de velocidade. Os resultados obtidos indicaram que o escoamento em aorta ascendente é fortemente afetado pela direção do fluxo de entrada na aorta. / [en] Aortic stenosis is one of the most serious problems arising from valve diseases. Transcatheter Aortic Valve Implantation (TAVI) has become the preferred treatment for high-risk or inoperable patients with severe aortic stenosis that could be a lifethreatening condition when left untreated. Due to the nature of the TAVI procedure, a variability on the tilt angle of the deployed valve is expected. The present work, investigated the effects on the flow field in the ascending aorta due angle variation of the transvalvular jet. Understanding the hemodynamic patterns of blood flow in the ascending aorta is important because they are closely related to the development of cardiovascular diseases. To this end, a patient-specific vascular phantom was produced by a 3D printed model and transparent silicon resin. A special setup was designed to allow measurements of the 3D flow at different cross sections of the aorta. A stereoscopic particle image velocimetry system was implemented to yield instantaneous and averaged turbulent flow information, such as three-dimensional average velocity fields, turbulent kinetic energy, and correlations between the components of velocity fluctuation. The results obtained indicated that the velocity field in the ascending aorta is strongly affected by the inlet flow direction into the aorta.