Biomedical subjects

N Stergiopulos

Publications and source records attributed to N Stergiopulos.

At least 37 records · Page 2Linked to original sources

PubMed1999

Use of pulse pressure method for estimating total arterial compliance in vivo.

We determined total arterial compliance from pressure and flow in the ascending aorta of seven anesthetized dogs using the pulse pressure method (PPM) and the decay time method (DTM). Compliance was determined under control and during occlusion of the aorta at four different locations (iliac, renal, diaphragm, and proximal descending thoracic aorta). Compliance of PPM gave consistently lower values (0.893 +/- 0.015) compared with the compliance of DTM (means +/- SE; r = 0.989). The lower compliance estimates by the PPM can be attributed to the difference in mean pressures at which compliance is determined (mean pressure, 81.0 +/- 3.6 mmHg; mean diastolic pressure, over which the DTM applies, 67.0 +/- 3.6 mmHg). Total arterial compliance under control conditions was 0.169 +/- 0. 007 ml/mmHg. Compliance of the proximal aorta, obtained during occlusion of the proximal descending aorta, was 0.100 +/- 0.007 ml/mmHg. Mean aortic pressure was 80.4 +/- 3.6 mmHg during control and 102 +/- 7.7 mmHg during proximal descending aortic occlusion. From these results and assuming that upper limbs and the head contribute as little as the lower limbs, we conclude that 60% of total arterial compliance resides in the proximal aorta. When we take into account the inverse relationship between pressure and compliance, the contribution of the proximal aorta to the total arterial compliance is even more significant.

Animals↗

PubMed1999

Pulmonary arterial compliance in dogs and pigs: the three-element windkessel model revisited.

In six dogs and six weight-matched miniature pigs at baseline and after pulmonary embolization, pulmonary arterial compliance was determined using the pulse pressure method (C(PPM)), the three-element windkessel model (C(WK-3)), and the ratio of stroke volume to pulse pressure (SV/PP). C(PPM) was lower in pigs than in dogs at baseline (0.72 +/- 0.23 vs. 1.14 +/- 0.29 ml/mmHg, P < 0.05) and after embolism (0.37 +/- 0.14 vs. 0.54 +/- 0.16 ml/mmHg, P = 0. 07) at matched flow, but not at matched flow and pressure. C(PPM) showed the expected inverse relation with pressure and a direct relation with flow. C(WK-3) was closely correlated with C(PPM), except for all dogs at baseline where C(WK-3) was up to 100% higher than C(PPM). Excluding these data, regression analysis yielded C(WK-3) = -0.01 + 1.30. C(PPM) (r(2) = 0.97). C(WK-3) was found to be unreliable when input impedance first harmonic modulus was close to characteristic impedance, i.e., when reflections were small. SV/PP correlated well with C(PPM) (SV/PP = -0.10 + 1.76. C(PPM), r(2) = 0.89). We conclude that 1) C(PPM) is a consistent estimate of pulmonary arterial compliance in pigs and dogs, 2) C(WK-3) and SV/PP overestimate compliance, and 3) C(WK-3) is unreliable when wave reflections are small.

Animals↗

PubMed1999

Role of total arterial compliance and peripheral resistance in the determination of systolic and diastolic aortic pressure.

The goal of the study was to define the major arterial parameters that determine aortic systolic (Ps) and diastolic (Pd) pressure in the dog. Measured aortic flows were used as input to the two-element windkessel model of the arterial system, with peripheral resistance calculated as mean pressure over mean flow and total arterial compliance calculated from the decay time in diastole. The windkessel model yielded an aortic pressure wave from which we obtained the predicted systolic (Ps, wk) and diastolic (Pd, wk) pressure. These predicted pressures were compared with the measured systolic and diastolic pressures. The measurements and calculations were carried out in 7 dogs in control conditions, during aortic occlusion at four locations (the trifurcation, between trifurcation and diaphragm, the diaphragm and the proximal descending thoracic aorta) and during occlusion of both carotid arteries. Under all conditions studied the predicted systolic and diastolic pressure matched the experimental ones very well: Ps, wk = (1.000 +/- 0.0055) Ps with r = 0.958 and Pd, wk = (1.024 +/- 0.0035) Pd with r = 0.995. Linear regression for pulse pressure gave PPwk = (0.99 +/- 0.016) PP (r = 0.911). We found the accuracy of prediction equally good under control conditions and in presence of aortic or carotid artery occlusions. Multiple regression between pulse pressure and arterial resistance and total arterial compliance yielded a poor regression constant (r2 = 0.19) suggesting that the two arterial parameters alone cannot explain pulse pressure and that flow is an important determinant as well. We conclude that, for a given ejection pattern (aortic flow), two arterial parameters, total arterial resistance and total arterial compliance are sufficient to accurately describe systolic and diastolic aortic pressure.

Animals↗

PubMed1998

Mechanical properties of the fetal ductus venosus and umbilical vein.

During fetal circulatory compromise, velocity pulsations in the precordial veins increase and are commonly transmitted through the ductus venosus into the umbilical vein, indicating a serious prognosis. The nature of the pulsations and their transmission into the periphery, specifically the umbilical vein, is poorly understood. We present information on the mechanical properties of fetal veins as a basis for describing the pulse wave propagation. Five fetal sheep livers with connecting veins (gestational age 0.8-0.9) were studied in vitro. The transmural pressure, obtained with a fluid-filled catheter, was reduced stepwise from 10.3 to 0 mmHg, and the diameter determined by ultrasonography. Each data set was fitted to an exponential function to determine the stiffness parameter and the area at a standard pressure, which we proposed to be 5 mmHg for the fetal venous circulation. The stiffness parameter was 6.2+/-1.8 at the ductus venosus outlet, 3.4+/-1.3 at the ductus venosus inlet, and 4.0+/-1.0 in the umbilical vein. Correspondingly, values for compliance and pulse wave velocity for the three venous sections were established for a physiological pressure range. The estimated pulse wave velocity of 1-3m/s is comparable with values estimated for veins in adults. The mechanical properties of fetal veins are comparable with those described for veins later in life. The stiffness parameter represents the elastic properties at all pressure levels and conveniently permits inference of compliance and pulse wave velocity.

Animals↗

PubMed1998

A model for geometric and mechanical adaptation of arteries to sustained hypertension.

This study aimed to model phenomenologically the dynamics of arterial wall remodeling under hypertensive conditions. Sustained hypertension was simulated by a step increase in blood pressure. The arterial wall was considered to be a thick-walled tube made of nonlinear elastic incompressible material. Remodeling rate equations were postulated for the evolution of the geometric dimensions of the hypertensive artery at the zero-stress state, as well as for one of the material constants in the constitutive equations. The driving stimuli for the geometric adaptation are the normalized deviations of wall stresses from their values under normotensive conditions. The geometric dimensions are modulated by the evolution of the deformed inner radius, which serves to restore the level of the flow-induced shear stresses at the arterial endothelium. Mechanical adaptation is driven by the difference between the area compliance under hypertensive and normotensive conditions. The predicted time course of the geometry and mechanical properties of arterial wall are in good qualitative agreement with published experimental findings. The model predicts that the geometric adaptation maintains the stress distribution in arterial wall to its control level, while the mechanical adaptation restores the normal arterial function under induced hypertension.

Adaptation, Physiological↗

PubMed1998

Physical basis of pressure transfer from periphery to aorta: a model-based study.

We propose a new method to derive aortic pressure from peripheral pressure and velocity by using a time domain approach. Peripheral pressure is separated into its forward and backward components, and these components are then shifted with a delay time, which is the ratio of wave speed and distance, and added again to reconstruct aortic pressure. We tested the method on a distributed model of the human systemic arterial tree. From carotid and brachial artery pressure and velocity, aortic systolic and diastolic pressure could be predicted within 0.3 and 0.1 mmHg and 0.4 and 1.0 mmHg, respectively. The central aortic pressure wave shape was also predicted accurately from carotid and brachial pressure and velocity (root mean square error: 1.07 and 1.56 mmHg, respectively). The pressure transfer function depends on the reflection coefficient at the site of peripheral measurement and the delay time. A 50% decrease in arterial compliance had a considerable effect on reconstructed pressure when the control transfer function was used. A 70% decrease in arm resistance did not affect the reconstructed pressure. The transfer function thus depends on wave speed but has little dependence on vasoactive state. We conclude that central aortic pressure and the transfer function can be derived from peripheral pressure and velocity.

Animals↗

PubMed1998

Arterial vasomotion: effect of flow and evidence of nonlinear dynamics.

Vasomotion has been studied on segments of rat mesenteric and femoral arteries perfused in vitro. We have investigated 1) the effect of perfusion flow on the characteristics of vasomotion and 2) the nature and patterns of vasomotion. We have found that perfusion flow is not a control parameter that contributes to the genesis of vasomotion but that it affects, in most cases only slightly, the frequency and amplitude of vasomotion. We have found evidence that vasomotion is low-dimensional chaotic. The correlation dimension ranged between 2 and 4, and the average Lyapunov's coefficient was approximately 0.1. A great variety of vasomotion patterns was observed with features that are typical of nonlinear deterministic systems: regular and irregular vasomotion, quasiperiodicity, period doubling and higher-order periods, intermittency, mixed modes, and bursting activity. Vasomotion patterns appeared occasionally to be highly sensitive to perturbations in perfusion flow, which also supported the existence of nonlinear dynamics. Finally, entrainment (phase locking) was observed when arteries were perfused with oscillatory flow with frequency in the neighborhood of the frequency of vasomotion.

Animals↗

PubMed1998

Differences in the mechanical properties of the rat carotid artery in vivo, in situ, and in vitro.

The elastic properties of carotid arteries of spontaneously hypertensive rats (SHR) and normotensive controls (Wistar-Kyoto rats [WKY]) were examined in vivo, in situ, and in vitro. The changes of internal diameter were measured with a high-resolution A-mode echo-tracking device simultaneously with the intra-arterial pressure at the carotid. The internal diameter at mean arterial blood pressure (MBP) was substantially smaller in vitro than in vivo in SHR (-33.8%) and WKY (-48.3%). The arterial distensibility was lower in vitro in all arteries compared with in vivo conditions (SHR, -30.1%; WKY, -60.4%; at MBP) despite a reduced incremental elastic modulus in vitro (SHR, -56.9%; WKY, -45.1%; at MBP). However, the in vitro and in vivo measurements show consistent elastic behavior of the carotid arteries between both strains of rats. Carotid arteries from WKY were also examined in situ. Although no significant reduction in internal diameter could be observed in situ, distensibility was dramatically decreased (-87% at MBP). These results emphasize the importance of considering the original vascular geometry when determining elastic properties of arteries. We conclude that experimental conditions are likely to be a critical determinant for the assessment of the mechanical properties of conduit vessels.

Animals↗

PubMed1998

Determinants of pulse pressure.

We have searched to define the major arterial parameters that determine aortic systolic (Ps) and diastolic (Pd) pressure in the dog. Measured aortic flows were used as input to the 2-element windkessel model of the arterial system, with peripheral resistance calculated as mean pressure divided by mean flow and total arterial compliance calculated from the decay time in diastole. The windkessel model yielded an aortic pressure wave from which we obtained the predicted systolic (Ps,wk) and diastolic (Pd,wk) pressures. These predicted pressures were compared with the measured systolic and diastolic pressures. The measurements and calculations were performed for 7 dogs under control conditions during aortic occlusion at 4 locations (the trifurcation, between the trifurcation and diaphragm, the diaphragm, and the proximal descending thoracic aorta) and during occlusion of both carotid arteries. Under all conditions studied, the predicted systolic and diastolic pressures matched the experimental ones very well: Ps,wk=(1.000+/-0.0055) Ps with r=0.958 and Pd,wk=(1.024+/-0.0035) Pd with r=0.995. Linear regression for pulse pressure (PP) resulted in PPwk=(0.99+/-0.016) PP with r=0.911. We found the accuracy of prediction equally good under control conditions and in the presence of aortic or carotid artery occlusion. Multiple regression between pulse pressure and arterial resistance and total arterial compliance yielded a poor regression constant (R2=0.19), suggesting that the 2 arterial parameters alone cannot explain pulse pressure and that flow is an important determinant as well. We conclude that for a given ejection pattern (aortic flow), 2 arterial parameters, total arterial resistance and total arterial compliance, are sufficient to accurately describe systolic and diastolic aortic pressure.

Animals↗

PubMed1997

Assessment of distributed arterial network models.

The aim of this study is to evaluate the relative importance of elastic non-linearities, viscoelasticity and resistance vessel modelling on arterial pressure and flow wave contours computed with distributed arterial network models. The computational results of a non-linear (time-domain) and a linear (frequency-domain) mode were compared using the same geometrical configuration and identical upstream and downstream boundary conditions and mechanical properties. pressures were computed at the ascending aorta, brachial and femoral artery. In spite of the identical problem definition, computational differences were found in input impedance modulus (max. 15-20%), systolic pressure (max. 5%) and pulse pressure (max. 10%). For the brachial artery, the ratio of pulse pressure to aortic pulse pressure was practically identical for both models (3%), whereas for the femoral artery higher values are found for the linear model (+10%). The aortic/brachial pressure transfer function indicates that pressure harmonic amplification is somewhat higher in the linear model for frequencies lower than 6 Hz while the opposite is true for higher frequencies. These computational disparities were attributed to conceptual model differences, such as the treatment of geometric tapering, rather than to elastic or convective non-linearities. Compared to the effect of viscoelasticity, the discrepancy between the linear and non-linear model is of the same importance. At peripheral locations, the correct representation of terminal impedance outweight the computational differences between the linear and non-linear models.

Aorta↗

PubMed1997

Residual strain effects on the stress field in a thick wall finite element model of the human carotid bifurcation.

A three-dimensional finite element model of the carotid artery bifurcation was constructed in order to determine the stress field and assess the modification of the stress field when residual strain is taken into account. Residual strain in the carotid bifurcation was characterized by experimental observations. According to these observations, a geometrical model of the carotid artery was constructed to exhibit a state free of strain. Appropriate boundary conditions were applied to yield the correct geometry in the unloaded state, and physiological levels of pressure and axial stretching were applied. The model took into account the varying thickness of the arterial wall along the bifurcation. For modeling purposes, the material was considered to be hyperelastic, incompressible, homogenous and isotropic. For comparison, a similar model of the carotid artery which does not include the effects of residual strain was also created. The results demonstrate that in the model of the carotid artery bifurcation with residual strain, the distribution of maximum principal stress along the inner wall and the circumferential stress throughout the wall is much more uniform than in the model without residual strain. The ratio between the stress at the inner and the outer walls is highest at the lateral wall of the carotid sinus; this is the same location known to be a site of low and oscillatory fluid wall shear stress, and the principal location of early intimal thickening. These results suggest that the localization of atherosclerosis in the carotid artery may be due to local variations in both fluid wall shear stress and solid wall stress.

Animals↗

PubMed1996

On the wave transmission and reflection properties of stenoses.

This study is concerned with the wave reflection properties of arterial stenoses. Two theoretical models have been developed for deriving the reflection coefficient: a linear model resulting from the linearization of the pressure drop-flow equation and an indirect, quasi-nonlinear model, based on the separation of pressure waves into their forward and backward running components proximal and distal to the stenosis. The linear method gave consistently lower values for the reflection coefficient when compared to the quasi-nonlinear model. In vitro experiments in elastic tubes showed that the reflection coefficient is strongly dependent on stenosis severity, mean flowrate, and the elastic properties of the proximal unobstructed artery. For critical stenoses the reflection coefficient is frequency and pulsatility independent. The results suggest that hemodynamically nonsevere stenoses may cause significant wave reflections.

Algorithms↗

PubMed1996

Theoretical study of dynamics of arterial wall remodeling in response to changes in blood pressure.

The dynamics of arterial wall remodeling was studied on the basis of a phenomenological mathematical model. Sustained hypertension was simulated by a step increase in blood pressure. Remodeling rate equations were postulated for the evolution of the geometrical dimensions that characterize the zero stress state of the artery. The driving stimuli are the deviations of the extreme values of the circumferential stretch ratios and the average stress from their values at the normotensive state. Arterial wall was considered to be a thick-walled tube made of nonlinear elastic incompressible material. Results showed that thickness increases montonically with time whereas the opening angle exhibits a biphasic pattern. Geometric characteristics reach asymptotically a new homeostatic steady state, in which the stress and strain distribution is practically identical with the distribution under normotensive conditions. The model predictions are in good agreement with published experimental findings.

Algorithms↗

PubMed1996

Effects of friction and nonlinearities on the separation of arterial waves into their forward and backward components.

In this paper we examine the importance of fluid friction and nonlinearities due to the area-pressure relationship and to the convective acceleration on the separation of arterial pressure and flow waves into their forward and backward components. Experiments were run in straight uniform nonlinearly elastic tubes. Different degrees of fluid friction and nonlinearities, covering the physiological range, have been tested. We predicted the forward and backward running pressure components using two wave separation methods: the classical linear method (Westerhof et al., Cardiovasc. Res, 6,648-656, 1972) and the first order correction (FOC) method (Pythoud et al., Trans ASME J. Biomech. Engng, in press) which takes nonlinearities and fluid friction into account. We found that the two methods yield somewhat different predictions. The differences tend to increase with the degree of fluid friction and nonlinearities and are typically of the order of 4-8%. We further compared the transmission ratio of forward and backward waves predicted by both methods. The transmission ratio was found to be overestimated by 10% by the classical linear method. The nonlinear method gave more accurate estimates, consistent with theory. We conclude that, for in vivo applications, the classical linear method should be the method of choice because it is simpler to use and the erros involved (4-8%) are comparable to measurement erros.

Arteries↗

PubMed1996

Separation of arterial pressure waves into their forward and backward running components.

A new separation technique has been developed to determine the forward and backward running arterial pressure wave components. It takes into account friction as well as nonlinear effects due to convective acceleration and to the pressure dependence of the arterial compliance. The new method is a combination of two methods treating friction and nonlinearities separately. The method requires the measurements of pressure and flow at one location as well as the knowledge of the area-pressure relationship. The validity of the method was tested by a simulation experiment in which the forward and backward waves were known a priori. It was shown that the new method is significantly more accurate in the predictions of the forward and backward waves when compared to the classical method assuming linearity and no dissipation. The new wave separation method was also applied to simulated aortic waves for (a) a healthy subject and (b) a subject with decreased compliance. Comparison with the classical linear method showed that neglecting nonlinearities leads to an overestimation of the forward and backward pressure wave amplitudes. The errors, however, were in the order of 5 to 10 percent. We concluded that, for most clinical purposes, the improvement using the nonlinear method is of the same magnitude as experimental errors, and thus the linear method would suffice.

Acceleration↗

PubMed1996

Determinants of stroke volume and systolic and diastolic aortic pressure.

We investigated how parameters describing the heart and the arterial system contribute to the systolic and diastolic pressures (Ps and Pd, respectively) and stroke volume (SV). We have described the heart by the varying-elastance model with six parameters and the systemic arterial tree by the three-element windkessel model, leading to a total of nine parameters. Application of dimensional analysis led to a total of six dimensionless parameters describing dimensionless Ps and Pd, i.e., pressures with respect to venous pressure (Ps/Pv and Pd/Pv). SV was normalized with respect to unloaded ventricular volume (Vd). Sensitivity analysis showed that Ps/Pv, Pd/Pv, and SV/Vd could be accurately described by four, three, and three dimensionless parameters, respectively. With this limited number of parameters, it was then possible to obtain empirical analytical expressions for Ps/Pv, Pd/Pv, and SV/Vd. The analytic predictions were tested against the model values and found to be as follows: Ps predicted = (1.0007 +/- 0.0062) Ps, r = 0.987; Pd predicted = (1.016 +/- 0.0085) Pd, r = 0.992; and SV predicted = (0.9987 +/- 0.0028) SV, r = 0.996. We conclude that aortic Ps, Pd, and SV can be accurately described by a limited number of parameters and that, for any condition of the heart and the arterial system, Ps, Pd, and SV can be presented in analytical form.

Animals↗

PubMed1996

Method for determining distribution of reflection sites in the arterial system.

We developed a new method to determine the location and importance of reflection sites in the arterial system. The method is based on the decomposition of the aortic pressure wave into its forward and backward components, and it provides the reflection profile of the arterial system as a wave reflection site amplitude versus distance from the heart. The reflection profile can be seen as the response of the arterial system to a pressure delta pulse where reflections upstream from the measurement location have been eliminated. The method was successfully tested on a simple model loaded with a pure resistor, a two-element windkessel, and a bifurcating tube system. It was then applied to the aortic pressure and flow signals measured in six mongrel dogs whose aorta was occluded at different levels. The profiles obtained from measurements at control showed two main reflection regions, one located in the vicinity (0.1-0.2 m) of the heart and the other located in the region of the iliac bifurcation. All occlusions, even the most distant one at the iliac bifurcation, could be identified in both amplitude (amount of reflections) and distance from the heart. The spatial resolution of the profiles was approximately 0.1 m as a result of the limited power spectrum contained in the arterial pulse, and the identification of reflection sites decreased rapidly with the distance.

Animals↗

PubMed1996

Contributions of vascular tone and structure to elastic properties of a medium-sized artery.

Isobaric compliance and distensibility of the radial artery were recently reported to be normal or slightly increased in untreated hypertensive patients. However, these findings provide no information on the intrinsic mechanical properties of the wall material. To address this question, we determined intima-media wall thickness, wall-to-lumen ratio, and incremental elastic modulus in the radial artery of 25 untreated hypertensive patients with blood pressure of 150 +/- 14/103 +/- 6 mm Hg (mean +/- SD) and 25 matched control subjects with blood pressure of 118 +/- 9/79 +/- 6 mm Hg. High-resolution echotracking for assessment of internal diameter and intima-media wall thickness was combined with measurements of blood flow velocity by Doppler and blood pressure by photoplethysmography. In addition, isobaric compliance and distensibility and incremental elastic modulus were measured at peak diameter during reactive hyperemia after a 5-minute brachial occlusion. No significant difference was found between the two groups for isobaric compliance or distensibility at baseline or during hyperemia. However, incremental elastic modulus at 100 mg Hg tended to be lower in hypertensive patients than control subjects (1.9 +/- 1.1 versus 2.5 +/- 1.2 mm Hg x 10(4), P = .1) in resting conditions. Hypertensive patients and control subjects had similar internal diameters (2.47 +/- 0.32 versus 2.41 +/- 0.35 microm), but intima-media wall thickness and wall-to-lumen ratio were significantly increased in hypertensive patients compared with control subjects (0.268 +/- 0.032 versus 0.236 +/- 0.025 mm -P < or = .01- and 0.220 +/- 0.038 versus 0.195 +/- 0.028 -P < or = .05-, respectively). Peak hyperemic blood flow response (hypertensive patients versus control subjects: 349% versus 360% increase from baseline) and reactive hyperemic dilation (7.2% versus 7.9%) were similar in amplitude and duration in the two groups. These results suggest that wall thickening is an adaptive process that reduces wall tension in hypertensive patients while preserving a normal mechanical behavior of the radial artery. This is most likely accomplished by modification of the incremental elastic modulus of wall components rather than by a change in vascular tone.

Adult↗