Material properties of aged human mitral valve leaflets

This study aimed to characterize the mechanical properties of aged human anterior mitral leaflets (AML) and posterior mitral leaflets (PML). The AML and PML samples from explanted human hearts (n = 21, mean age of 82.62 ± 8.77-years-old) were subjected to planar biaxial mechanical tests. The material stiffness, extensibility, and degree of anisotropy of the leaflet samples were quantified. The microstructure of the samples was assessed through histology. Both the AML and PML samples exhibited a nonlinear and anisotropic behavior with the circumferential direction being stiffer than the radial direction. The AML samples were significantly stiffer than the PML samples in both directions, suggesting that they should be modeled with separate sets of material properties in computational studies. Histological analysis indicated the changes in the tissue elastic constituents, including the fragmented and disorganized elastin network, the presence of fibrosis and proteoglycan/glycosaminoglycan infiltration and calcification, suggesting possible valvular degenerative characteristics in the aged human leaflet samples. Overall, stiffness increased and areal strain decreased with calcification severity. In addition, leaflet tissues from hypertensive individuals also exhibited a higher stiffness and low areal strain than normotensive individuals. There are significant differences in the mechanical properties of the two human mitral valve leaflets from this advanced age group. The morphologic changes in the tissue composition and structure also infer the structural and functional difference between aged human valves and those of animals.