Department of Mechanical and Biomedical Engineering, Kangwon National University, Chuncheon, Korea.
J Korean Med Sci. 2013 Aug;28(8):1161-8. doi: 10.3346/jkms.2013.28.8.1161. Epub 2013 Jul 31.
The current study proposes a model of the cardiovascular system that couples heart cell mechanics with arterial hemodynamics to examine the physiological role of arterial blood pressure (BP) in left ventricular hypertrophy (LVH). We developed a comprehensive multiphysics and multiscale cardiovascular model of the cardiovascular system that simulates physiological events, from membrane excitation and the contraction of a cardiac cell to heart mechanics and arterial blood hemodynamics. Using this model, we delineated the relationship between arterial BP or pulse wave velocity and LVH. Computed results were compared with existing clinical and experimental observations. To investigate the relationship between arterial hemodynamics and LVH, we performed a parametric study based on arterial wall stiffness, which was obtained in the model. Peak cellular stress of the left ventricle and systolic blood pressure (SBP) in the brachial and central arteries also increased; however, further increases were limited for higher arterial stiffness values. Interestingly, when we doubled the value of arterial stiffness from the baseline value, the percentage increase of SBP in the central artery was about 6.7% whereas that of the brachial artery was about 3.4%. It is suggested that SBP in the central artery is more critical for predicting LVH as compared with other blood pressure measurements.
本研究提出了一个耦合心肌细胞力学和动脉血液动力学的心血管系统模型，以研究动脉血压（BP）在左心室肥厚（LVH）中的生理作用。我们开发了一个全面的多物理和多尺度心血管系统模型，模拟了从细胞膜兴奋和心肌细胞收缩到心脏力学和动脉血液动力学的生理事件。使用该模型，我们描绘了动脉 BP 或脉搏波速度与 LVH 之间的关系。计算结果与现有的临床和实验观察进行了比较。为了研究动脉血液动力学与 LVH 之间的关系，我们根据模型中获得的动脉壁刚度进行了参数研究。左心室细胞峰值应力和肱动脉及中心动脉的收缩压（SBP）也随之升高；然而，对于更高的动脉刚度值，进一步的增加受到限制。有趣的是，当我们将动脉刚度值从基线值增加一倍时，中心动脉的 SBP 增加百分比约为 6.7%，而肱动脉的增加百分比约为 3.4%。这表明与其他血压测量相比，中心动脉的 SBP 对预测 LVH 更为关键。
