Age-Dependent Changes in Geometry, Tissue Composition and Mechanical Properties of Fetal to Adult Cryopreserved Human Heart Valves

PLoS One. 2016 Feb 11;11(2):e0149020. doi: 10.1371/journal.pone.0149020. eCollection 2016.

Abstract

There is limited information about age-specific structural and functional properties of human heart valves, while this information is key to the development and evaluation of living valve replacements for pediatric and adolescent patients. Here, we present an extended data set of structure-function properties of cryopreserved human pulmonary and aortic heart valves, providing age-specific information for living valve replacements. Tissue composition, morphology, mechanical properties, and maturation of leaflets from 16 pairs of structurally unaffected aortic and pulmonary valves of human donors (fetal-53 years) were analyzed. Interestingly, no major differences were observed between the aortic and pulmonary valves. Valve annulus and leaflet dimensions increase throughout life. The typical three-layered leaflet structure is present before birth, but becomes more distinct with age. After birth, cell numbers decrease rapidly, while remaining cells obtain a quiescent phenotype and reside in the ventricularis and spongiosa. With age and maturation-but more pronounced in aortic valves-the matrix shows an increasing amount of collagen and collagen cross-links and a reduction in glycosaminoglycans. These matrix changes correlate with increasing leaflet stiffness with age. Our data provide a new and comprehensive overview of the changes of structure-function properties of fetal to adult human semilunar heart valves that can be used to evaluate and optimize future therapies, such as tissue engineering of heart valves. Changing hemodynamic conditions with age can explain initial changes in matrix composition and consequent mechanical properties, but cannot explain the ongoing changes in valve dimensions and matrix composition at older age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aortic Valve / anatomy & histology
  • Aortic Valve / embryology
  • Aortic Valve / pathology
  • Child
  • Child, Preschool
  • Cryopreservation* / methods
  • Fetus
  • Glycosaminoglycans / chemistry
  • Heart Valves / anatomy & histology*
  • Heart Valves / embryology*
  • Heart Valves / pathology
  • Hemodynamics
  • Humans
  • Infant
  • Infant, Newborn
  • Microscopy, Fluorescence
  • Middle Aged
  • Phenotype
  • Pulmonary Valve / anatomy & histology
  • Pulmonary Valve / embryology
  • Pulmonary Valve / pathology
  • Stress, Mechanical
  • Tensile Strength
  • Young Adult

Substances

  • Glycosaminoglycans

Grants and funding

This research is supported by the Dutch Technology Foundation (STW, http://www.stw.nl/en), applied science division of The Netherlands Organisation for Scientific Research (NWO, http://www.nwo.nl/en/), and the Technology Program of the Dutch Ministry of Economic Affairs under grant agreement under grant number 06233. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.