The living aortic valve: From molecules to function.
The living aortic valve: From molecules to function.
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DOI：
10.5339/gcsp.2014.11
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Yacoub MH
中科院分区：
文献类型：
--
作者：
Chester AH;El-Hamamsy I;Butcher JT;Latif N;Bertazzo S;Yacoub MH
主动脉瓣处于一种独特的血液动力学环境中，这种环境的特点是在整个心脏周期中存在一系列的应力(剪切力、弯曲力、负载力和应变)，这些应力的强度和方向都不同。然而，尽管环境不断变化，主动脉瓣每天仍有超过10万次的开关，对大多数人来说，在70-90岁的寿命内仍能正常工作。直到最近，心脏瓣膜还被认为是被动结构，在瓣膜的功能或维持其完整性和耐用性方面不起积极作用。然而，通过临床经验和基础研究，主动脉瓣现在可以被描述为一个活的、动态的器官，能够通过其组成部分之间的主动和被动沟通来适应其复杂的机械和生物力学环境。在需要主动脉瓣置换术的患者中，活瓣替代物的临床相关性已经得到证实。这突显了利用组织工程学开发含有活细胞的心脏瓣膜替代品的重要性，这些细胞具有承担天然瓣膜的复杂功能的能力。
The aortic valve lies in a unique hemodynamic environment, one characterized by a range of stresses (shear stress, bending forces, loading forces and strain) that vary in intensity and direction throughout the cardiac cycle. Yet, despite its changing environment, the aortic valve opens and closes over 100,000 times a day and, in the majority of human beings, will function normally over a lifespan of 70–90 years. Until relatively recently heart valves were considered passive structures that play no active role in the functioning of a valve, or in the maintenance of its integrity and durability. However, through clinical experience and basic research the aortic valve can now be characterized as a living, dynamic organ with the capacity to adapt to its complex mechanical and biomechanical environment through active and passive communication between its constituent parts. The clinical relevance of a living valve substitute in patients requiring aortic valve replacement has been confirmed. This highlights the importance of using tissue engineering to develop heart valve substitutes containing living cells which have the ability to assume the complex functioning of the native valve.