Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Aakhus, Svend; Bjørnstad, Knut; Soma, Johannes; Skjærpe, Terje; Angelsen, Bjørn

doi:10.1159/000177130

Cited by 5 publications

(2 citation statements)

References 26 publications

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“…4A). Similar decreases in arterial compliances have been documented in patients with reduced cardiac output after myocardial infarction (1). Similarly, increased pulse wave velocity (an indicator of decreased arterial compliance) is highly correlated to incidence of heart failure (40,47).…”

Section: Judicious Use Of Simplifying Assumptions Allowed Identificatmentioning

confidence: 70%

Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses

Nguyen

Tüzün²,

Quick

2016

American Journal of Physiology-Regulatory, Integrative and Comp

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Nguyen PH, Tuzun E, Quick CM. Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses. Am J Physiol Regul Integr Comp Physiol 311: R522-R531, 2016. First published June 15, 2016 doi:10.1152/ajpregu.00402.2015.-Aortic pulse pressure arises from the interaction of the heart, the systemic arterial system, and peripheral microcirculations. The complex interaction between hemodynamics and arterial remodeling precludes the ability to experimentally ascribe changes in aortic pulse pressure to particular adaptive responses. Therefore, the purpose of the present work was to use a human systemic arterial system model to test the hypothesis that pulse pressure homeostasis can emerge from physiological adaptation of systemic arteries to local mechanical stresses. First, we assumed a systemic arterial system that had a realistic topology consisting of 121 arterial segments. Then the relationships of pulsatile blood pressures and flows in arterial segments were characterized by standard pulse transmission equations. Finally, each arterial segment was assumed to remodel to local stresses following three simple rules: 1) increases in endothelial shear stress increases radius, 2) increases in wall circumferential stress increases wall thickness, and 3) increases in wall circumferential stress decreases wall stiffness. Simulation of adaptation by iteratively calculating pulsatile hemodynamics, mechanical stresses, and vascular remodeling led to a general behavior in response to mechanical perturbations: initial increases in pulse pressure led to increased arterial compliances, and decreases in pulse pressure led to decreased compliances. Consequently, vascular adaptation returned pulse pressures back toward baseline conditions. This behavior manifested when modeling physiological adaptive responses to changes in cardiac output, changes in peripheral resistances, and changes in local arterial radii. The present work, thus, revealed that pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses. vascular adaptation; compliance resetting; pulsatile hemodynamics; multiscale modeling AORTIC PULSE PRESSURE APPEARS to be homeostatic despite the lack of global regulatory mechanisms affecting elastic arteries. Cardiac output, peripheral resistances, and arterial compliances are the primary mechanical determinants of aortic pressures (40,47). Whereas mean pressure is predominantly determined by cardiac output and peripheral resistance, pulse pressure (systolic-diastolic) is also affected by compliance (the change in volume per change in transmural pressure) of the large elastic arteries (69). As arterial compliances decrease, pulse pressures tend to increase (40,41,47,48). Acutely, mean pressure and pulse pressure are physiologically coupled by feedback mechanisms: when pulse pressure rises, stretch-sensitive baroreceptors lower peripheral resistance, i.e., the baroreflex, which, in turn, lowers mean pressure. Furthe...

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Section: Judicious Use Of Simplifying Assumptions Allowed Identificatmentioning

confidence: 70%

Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses

Nguyen

Tüzün²,

Quick

2016

American Journal of Physiology-Regulatory, Integrative and Comp

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“…However, age is only one factor that has been shown to affect arterial compliance; there are others such as diabetes, exercise and drugs [2,3]. A decreased arterial compliance has been found in patients with myocardial infarction and other studies have found that the proximal arterial circulation is stiffer in patients with coronary heart disease [4,5]. There are many methods used to directly measure compliance, and others, such as the measurement of PWV (pulse wave velocity), provide a surrogate marker of compliance [6].…”

Section: Introductionmentioning

confidence: 99%

Repeatability of non-invasive measurement of intracerebral pulse wave velocity using transcranial Doppler

et al. 2005

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In the present study, the repeatability of three techniques for measuring peripheral PWV (pulse wave velocity) has been studied. A transcranial Doppler provided a wave reading from the middle cerebral artery. Using the transit time between the R-wave of an ECG and the 'foot' of this wave we were able to calculate a PWV (PWV-brain). An ear clip transducer provided a pressure wave reading (PWV-ear). A third pressure reading came from a Finapres transducer on the left middle finger (PWV-finger). The PWV was calculated as distance between two points/transit time of the pulse wave. Eleven volunteers had three sets of readings averaged for each technique taken in two separate sessions. There was good agreement between observers for the mean PWV values, and good agreement for mean results in different sessions. The RC%s (repeatability coefficient percentages) for between-observer repeatability in each session were good and approximately equivalent for PWV-finger (5-7%) and PWV-brain (5-7%). The repeatability of the PWV-ear measurement was less satisfactory (8-18%). The RC% for the same observer between sessions was less good, being 11% for the PWV-finger, 16-17% for PWV-brain and 11-19% for PWV-ear. The RC%s for the inter-session inter-observer measurements were between 10.7-12.1% for the PWV-finger, 14.7-19.5% for PWV-brain and 8.3-15% for PWV-ear. The transit time RC%s were lower in most measurements. The between-observer repeatability of all measures was satisfactory. Owing to the less good repeatability on different occasions, the use of PWV-brain and PWV-ear will depend on the magnitude of differences to be expected.

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An alternation in arterial compliance associated with elevated aerobic fitness

Terenzi¹

2000

Journal of Manipulative and Physiological Therapeutics

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Systemic Arterial Compliance Early and Late after a First Acute Myocardial Infarction

Cited by 5 publications

References 26 publications

Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses

Aortic pulse pressure homeostasis emerges from physiological adaptation of systemic arteries to local mechanical stresses

Repeatability of non-invasive measurement of intracerebral pulse wave velocity using transcranial Doppler

An alternation in arterial compliance associated with elevated aerobic fitness

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