Abstract
Jugular venous valve incompetence has no long-term remedy and symptoms of transient global amnesia and/or intracranial hypertension continue to discomfort patients. During this study, we interrogate the synergy of the collagen and elastin microstructure that compose the bi-layer extracellular matrix (ECM) of the jugular venous valve. In this study, we investigate the jugular venous valve and relate it to tissue-level mechanical properties, fibril orientation and fibril composition to improve fundamental knowledge of the jugular venous valves toward the development of bioprosthetic venous valve replacements. Steps include: (1) multi loading biaxial mechanical tests; (2) isolation of the elastin microstructure; (3) imaging of the elastin microstructure; and (4) imaging of the collagen microstructure, including an experimental analysis of crimp. Results from this study show that, during a 3:1 loading ratio (circumferential direction: 900 mN and radial direction: 300 mN), elastin may have the ability to contribute to the circumferential mechanical properties at low strains, for example, shifting the inflection point toward lower strains in comparison to other loading ratios. After isolating the elastin microstructure, light microscopy revealed that the overall elastin orients in the radial direction while forming a crosslinked mesh. Collagen fibers were found undulated, aligning in parallel with neighboring fibers and orienting in the circumferential direction with an interquartile range of −10.38° to 7.58° from the circumferential axis (n = 20). Collagen crimp wavelength and amplitude was found to be 38.46 ± 8.06 µm and 4.51 ± 1.65 µm, respectively (n = 87). Analyzing collagen crimp shows that crimp permits about 12% true strain circumferentially, while straightening of the overall fibers accounts for more. To the best of the authors’ knowledge, this is the first study of the jugular venous valve linking the composition and orientation of the ECM to its mechanical properties and this study will aid in forming a structure-based constitutive model.
Highlights
Venous valves are semi-lunar cusps that prevent retrograde blood flow in the venous system
Results from this study show that, during a 3:1 loading ratio, elastin may have the ability to contribute to the circumferential mechanical properties at low strains, for example, shifting the inflection point toward lower strains in comparison to other loading ratios
The mechanical test characterized fiber rotation and we related this information to the imaged collagen and elastin microstructures
Summary
Venous valves are semi-lunar cusps that prevent retrograde blood flow in the venous system. It is hypothesized that increased intra-abdominal pressure is transmitted into the intracranial venous system, causing intracranial hypertension; jugular valve insufficiency may facilitate pressure transmission [4]. Chronic venous insufficiency (CVI) occurs when the saphenous venous valves in the vein are damaged or malfunctioning, leading to blood pooling at the distal end of the legs, causing swelling in the legs. Current treatments for CVI, such as venous valve replacement, have been developed and jugular venous valves were generally used in need of surgical replacement: replacing incompetent saphenous venous valves in the legs to prevent varicose veins, edema, poor circulation, valvular incompetence and all other symptoms of CVI. Fixated tissues tend to have warped mechanical properties and can affect valvular hemodynamic performance, which was shown in a study of the mitral valve [8]. This study highlights the characteristics that should be desired when creating tissue-engineered substitutes, including mechanical properties, fibril orientation and fibril composition
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