Department of Biomedical Engineering, Rutgers University, Piscataway, NJ, USA.
Adv Exp Med Biol. 2018;1065:207-224. doi: 10.1007/978-3-319-77932-4_14.
The classic works of "On Growth and Form" and "The Problem of Relative Growth" that began a century ago have so fittingly, albeit unintentionally, become pertinent to the modern-day clinical treatment strategy of the many patients with cardiovascular disease. This chapter uses allometry, which was established for comparative biology, to explore physiological and pathological differences due to differential growth, which may lead to differing diagnostic and treatment approaches for male versus female patients. Men and women have obvious differences in body and heart weights, as well as different geometries and structures of their blood vessels; the analysis in this chapter extends to their hemodynamic functional differences. This includes dimensional analysis to establish criteria for characterizing functions based on allometric formulations. The clinical applications of sex differences are analyzed for arterial stenosis, aneurysm, atherosclerosis, hypertension, and coronary revascularization. Allometric approaches are applied specifically to isolated cases of systolic hypertension to delineate the intermingled relations of aging and sex differences. This chapter aims to provide some preliminary insights into the usefulness of cardiovascular allometry. Its future impact on clinical diagnosis remains largely unexplored.
一个世纪以前出版的经典著作《论生长和形态》和《论相对生长问题》,虽然并非有意为之,但非常恰当地成为了当今许多心血管疾病患者临床治疗策略的基础。本章使用比较生物学中建立的异速生长理论,探讨了由于生长差异导致的生理和病理差异,这可能导致男女患者的诊断和治疗方法不同。男性和女性的体重和心脏重量明显不同,血管的几何形状和结构也不同;本章的分析还扩展到了他们的血流动力学功能差异。这包括维度分析,以根据异速生长公式建立基于特征函数的标准。本章还分析了动脉狭窄、动脉瘤、动脉粥样硬化、高血压和冠状动脉血运重建等疾病中的性别差异的临床应用。特别将异速生长方法应用于单纯性收缩期高血压的病例,以阐明衰老和性别差异的相互关系。本章旨在为心血管异速生长的有用性提供一些初步的见解。它对临床诊断的未来影响在很大程度上仍未得到探索。