Terminal vascular beds continually adapt to changing demands. A theoretical model is used to simulate structural diameter changes in response to hemodynamic and metabolic stimuli in microvascular networks. Increased wall shear stress and decreased intravascular pressure are assumed to stimulate diameter increase. Intravascular partial pressure of oxygen (PO(2)) is estimated for each segment. Decreasing PO(2) is assumed to generate a metabolic stimulus for diameter increase, which acts locally, upstream via conduction along vessel walls, and downstream via metabolite convection. By adjusting the sensitivities to these stimuli, good agreement is achieved between predicted network characteristics and experimental data from microvascular networks in rat mesentery. Reduced pressure sensitivity leads to increased capillary pressure with reduced viscous energy dissipation and little change in tissue oxygenation. Dissipation decreases strongly with decreased metabolic response. Below a threshold level of metabolic response flow shifts to shorter pathways through the network, and oxygen supply efficiency decreases sharply. In summary, the distribution of vessel diameters generated by the simulated adaptive process allows the network to meet the functional demands of tissue while avoiding excessive viscous energy dissipation.

Matching blood flow to metabolic demand in terminal vascular beds involves coordinated changes in diameters of vessels along flow pathways, requiring upstream and downstream transfer of information on local conditions. Here, the role of information transfer mechanisms in structural adaptation of microvascular networks after a small change in capillary oxygen demand was studied using a theoretical model. The model includes diameter adaptation and information transfer via vascular reactions to wall shear stress, transmural pressure, and oxygen levels. Information transfer is additionally effected by conduction along vessel walls and by convection of metabolites. The model permits selective blocking of information transfer mechanisms. Six networks, based on in vivo data, were considered. With information transfer, increases in network conductance and capillary oxygen supply were amplified by factors of 4.9 +/- 0.2 and 9.4 +/- 1.1 (means +/- SE), relative to increases when information transfer was blocked. Information transfer by flow coupling alone, in which increased shear stress triggers vascular enlargement, gave amplifications of 4.0 +/- 0.3 and 4.9 +/- 0.5. Other information transfer mechanisms acting alone gave amplifications below 1.6. Thus shear-stress-mediated flow coupling is the main mechanism for the structural adjustment of feeding and draining vessel diameters to small changes in capillary oxygen demand.

Coronary microvascular networks play the key role in determining blood flow distribution in the heart. Matching local blood supply to tissue metabolic demand entails continuous adaptation of coronary vessels via regulation of smooth muscle tone and structural dilated vessel diameter. The importance of coronary microcirculation for relevant pathological conditions including angina in patients with normal or near-normal coronary angiograms [microvascular angina (MVA)] and heart failure with preserved ejection fraction (HFpEF) is increasingly recognized. For MVA, clinical studies have shown a prevalence of up to 40% in patients with suspected coronary artery disease and a relevant impact on adverse cardiovascular events including cardiac death, stroke, and heart failure. Despite a continuously increasing number of corresponding clinical studies, the knowledge on pathophysiological cause–effect relations involving coronary microcirculation is, however, still very limited. A number of pathophysiological hypotheses for MVA and HFpEF have been suggested but are not established to a degree, which would allow definition of nosological entities, stratification of affected patients, or development of effective therapeutic strategies. This may be related to a steep decline in experimental (animal) pathophysiological studies in this area during the last 15 years. Since technology to experimentally investigate microvascular pathophysiology in the beating heart is increasingly, in principle, available, a concerted effort to build ‘coronary microcirculatory observatories’ to close this gap and to accelerate clinical progress in this area is suggested.

Abstract-Vascular functions, including tissue perfusion and peripheral resistance, reflect continuous structural adaptation (remodeling) of blood vessels in response to several stimuli. Here, a theoretical model is presented that relates the structural and functional properties of microvascular networks to the adaptive responses of individual segments to hemodynamic and metabolic stimuli. All vessels are assumed to respond, according to a common set of adaptation rules, to changes in wall shear stress, circumferential wall stress, and tissue metabolic status (indicated by partial pressure of oxygen). An increase in vessel diameter with increasing wall shear stress and an increase in wall mass with increased circumferential stress are needed to ensure stable vascular adaptation. The model allows quantitative predictions of the effects of changes in systemic hemodynamic conditions or local adaptation characteristics on vessel structure and on peripheral resistance. Predicted effects of driving pressure on the ratio of wall thickness to vessel diameter are consistent with experimental observations. In addition, peripheral resistance increases by Ϸ65% for an increase in driving pressure from 50 to 150 mm Hg. Peripheral resistance is predicted to be markedly increased in response to a decrease in vascular sensitivity to wall shear stress, and to be decreased in response to increased tissue metabolic demand. This theoretical approach provides a framework for integrating available information on structural remodeling in the vascular system and predicting responses to changing conditions or altered vascular reactivity, as may occur in hypertension.

Abstract-Structural reductions in vessel luminal diameters in response to elevated pressure may play a role in the elevation of peripheral resistance generally observed in hypertension. In the present study, a theoretical model is used to simulate the effect of increased driving pressure on flow resistance in microvascular networks. The angioarchitecture (lengths and diameters of all segments, topology) of microvascular networks (nϭ6) in the rat mesentery was recorded by intravital microscopy. The model simulation of vascular adaptation in response to local wall shear stress, transmural pressure, and tissue PO 2 was used to predict changes in network pressure drop and flow resistance for a given change of driving pressure (⌬P). For ⌬P increasing from 15% to 190% of the normotensive value, a 3.3-fold increase in flow resistance was observed (structural autoregulation). If vascular reactivity to pressure was suppressed, the resistance increase was abolished. Suppressing pressure sensitivity also led to a rise in mean capillary pressure at normal driving pressure from 23.8Ϯ7.3 mm Hg to 34Ϯ6.9 mm Hg. These results indicate that low capillary pressure levels as well as structural autoregulation depend on vascular responses to circumferential wall stress (corresponding to pressure). This tendency of peripheral vascular beds to increase flow resistance for a given increase of bulk flow or driving pressure may amplify and stabilize blood pressure elevation in the development of hypertension. (Hypertension. 2001;38:1476-1479.)Key Words: angioadaptation Ⅲ microvessels Ⅲ pressure Ⅲ model simulation Ⅲ shear stress A sustained increase in peripheral resistance is a hallmark of established hypertension. Previous studies 1,2 have suggested that structural reduction in vessel diameters resulting from vascular responses to elevated pressure is an important factor in this increase in resistance. The average circumferential stress in vessel walls depends on intravascular pressure, being approximately ϭ[Pϫ(r/w)], where P is the transmural pressure, r is the vessel radius, and w is the wall thickness. Increased intravascular pressure is observed to lead to structural reduction of luminal diameter and increase in vessel wall thickness, both tending to counteract the initial increase in circumferential wall stress. 3-7 However, increased pressure also increases the pressure gradient driving blood flow. This tends to increase the fluid shear stress at the endothelial surface, which causes luminal diameter to increase. 8 -11 The net change in resistance in a vascular bed resulting from an increase in arterial pressure depends on the interaction between these adaptive responses.Theoretical models provide a framework for simulating the interaction of structural responses to pressure, shear stress, and other stimuli in the context of network hemodynamics. A network model for structural diameter changes in the microcirculation, including structural responses to intravascular pressure and wall shear stress, was developed by Pries et al. 12 ...

Chronic kidney disease (CKD) is associated with excessive mortality from cardiovascular disease (CVD). Endothelial dysfunction, an early manifestation of CVD, is consistently observed in CKD patients and might be linked to structural defects of the microcirculation including microvascular rarefaction. However, patterns of microvascular rarefaction in CKD and their relation to functional deficits in perfusion and oxygen delivery are currently unknown. In this in-vivo microscopy study of the cremaster muscle microcirculation in BALB/c mice with moderate to severe uremia, we show in two experimental models (adenine feeding or subtotal nephrectomy), that serum urea levels associate incrementally with a distinct microangiopathy. Structural changes were characterized by a heterogeneous pattern of focal microvascular rarefaction with loss of coherent microvascular networks resulting in large avascular areas. Corresponding microvascular dysfunction was evident by significantly diminished blood flow velocity, vascular tone, and oxygen uptake. Microvascular rarefaction in the cremaster muscle paralleled rarefaction in the myocardium, which was accompanied by a decrease in transcription levels not only of the transcriptional regulator HIF-1α, but also of its target genes Angpt-2, TIE-1 and TIE-2, Flkt-1 and MMP-9, indicating an impaired hypoxia-driven angiogenesis. Thus, experimental uremia in mice associates with systemic microvascular disease with rarefaction, tissue hypoxia and dysfunctional angiogenesis.

Maintenance of functional vascular networks requires structural adaptation of vessel diameters in response to hemodynamic and metabolic conditions. The mechanisms by which diameters respond to the metabolic state are not known, but may involve the release of vasoactive substances in response to low oxygen by tissue ("tissue signaling", e.g., CO2, adenosine), by vessel walls ("wall signaling", e.g., prostaglandins, adenosine), and/or by red blood cells (RBCs) ("RBC signaling", e.g., ATP and nitric oxide). Here, the goal was to test the potential of each of these locations of oxygen-dependent signaling to control steady-state vascular diameters and tissue oxygenation. A previously developed theoretical model of structural diameter adaptation based on experimental data on microvascular network morphology and hemodynamics was used. Resulting network characteristics were analyzed with regard to tissue oxygenation (Oxdef; percentage of tissue volume with PO2<1 Torr) and the difference between estimated blood flow velocities and corresponding experimental data [velocity error (Verr); root mean square deviation of estimated vs. measured velocity]. Wall signaling led to Oxdef<1% and to the closest hemodynamic similarity (Verr: 0.60). Tissue signaling also resulted in a low oxygen deficit, but a higher Verr (0.73) and systematic diameter deviations. RBC signaling led to widespread hypoxia (Oxdef: 4.7%), unrealistic velocity distributions (Verr: 0.81), and shrinkage of small vessels. The results suggest that wall signaling plays a central role in structural control of vessel diameters in microvascular networks of given angioarchitecture. Tissue-derived and RBC-derived signaling of oxygen levels may be more relevant for the regulation of angiogenesis and/or smooth muscle tone.

Techniques that model microvascular hemodynamics have been developed for decades. While the physiological significance of pressure pulsatility is acknowledged, most of the microcirculatory models use steady flow approaches. To theoretically study the extent and transmission of pulsatility in microcirculation, dynamic models need to be developed. In this paper, we present a one-dimensional model to describe the dynamic behavior of microvascular blood flow. The model is applied to a microvascular network from a rat mesentery. Intravital microscopy was used to record the morphology and flow velocities in individual vessel segments, and boundaries are defined according to the experimental data. The system of governing equations constituting the model is solved numerically using the discontinuous Galerkin method. An implicit integration scheme is adopted to increase computing efficiency. The model allows the simulation of the dynamic properties of blood flow in microcirculatory networks, including the pressure pulsatility (quantified by a pulsatility index) and pulse wave velocity (PWV). From the main input arteriole to the main output venule, the pulsatility index decreases by 66.7%. PWV obtained along arterioles declines with decreasing diameters, with mean values of 77.16, 25.31, and 8.30 cm/s for diameters of 26.84, 17.46, and 13.33 μm, respectively. These results suggest that the 1D model developed is able to simulate the characteristics of pressure pulsatility and wave propagation in complex microvascular networks.