Structural and Histochemical Alterations in the Aortic Valves of Elderly Patients: A Comparative Study of Aortic Stenosis, Aortic Regurgitation, and Normal Valves

Figure 1

Speed of sound images from scanning acoustic microscopy and the corresponding light microscopic images with elastica Van Gieson staining. Speed of sound (SOS) image of a representative AS case (a) showing thick fibrosa (indicated by “F”) with calcification (“Ca”) and thrombus-formed ventricularis (“V”). The thick fibrosa revealed variable SOS values, except in the nodular calcified areas, which corresponded to the highest SOS values. SOS image of a representative AR case (b) displaying a thin AV composed of a regular, three-layered structure. The fibrosa corresponded to a high SOS value, and the ventricularis (almost the same thickness) displayed a higher SOS than that in the AS group. SOS image of a representative normal (NOR) AV case (c) displaying a three-layered structure with thin, regular ventricularis. Light microscopy (LM) of AS (d) showed atherosclerosis on the fibrosa with an irregular array of collagen fibres. The elastic lamina of the ventricularis was interrupted and protruded into the endothelial surface. The fibrosa in AR visualized via LM (e) consisted of a regular array of thick collagen fibres. The fibrosa of a normal aortic valve (f) occupied approximately half of the total thickness. Scale in LM = 1 mm.

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