Evidence map›Paper›PMID 22123981›Full record

ArticleProceedings of the National Academy of Sciences of the United States of America2011

Cyclic strain induces dual-mode endothelial-mesenchymal transformation of the cardiac valve.

Kartik Balachandran, Patrick W Alford, Jill Wylie-Sears, Josue A Goss, Anna Grosberg, Joyce Bischoff, Elena Aikawa, Robert A Levine, Kevin Kit Parker

Open access · bronzeAbstract read
In one paragraph

Article in Proceedings of the National Academy of Sciences of the United States of America, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers.

0numbers the graph read from it
0cells of the map it votes in
88citing papers in PubMed
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

88 citing papers in PubMed, 173 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
  4. Review
  5. Vascular endothelial integration of multiple biophysical stimuli.Frontiers in cardiovascular medicine · 2026
    Article
  6. Article
  7. Unveiling the intricacies of cardiac valve pathophysiology.Frontiers in cardiovascular medicine · 2025
    Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Article
  14. Parametric optimization of culture chamber for cell mechanobiology research.Experimental biology and medicine (Maywood, N.J.) · 2023
    Article
  15. Article
  16. Review
  17. Review
  18. Article
  19. Article
  20. Review

28 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Kartik BalachandranDisease Biophysics Group, Wyss Institute for Biologically Inspired Engineering, School of Engineering and Applied Sciences, Harvard University, Cambridge, MA 02138, USA.
Patrick W Alford
Jill Wylie-Sears
Josue A Goss
Anna Grosberg
Joyce Bischoff
Elena Aikawa
Robert A Levine
Kevin Kit Parker
Harvard University · USMassachusetts General Hospital · US

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Human Pluripotent Stem Cell and Progenitor Models of Cardiac and Blood DiseasesU01HL100408 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI COWAN, CHAD ALBERT, MELTON, DOUGLAS A · 2009 to 2015
$8.9M
Effect of Mitral Regurgitation on Ischemic LV RemodelingR01HL072265 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI LEVINE, ROBERT A · 2003 to 2013
$3.5M
ISCHEMIC MITRAL REGURGITATION: FROM MECHANISM TO THERAPYK24HL067434 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI LEVINE, ROBERT A · 2001 to 2011
$1.6M
NCRR NIH HHS 5UL1RR025758NCRR NIH HHS UL1 RR025758NHLBI NIH HHS 5U01HL100408-02NHLBI NIH HHS K24 HL067434NHLBI NIH HHS R01 HL072265NHLBI NIH HHS U01 HL100408
6 · The paper itself

Abstract

Endothelial-mesenchymal transformation (EMT) is a critical event for the embryonic morphogenesis of cardiac valves. Inducers of EMT during valvulogenesis include VEGF, TGF-β1, and wnt/β-catenin (where wnt refers to the wingless-type mammary tumor virus integration site family of proteins), that are regulated in a spatiotemporal manner. EMT has also been observed in diseased, strain-overloaded valve leaflets, suggesting a regulatory role for mechanical strain. Although the preponderance of studies have focused on the role of soluble mitogens, we asked if the valve tissue microenvironment contributed to EMT. To recapitulate these microenvironments in a controlled, in vitro environment, we engineered 2D valve endothelium from sheep valve endothelial cells, using microcontact printing to mimic the regions of isotropy and anisotropy of the leaflet, and applied cyclic mechanical strain in an attempt to induce EMT. We measured EMT in response to both low (10%) and high strain (20%), where low-strain EMT occurred via increased TGF-β1 signaling and high strain via increased wnt/β-catenin signaling, suggesting dual strain-dependent routes to distinguish EMT in healthy versus diseased valve tissue. The effect was also directionally dependent, where cyclic strain applied orthogonal to axis of the engineered valve endothelium alignment resulted in severe disruption of cell microarchitecture and greater EMT. Once transformed, these tissues exhibited increased contractility in the presence of endothelin-1 and larger basal mechanical tone in a unique assay developed to measure the contractile tone of the engineered valve tissues. This finding is important, because it implies that the functional properties of the valve are sensitive to EMT. Our results suggest that cyclic mechanical strain regulates EMT in a strain magnitude and directionally dependent manner.

Indexed as

MorphogenesisStress, MechanicalActinsAnimalsAnisotropyCell NucleusEndotheliumHeart ValvesMesodermModels, BiologicalMyocardial ContractionSheepSignal TransductionTissue EngineeringActins

Identifiers

PMID22123981
PMCPMC3250145
OpenAlexW2043635105

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.