Is the time-dependent behaviour of the aortic valve intrinsically quasi-linear?

The widely popular quasi-linear viscoelasticity (QLV) theory has been employed extensively in the literature for characterising the time-dependent behaviour of many biological tissues, including the aortic valve (AV). However, in contrast to other tissues, application of QLV to AV data has been met with varying success, with studies reporting discrepancies in the values of the associated quantified parameters for data collected from different timescales in experiments. Furthermore, some studies investigating the stress-relaxation phenomenon in valvular tissues have suggested discrete relaxation spectra, as an alternative to the continuous spectrum proposed by the QLV. These indications put forward a more fundamental question: Is the time-dependent behaviour of the aortic valve intrinsically quasi-linear? In other words, can the inherent characteristics of the tissue that govern its biomechanical behaviour facilitate a quasi-linear time-dependent behaviour? This paper attempts to address these questions by presenting a mathematical analysis to derive the expressions for the stress-relaxation G(t) and creep J(t) functions for the AV tissue within the QLV theory. The principal inherent characteristic of the tissue is incorporated into the QLV formulation in the form of the well-established gradual fibre recruitment model, and the corresponding expressions for G(t) and J(t) are derived. The outcomes indicate that the resulting stress-relaxation and creep functions do not appear to voluntarily follow the observed experimental trends reported in previous studies. These results highlight that the time-dependent behaviour of the AV may not be quasi-linear, and more suitable theoretical criteria and models may be required to explain the phenomenon based on tissue's microstructure, and for more accurate estimation of the associated material parameters. In general, these results may further be applicable to other planar soft tissues of the same class, i.e. with the same representation for fibre recruitment mechanism and discrete time-dependent spectra.