Biomedical subjects

N Stergiopulos

Publications and source records attributed to N Stergiopulos.

At least 55 records · Page 3Linked to original sources

PubMed1996

Bisferiens peaks in the radial artery pressure wave during patent ductus arteriosus in newborn infants: relationship with ascending aortic flow.

Previously, we found evidence that bisferiens peaks in the radial artery pressure wave in the newborn infant may suggest the presence of a left-to-right shunt through a patent ductus arteriosus (PDA). The purpose of the present study was to analyze the origin of this pulsus bisferiens. Starting from the assumption that the radial artery pressure wave form is similar to the aortic pressure wave form, as described previously, we attempted to explain the bisferiens peaks on the basis of echocardiographically obtained ascending aortic flow. We studied 11 preterm mechanically ventilated infants with a left-to-right shunt through a PDA and 7 without. Aortic volume flow was established echocardiographically, and radial artery blood pressure measurement was performed with a high fidelity cathetermanometer system. Ascending aortic peak flow during PDA was significantly higher in the case of PDA, compared with the case without PDA. An augmented peak flow with an abrupt decline after the high peak in PDA, resulting in a sharp pressure peak with a steep decline after the peak, was thought to explain the first sharp peak of pulsus bisferiens. An abrupt decline of flow after peak flow is thought to be due to the fast runoff of blood through the ductus. According to the pulsatile pressure dynamics theories, which state that pressure wave forms consist of forward and backward wave forms, the second peak of the pulsus bisferiens can be explained by the return of the reflected (backward) wave form when the forward wave form has already considerably decreased. We conclude that the bisferiens peaks found in PDA result from a combination of large stroke volume (augmented first peak) and large runoff (quick decline of the forward wave) before the return of the reflected wave.

Aorta↗

PubMed1995

Evaluation of methods for estimation of total arterial compliance.

Seven classic and recently proposed methods used for the estimation of total arterial compliance have been evaluated for their accuracy and applicability in different physiological conditions. The pressure and flow data are taken from a computer model that provides realistic simulations of the nonlinear-distributed systemic arterial tree. Besides the great flexibility in simulating different physiological or pathological cases, the major advantage of the computer model is that it allows precise knowledge of the pressure-dependent total arterial compliance, which is the variable of interest. The results show that the methods based on the two-element windkessel (WK) model are more accurate than those based on the three-element WK model. The classic exponential decay and the diastolic area method yield essentially similar results, and their compliance estimates are accurate within 10% except at high heart rates. The later part of diastole, i.e., from the time that the systolic pressure wave has reached all peripheral beds, gives the best results. The newly proposed two-area and pulse pressure methods, both based on the two-element WK model, are accurate (errors in general < 10%) and can be applied to other locations in the arterial tree where the decay time and area method cannot. Methods based on the three-element WK model consistently overestimate total arterial compliance (> or = 25%). The errors in the methods based on the three-element WK model arise from the fact that the input impedance in that model deviates significantly from the true input impedance at low frequencies. The strong dependence of compliance on pressure (elastic nonlinearity) does not invalidate the compliance estimates.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1995

Scatter in input impedance spectrum may result from the elastic nonlinearity of the arterial wall.

We have examined the role of the nonlinear elastic properties of the arterial wall on the human aortic input impedance obtained at different heart rates and different pressure and flow wave shapes. Pressure and flow were taken from a computer model that provides realistic simulations of the nonlinear distributed systemic arterial tree. Different wave shapes of ascending aorta pressure and flow and different heart rates were used to derive input impedance moduli and phase angles via Fourier analysis. The results show that the nonlinear elastic properties of the arterial wall are responsible for significant variations in the input impedance spectrum when changes in heart rate and aortic flow wave shape take place. This finding may explain the scatter often observed in experimentally determined input impedance data using different heart rates obtained by pacing.

Arteries↗

PubMed1995

Simultaneous ipsilateral and contralateral measurements of vasomotion in conduit arteries of human upper limbs.

We investigated the patterns of vasomotion in various conduit arteries of the human arm. The internal diameter of the brachial, radial, ulnar, and digital artery was measured noninvasively in 17 healthy volunteers (aged 24-40 yr), using a high-precision ultrasonic echotracking device. Under resting conditions, the radial, ulnar, and digital internal diameter exhibited spontaneous oscillations (vasomotion) with a relative amplitude ranging from 1 to 5% of the mean diameter and a fundamental frequency ranging from 0.01 to 0.05 Hz. This oscillatory behavior was either quasi-periodic or irregular. The low-frequency mode (f < or = 0.05 Hz) present in the diameter signal was identified neither in the heart rate nor in the blood pressure signal. To determine whether the oscillatory activity was propagative, simultaneous measurements of diameter at two sites on the right radial artery were performed and revealed no significant consistent phase shift. Ipsilateral radial and ulnar diameters, measured at the wrist level, exhibited similar and synchronous vasomotion patterns, despite differences in the amplitude. For all subjects, contralateral measurements, performed at two symmetrical sites of the radial arteries, showed similar oscillatory patterns with a strong correlation (0.85 < r < 0.99, n = 12). These results suggested the existence of a global regulatory mechanism that coordinates vasomotion in the large conduit arteries of the human arm.

Adult↗

PubMed1995

Flow-diameter phase shift. A potential indicator of conduit artery function.

This study assesses (1) the relation of the very-low-frequency vasomotion (< 0.02 Hz) of the radial artery of young healthy volunteers to regional blood flow and (2) its distribution in the upper extremities. Radial artery diameters from comparable sites were measured on contralateral extremities in 18 young healthy volunteers by an echo tracking system simultaneously with blood flow velocity determined by continuous wave Doppler and blood pressure acquired by photoplethysmography in the middle finger. A synchronous global pattern of vasomotion was detected on contralateral radial arteries, suggesting the presence of either a centrally located pacemaker or a humoral system. Modulation of sympathovagal balance in 8 subjects did not significantly alter either the frequency or amplitude of the very-low-frequency vasomotor waves. Matching patterns of diameter and flow oscillations of the very-low-frequency type recorded at the same site were obtained in 10 strictly nonsmoking volunteers for given periods of time. A consistent phase lag was observed between flow and diameter signals. Flow always preceded the diameter fluctuations by a mean (+/- SEM) course of 20.8 +/- 1.56 seconds. Although the physiological basis for oscillatory behavior remains for the moment highly speculative, these results suggest that the very-low-frequency vasomotion pattern in this conduit vessel might be a flow- or shear stress-dependent phenomenon. Shear stress changes at the endothelium modulate vascular tone through the release of vasodilators. The noninvasive assessment of the diameter-flow relation may thus offer a new way of addressing vascular wall function in medium-sized and large arteries in subjects with cardiovascular risk factors.

Adult↗

PubMed1995

Forward and backward waves in the arterial system: nonlinear separation using Riemann invariants.

A nonlinear method has been developed to separate arterial pressure and flow waves into their forward and backward running components. It takes into account nonlinearities arising from the area-pressure relationship as well as convective acceleration. The method is based on the treatment of the Riemann invariants and requires measurements of pressure, flow and diameter at one arterial location. The method has been successfully tested by means of 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 linear method. The new wave separation method was then 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 of the order of 5 to 10%.

Adult↗

PubMed1994

Modeling of the wave transmission properties of large arteries using nonlinear elastic tubes.

We propose a new, simple way of constructing elastic tubes which can be used to model the nonlinear elastic properties of large arteries. The tube models are constructed from a silicon elastomer (Sylgard 184, Dow Corning), which exhibits a nonlinear behavior with increased stiffness at high strains. Tests conducted on different tube models showed that, with the proper choice of geometric parameters, the elastic properties, in terms of area-pressure relation and compliance, can be similar to that of real arteries.

Arteries↗

PubMed1993

Nonlinear separation of forward and backward running waves in elastic conduits.

A new method for the separation of forward and backward running waves in elastic conduits, with possible extension to the arterial system, has been developed. The mathematical model is based on the one-dimensional flow equations which allow the treatment of non-periodic or transient pressure and flow pulses. The method is fully nonlinear, i.e. no linearizing assumptions are made. The method includes the effects of convective acceleration and pressure-dependent vessel compliance. A first approximation for the fluid friction at the wall is also included. The application of the method requires the knowledge of the elastic properties, the instantaneous pressure and flow, as well as the instantaneous spatial derivatives of pressure and flow. Analysis of simulated data shows good results and suggests that the proposed method, unlike previous quasi-nonlinear and frequency domain methods, can be applied to strongly nonlinear and/or nonperiodic flows. The method predicts that if a linear analysis is applied to a nonlinear system errors arise.

Arteries↗

PubMed1992

Computer simulation of arterial flow with applications to arterial and aortic stenoses.

A computer model for simulating pressure and flow propagation in the human arterial system is developed. The model is based on the one-dimensional flow equations and includes nonlinearities arising from geometry and material properties. Fifty-five arterial segments, representing the various major arteries, are combined to form the model of the arterial system. Particular attention is paid to the development of peripheral pressure and flow pulses under normal flow conditions and under conditions of arterial and aortic stenoses. Results show that the presence of severe arterial stenoses significantly affects the nature of the distal pressure and flow pulses. Aortic stenoses also have a profound effect on central and peripheral pressure pulse formation. Comparison with the published experimental data suggests that the model is capable of simulating arterial flow under normal flow conditions as well as conditions of stenotic obstructions in a satisfactory manner.

Aortic Valve Stenosis↗

PubMed1992

Non-invasive method for the assessment of non-linear elastic properties and stress of forearm arteries in vivo.

AIM: To propose a method for obtaining non-invasive highly accurate measurements of arterial diameter, thickness and pressure at a single location on a peripheral arm artery, and use this data to estimate the status of the arterial wall. METHODS: Diameter and thickness were measured with an A-mode ultrasonic echo-tracking device, with a precision of close to 1 micron. Pressure was measured with a photoplethysmograph at the finger level. A simple hemodynamic model was used to estimate, from the measured pressure pulse, the pressure waveform at the diameter-measuring site. RESULTS: The collected data made it possible to assess (1) the elastic response of the artery, through the compliance and distensibility, (2) the loading conditions, through the average stress-diameter curve and (3) the elastic properties of the wall material, through the incremental modulus of elasticity. CONCLUSION: This information can be used to assess the overall status of the arterial wall.

Blood Pressure↗

PubMed1991

Numerical study of pressure and flow propagation in arteries.

A computer model for simulating pressure and flow propagation in the human arterial system is developed. The model is based on the one-dimensional flow equations and includes non-linearities arising from geometry and material properties. Fifty five arterial segments, representing the various major arteries, are combined to form the model of the arterial system. Particular attention is paid to the development of peripheral pressure and flow pulses under normal flow conditions and under conditions of arterial disease. Cases investigated include arteriosclerosis and hypertension as well as the presence of single or multiple vascular occlusions. Results demonstrate that the model is capable of simulating arterial flow in a satisfactory manner.

Arteries↗

PubMed1988

The inverse Womersley problem for pulsatile flow in straight rigid tubes.

In this study a numerical solution for the problem of pulsating flow in rigid tubes is described. The method applies to the case of known flow rate waveform, as opposed to Womersley solution where the pressure gradient was the known quantity. The solution provides the pressure gradient and wall shear stress waveforms as well as the instantaneous velocity profiles. Results show that the method can be used to study the blood flow characteristics in large arteries.

Mathematics↗

PubMedDate not supplied

A theoretical investigation of low frequency diameter oscillations of muscular arteries.

Spontaneous low frequency diameter oscillations have been observed in vivo in some muscular arteries. The aim of this paper is to propose a possible mechanism for their appearance. A lumped parameter mathematical model for the mechanical response of an artery perfused with constant flow is proposed, which takes into account the active behavior of the vascular smooth muscle. The system of governing equations is reduced into two nonlinear autonomous differential equations for the arterial circumferential stretch ratio, and the concentration of calcium ions, Ca2+, within the smooth muscle cells. Factors controlling the muscular tone are taken into account by assuming that the rate of change of Ca2+ depends on arterial pressure and on shear stress acting on the endothelium. Using the theory of dynamical systems, it was found that the stationary solution of the set of governing equations may become unstable and a periodic solution arises, yielding self-sustained diameter oscillations. It is found that a necessary condition for the appearance of diameter oscillations is the existence of a negative slope of the steady state pressure-diameter relationship, a phenomenon known to exist in arterioles. A numerical parametric study was performed and bifurcation diagrams were obtained for a typical muscular artery. Results show that low frequency diameter oscillations develop when the magnitude of the perfused inflow, the distal resistance, as well as the length of the artery are within a range of critical values.

Arteries↗

PubMedDate not supplied

Simple and accurate way for estimating total and segmental arterial compliance: the pulse pressure method.

We derived and tested a new, simple, and accurate method to estimate the compliance of the entire arterial tree and parts thereof. The method requires the measurements of pressure and flow and is based on fitting the pulse pressure (systolic minus diastolic pressure) predicted by the two-element windkessel model to the measured pulse pressure. We show that the two-element windkessel model accurately describes the modulus of the input impedance at low harmonics (0-4th) of the heart rate so that the gross features of the arterial pressure wave, including pulse pressure, are accounted for. The method was tested using a distributed nonlinear model of the human systemic arterial tree. Pressure and flow were calculated in the ascending aorta, thoracic aorta, common carotid, and iliac artery. In a linear version of the systemic model the estimated compliance was within 1% of the compliance at the first three locations. In the iliac artery an error of 7% was found. In a nonlinear version, we compared the estimates of compliance with the average compliance over the cardiac cycle and the compliance at the mean working pressure. At the first three locations we found the estimated and "actual" compliance to be within 12% of each other. In the iliac artery the error was larger. We also investigated an increase and decrease in heart rate, a decrease in wall elasticity and exercise conditions. In all cases the estimated total arterial compliance was within 10% of mean compliance. Thus, the errors result mainly from the nonlinearity of the arterial system. Segmental compliance can be obtained by subtraction of compliance determined at two locations.

Aorta↗

PubMedDate not supplied

Adaptation of conduit artery vascular smooth muscle tone to induced hypertension.

We studied the changes in vascular smooth muscle (VSM) cell tone during the adaptation of rat common carotids to induced hypertension. Hypertension was induced in 8 week old male Wistar rats by total ligation of the aorta between the two kidneys. Mean blood pressure increased abruptly from 92 +/- 2mm Hg (mean +/- SE) to 145 +/- 4 mm Hg and remained constant thereafter. Rats were sacrificed 2, 4, 8, and 56 days after surgery and the left common carotid artery was excised for analysis. Pressure-diameter curves were measured in vitro under normal, maximally contracted, and totally relaxed VSM. The VSM tone was analyzed in terms of its basal tone (active stress at low strains) and its myogenic tone (increase in active stress at high strains). Our results show that the capacity of the VSM to develop maximal active stress is not altered in hypertension. Basal tone, however, increases rapidly in the acute hypertension phase (2-8 days postsurgery) and drops to nearly control values at 56 days postsurgery. Also, the onset of myogenic response decreases to lower strains following the step change in pressure, to be restored back to control levels at 56 days postsurgery. We conclude that VSM adaptation is most significant in the acute hypertension phase and acts as a first, rapid defense mechanism for the arterial wall. The VSM tone returns back to normal levels once the slower geometrical and structural remodeling is developed sufficiently to restore the biomechanical environment and function of the arterial wall to control levels.

Adaptation, Physiological↗

PubMedDate not supplied

Pulse pressure method and the area method for the estimation of total arterial compliance in dogs: sensitivity to wave reflection intensity.

We estimated total arterial compliance (C) in eight anesthetized mongrel dogs with (i) the area method (AM), (ii) the pulse pressure method (PPM), and (iii) the stroke volume-to-pulse pressure ratio (SV/PP). Average compliance was C(AM)=1.1+/-0.73 ml mm Hg(-1) using AM; C(PPM)=0.60+/-0.31 ml mm Hg(-1) using PPM and C(SV/PP)=0.87+/-0.49 ml mm Hg(-1) using SV/PP. Mean aortic pressure was 64+/-23 mm Hg. The overall agreement between C(AM) and C(PPM) was relatively poor (C(AM)=0.15+/-1.61 C(PPM); r2=0.48), with a consistent overestimation of the area method with respect to the pulse pressure method. There was a significant correlation (r=-0.78) between the relative difference between PPM and AM, and the modulus of the first harmonic of the wave reflection coefficient [gamma] which was low in our dog population (0.37+/-0.18). SV/PP overestimated PPM, but both methods were highly correlated (C(SV/PP)=0.06+/-1.60C(PPM); r2=0.97). C(SV/PP) and C(AM) were similar only for [gamma]>0.4. The effect of isolated changes of [gamma] on PPM, AM, and SV/PP was studied using the linear wave separation technique. The area method appeared very sensitive to the wave reflection intensity. For low reflection coefficients, the diastolic wave profile was flattened and compliance was overestimated. PPM and SV/PP were relatively independent of [gamma] and remained even applicable for [gamma]=0. We believe that the pulse pressure method is the most consistent method for the estimation of total arterial compliance in hemodynamic conditions characterized by a low wave reflection intensity.

Animals↗

PubMedDate not supplied

Flow-driven diameter response in rat femoral arteries perfused in vitro.

The effects of flow and flow changes on arterial diameter were investigated in vitro on isolated rat femoral arteries. Segments of femoral arteries were excised, mounted on microcannulas, and perfused with Tyrode's solution (37 degrees C). Perfusion pressure was kept constant at 90 mm Hg. The mean external diameter after equilibration at a transmural pressure of 90 mm Hg was 720 +/- 50 microm (n = 12). Vessels were then constricted with norepinephrine (1 microM in the superfusion solution) to 77% +/- 13% of the resting diameter; acetylcholine was used to check endothelial function. The external diameter was measured continuously using video microscopy. The arteries were subjected to two different types of flow variations: (a) step changes in flow (increase and decrease, n = 6) and (b) low-frequency sinusoidal flow variations (frequencies ranging from 0.002 to 0.1 Hz, n = 11). Flow ranged from 0 to 800 microl/min (shear stress ranging from 0 to 15 dyn/cm2). All measured vessels constricted as flow increased. Flow steps induced exponential-like contractions (flow increase) or relaxations (flow decrease) with mean characteristic time constants 31 +/- 4 and 22 +/- 2 s, respectively. Sinusoidal flow oscillations induced sinusoidal diameter oscillations with a time delay. An increase in the frequency of the flow led to a decrease of both the amplitude of the flow-induced diameter oscillations and the phase shift between flow and diameter. The dynamic diameter response to flow changes could be characterized by a first-order low-pass filter with a time constant of 22 s.

Animals↗

PubMedDate not supplied

Assessing the homogeneity of the elastic properties and composition of the pig aortic media.

Most previous studies of arterial wall elasticity and rheology have assumed that the properties of the wall are uniform across the thickness of the media and, therefore, that the relationship between stress and strain may be described by a constitutive equation based on a single strain energy function. The few studies where this assumption has been questioned, focussed on differences between the adventitia and the media rather than on differences within the media itself. Here, we report in vitro elasticity and residual strain measurements performed separately on the inner and outer half of the pig aortic media, together with a histomorphometric assessment of the radial distribution of elastin, collagen and smooth muscle cell numbers. Although we found that the pressure-diameter relationships of the two halves were dissimilar, when allowance was made for their different unloaded dimensions, their material properties agreed closely, a result in keeping with the observed uniform radial distribution of scleroprotein and vascular smooth muscle. We also found a difference in the opening angle (which is often taken as a measure of residual strain) between the inner and outer medial halves. However, strain analysis showed that the opening angle is an extremely sensitive measure of residual strain and that the difference in the actual magnitudes of residual strain between the two halves of the media was small. We conclude that the media of the porcine thoracic aorta has similar elastic properties throughout its thickness and that this uniformity is matched by a uniform distribution of matrix protein and vascular smooth muscle cells. Furthermore, the distribution of strain in the media can adequately be described by a single-layer model with uniform elastic properties throughout its thickness.

Anatomy, Cross-Sectional↗