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Glycosaminoglycan profiles of myxomatous mitral leaflets and chordae parallel the severity of mechanical alterations

K. Jane Grande-Allen, PhD^*, Brian P. Griffin, MD, FACC, Norman B. Ratliff, MD, Delos M. Cosgrove, III, MD and Ivan Vesely, PhD^*,*

^* Biomedical Engineering, The Cleveland Clinic Foundation,, Cleveland, Ohio USA
Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio USA
Anatomic Pathology, The Cleveland Clinic Foundation, Cleveland, Ohio USA
Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

View larger version (91K): [in a new window]   Figure 1 Hyaluronidase SD and chondroitinase ABC (HABC) and chondroitinase ACII (AC2) digests of leaflet and chordae, with the first lane showing monosaccharide/disaccharide standard (STD) bands. The 4S- and 6S-galNAc (N-acetylgalactosamine-4- and 6-sulfate) are the non-reducing terminal ends of the GAG chains. Di0S = unsulfated chondroitin; Di2S = chondroitin/dermatan 2-sulfate; Di4S = chondroitin/dermatan-4-sulfate; Di6S = chondroitin/dermatan-6-sulfate; Di4,6S = chondroitin/dermatan-4,6-sulfate; DiHA = hyaluronan.

View larger version (34K): [in a new window]   Figure 2 Concentrations of individual glycosaminoglycan (GAG) classes. C-0-S = unsulfated chondroitin; C-4-S = chondroitin-4-sulfate; C-6-S = chondroitin-6-sulfate; D-4-S = dermatan-4-sulfate; D-6-S = dermatan-6-sulfate; HA = hyaluronan; XS = oversulfated chondroitin/dermatan sulfate. *p < 0.05, chordae versus leaflets; p < 0.05, unileaflet prolapse (ULP) or bileaflet prolapse (BLP) versus normal.

View larger version (53K): [in a new window]   Figure 3 Proportions of different glycosaminoglycan classes. C-0-S = unsulfated chondroitin; C-4-S = chondroitin-4-sulfate; C-6-S = chondroitin-6-sulfate; D-4-S = dermatan-4-sulfate; D-6-S = dermatan-6-sulfate; HA = hyaluronan; XS = oversulfated chondroitin/dermatan sulfate.*p < 0.05, unileaflet prolapse (ULP) or bileaflet prolapse (BLP) versus normal.

View larger version (33K): [in a new window]   Figure 4 Lengths of chondroitin/dermatan sulfate chains. *p < 0.05, chordae versus leaflets; p < 0.05, unileaflet prolapse (ULP) or bileaflet prolapse (BLP) versus normal; p < 0.05, ULP versus BLP. GAG = glycosaminoglycan.