Shahmirzadi Danial, Konofagou Elisa E
Columbia University, New York, NY.
Artery Res. 2012 Sep;6(3). doi: 10.1016/j.artres.2012.05.004.
Monitoring of the regional stiffening of the arterial wall may prove important in the diagnosis of various vascular pathologies. The pulse wave velocity (PWV) along the aortic wall has been shown to be dependent on the wall stiffness and has played a fundamental role in a range of diagnostic methods. Conventional clinical methods involve a global examination of the pulse traveling between two remote sites, e.g. femoral and carotid arteries, to provide an average PWV estimate. However, the majority of vascular diseases entail regional vascular changes and therefore may not be detected by a global PWV estimate. In this paper, a fluid-structure interaction study of straight-geometry aortas was carried out to examine the effects of regional stiffness changes on PWV. Five homogeneous aortas with increasing wall stiffness as well as two aortas with soft and hard inclusions were considered. In each case, spatio-temporal maps of the wall motion were used to analyze the regional pulse wave propagation. On the homogeneous aortas, increasing PWVs were found to increase with the wall moduli ( = 0.9988), indicating the reliability of the model to accurately represent the wave propagation. On the inhomogeneous aortas, formation of reflected and standing waves was observed at the site of the hard and soft inclusions, respectively. Neither the hard nor the soft inclusion had a significant effect on the velocity of the traveling pulse beyond the inclusion site, which supported the hypothesis that a global measurement of the average PWV could fail to detect regional abnormalities.
监测动脉壁的局部硬化可能对各种血管病变的诊断具有重要意义。沿主动脉壁的脉搏波速度(PWV)已被证明取决于血管壁的硬度,并且在一系列诊断方法中发挥了重要作用。传统的临床方法包括对在两个远距离部位(例如股动脉和颈动脉)之间传播的脉搏进行整体检查,以提供平均PWV估计值。然而,大多数血管疾病会导致局部血管变化,因此可能无法通过整体PWV估计值检测到。在本文中,对直管状主动脉进行了流固耦合研究,以检查局部硬度变化对PWV的影响。研究考虑了五个血管壁硬度逐渐增加的均匀主动脉以及两个分别含有软硬内含物的主动脉。在每种情况下,利用壁运动的时空图来分析局部脉搏波传播。在均匀主动脉上,发现PWV随着壁模量的增加而增加( = 0.9988),这表明该模型能够准确表示波传播的可靠性。在非均匀主动脉上,分别在硬内含物和软内含物的位置观察到了反射波和驻波的形成。硬内含物和软内含物对内含物部位之外的行进脉冲速度均无显著影响,这支持了以下假设:对平均PWV进行整体测量可能无法检测到局部异常。