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Introduction
Current institution
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August 2013 - December 2013
Education
August 2014 - December 2019
August 2014 - December 2016
August 2010 - May 2014
Publications
Publications (40)
Despite its vital importance for establishing proper cardiovascular function, the process through which the vasculature develops and matures postnatally remains poorly understood. From a clinical perspective, an ability to mechanistically model the developmental time course in arteries and veins, as well as to predict how various pathologies and th...
Collagen is the most abundant protein in mammals; it exhibits a hierarchical organization and provides structural support to a wide range of soft tissues, including blood vessels. The architecture of collagen fibrils dictates vascular stiffness and strength, and changes therein can contribute to disease progression. While transmission electron micr...
Background:
Transmural failure of the aorta is responsible for substantial morbidity and mortality; it occurs when mechanical stress exceeds strength. The aortic root and ascending aorta are susceptible to dissection and rupture in Marfan syndrome, a connective tissue disorder characterized by a progressive reduction in elastic fiber integrity. Wh...
Collagen is the most abundant protein in mammals; it exhibits a hierarchical organization and provides structural support to a wide range of soft tissues, including blood vessels. The architecture of collagen fibrils dictates vascular stiffness and strength, and changes therein can contribute to disease progression. While transmission electron micr...
Each year, more than 40,000 people undergo mitral valve (MV) repair surgery domestically to treat regurgitation caused by myocardial infarction (MI). Although continual MV tissue remodelling following repair is believed to be a major contributor to regurgitation recurrence, the effects of the post-MI state on MV remodelling remain poorly understood...
Thoracic aortic aneurysm (TAA) is a localized dilatation of the aorta that can lead to life-threatening dissection or rupture. In vivo assessments of TAA progression are largely limited to measurements of aneurysm size and growth rate. There is promise, however, that computational modelling of the evolving biomechanics of the aorta could predict fu...
Left ventricular myocardial infarction (MI) has broad and debilitating effects on cardiac function. In many cases, MI leads to ischemic mitral regurgitation (IMR), a condition characterized by incompetency of the mitral valve (MV). IMR has many deleterious effects as well as a high mortality rate. While various clinical treatments for IMR exist, su...
Transmural rupture of the aorta is responsible for significant morbidity and mortality; it occurs when wall stress exceeds local wall strength. Amongst other conditions, the aortic root and ascending aorta become vulnerable to dissection and rupture in Marfan syndrome, a connective tissue disorder that results in a progressive fragmentation and deg...
Thoracic aortic aneurysm (TAA) is a localized dilatation of the aorta resulting from compromised wall composition, structure, and function, which can lead to life-threatening dissection or rupture. Several genetic mutations and predisposing factors that contribute to TAA have been studied in mouse models to characterize specific changes in aortic m...
Aortic dissection progresses mainly via delamination of the medial layer of the wall. Notwithstanding the complexity of this process, insight has been gleaned by studying in vitro and in silico the progression of dissection driven by quasi-static pressurization of the intramural space by fluid injection, which demonstrates that the differential pro...
Pressure and thermal injuries affect millions of lives every year. Typically, each injury mechanism is studied in isolation due to differences in the primary factors causing the trauma. The serial confluence of applied tissue deformation, inflammation, and ischemia imposed over time combine to cause mechanically derived injury, whereas high or low...
The clinical benefit of patient-specific modeling of heart valve disease remains an unrealized goal, often a result of our limited understanding of the in vivo milieu. This is particularly true in assessing bicuspid aortic valve (BAV) disease, the most common cardiac congenital defect in humans, which leads to premature and severe aortic stenosis o...
Thoracic aortopathy–aneurysm, dissection, and rupture–is increasingly responsible for significant morbidity and mortality. Advances in medical genetics and imaging have improved diagnosis and thus enabled earlier prophylactic surgical intervention in many cases. There remains a pressing need, however, to understand better the underlying molecular a...
The cover image is based on the Special Issue Article Uncertainty quantification in subject-specific estimation of local vessel mechanical properties by Bruno V. Rego et al., https://doi.org/10.1002/cnm.3535.
The clinical benefit of patient-specific modeling of heart valve disease remains an unrealized goal, often a result of our limited understanding of the in vivo milieu. This is particularly true in assessing bicuspid aortic valve (BAV) disease, the most common cardiac congenital defect in humans, which leads to premature and severe aortic stenosis or...
Quantitative estimation of local mechanical properties remains critically important in the ongoing effort to elucidate how blood vessels establish, maintain, or lose mechanical homeostasis. Recent advances based on panoramic digital image correlation (pDIC) have made high-fidelity 3D reconstructions of small-animal (e.g., murine) vessels possible w...
Aortic dissection progresses via delamination of the medial layer of the wall. Notwithstanding the complexity of this process, insight has been gleaned by studying in vitro and in silico the progression of dissection driven by quasi-static pressurization of the intramural space by fluid injection, which demonstrates that the differential propensity...
Quantitative estimation of local mechanical properties remains critically important in the ongoing effort to elucidate how blood vessels establish, maintain, or lose mechanical homeostasis. Recent advances based on panoramic digital image correlation (pDIC) have made high-fidelity 3D reconstructions of small-animal (e.g., murine) vessels possible w...
Abdominal aortic aneurysms (AAAs) are characterized histopathologically by compromised elastic fiber integrity, lost smooth muscle cells or their function, and remodeled collagen. We used a recently introduced mouse model of AAAs that combines enzymatic degradation of elastic fibers and blocking of lysyl oxidase, and thus matrix cross-linking, to s...
Objective
Ischemic mitral regurgitation (IMR) often develops after an ischemic event, which results in distortion of the valvulo-ventricular complex and incomplete mitral valve (MV) leaflet coaptation. After left ventricular ischemic events, only some patients develop IMR. The susceptibility of the MV to remodel may influence whether IMR develops....
Ischemic mitral regurgitation (IMR) is a prevalent cardiac disease associated with substantial morbidity and mortality. Contemporary surgical treatments continue to have limited long-term success, in part due to the complex and multi-factorial nature of IMR. There is thus a need to better understand IMR etiology to guide optimal patient specific tre...
Introduction: Ischemic mitral regurgitation (IMR) is a highly prevalent disorder, and current methods of repair have suboptimal rates of failure. Accounting for patient-specific variations in the pre-surgical deformation patterns of the mitral valve (MV) may allow for better prediction of post-surgical outcomes.
Methods: Real-time 3D echocardiograp...
Introduction: Ischemic mitral regurgitation (IMR) develops in a fraction of patients in response to left ventricular (LV) remodeling after ischemia. IMR independently predicts adverse events and doubles mortality. While largely driven by LV distortion, the susceptibility of the mitral valve (MV) to undergo remodeling may play a role in determining...
Ischaemic mitral regurgitation (IMR), a frequent complication following myocardial infarction (MI), leads to higher mortality and poor clinical prognosis if untreated. Accumulating evidence suggests that mitral valve (MV) leaflets actively remodel post MI, and this remodelling increases both the severity of IMR and the occurrence of MV repair failu...
Ischemic mitral regurgitation (IMR), a frequent complication following myocardial infarction (MI), leads to higher mortality and poor clinical prognosis if untreated. Accumulating evidence suggests that mitral valve (MV) leaflets actively remodel post-MI, and this remodeling increases both the severity of IMR and the occurrence of MV repair failure...
Aims: Ischemic mitral regurgitation is frequently observed following myocardial infarction and is associated with higher mortality and poor clinical prognosis if left untreated. Accumulating evidence suggests that mitral valve leaflets actively remodel post-myocardial infarction, yet the cellular mechanisms underlying these responses and how this a...
The mitral valve (MV) is the left atrioventricular heart valve that regulates blood flow between the left atrium and left ventricle (LV) during the cardiac cycle. Contrary to the aortic valve, the MV is intimately coupled, fully functional part of the LV. In situations where the MV fails to fully close during systole, the resulting blood regurgitat...
The cover image is based on the Research Article A noninvasive method for the determination of in vivo mitral valve leaflet strains by Bruno V. Rego et al., https://doi.org/10.1002/cnm.3142.
Ischemic mitral regurgitation (IMR) is a currently prevalent disease in the US that is projected to become increasingly common as the aging population grows. In recent years, image-based simulations of mitral valve (MV) function have improved significantly, providing new tools to refine IMR treatment. However, clinical implementation of MV simulati...
Assessment of mitral valve (MV) function is important in many diagnostic, prognostic, and surgical planning applications for treatment of MV disease. Yet, to date there are no accepted non‐invasive methods for determination of MV leaflet deformation, which is a critical metric of MV function. In this study, we present a novel, completely non‐invasi...
Heart valves are composed of multilayered tissues that contain a population of vascular endothelial cells (VEC) on the blood contacting surfaces and valve interstitial cells (VIC) in the bulk tissue mass that maintain homeostasis and respond to injury. The mechanosensitive nature of VICs facilitates the regulation of growth and remodeling of heart...
Little is known about how normal valvular tissues grow and remodel in response to altered loading. In the present work, we used the pregnancy state to represent a non-pathological cardiac volume overload that distends the mitral valve (MV), utilizing both extant and new experimental data and a modified form of our MV structural constitutive model....
Ischemic mitral regurgitation (IMR) occurs when a mitral valve (MV) is rendered incompetent by left ventricular (LV) remodeling induced by a myocardial infarction (MI). Hemodynamically significant, IMR affects at least 300,000 Americans. This important clinical problem is expected to grow substantially during the next 20 years as the population age...
Heterogeneities in structure and stress within heart valve leaflets are of significant concern to their functional physiology, as they affect how the tissue constituents remodel in response to pathological and non-pathological (e.g. exercise, pregnancy) alterations in cardiac function. Indeed, valve interstitial cells (VICs) are known to synthesize...
Little is known about how valvular tissues grow and remodel in response to altered loading. In this work, we used the pregnancy state to represent a non-pathological cardiac volume overload that distends the mitral valve (MV), using both extant and new experimental data and a modified form of our MV structural constitutive model. We determined that...