Westerhof Berend E, van Gemert Martin J C, van den Wijngaard Jeroen P
Cardiovascular and Respiratory Physiology, Technical Medical Centre, Faculty of Science and Technology, University of Twente, Enschede, Netherlands.
Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Free Universiteit Amsterdam, Amsterdam, Netherlands.
Front Pediatr. 2020 May 19;8:251. doi: 10.3389/fped.2020.00251. eCollection 2020.
Distributed models of the arterial tree allow studying the effect of physiological and pathophysiological changes in the vasculature on hemodynamics. For the adult, several models exist; however, a model encompassing the full age range from newborn to adult was until now lacking. Our goal is to describe a complete distributed hemodynamic model for normal development from newborn to adult. The arterial system was modeled by 121 segments characterized by length, radius, wall thickness, wall stiffness, and wall viscosity. The final segments ended in three-element Windkessels. All parameters were adapted based on body height and weight as a function of age as described in the literature. Pressures and flows are calculated as a function of age at sites along the arterial tree. Central to peripheral transfer functions are given. Our results indicate that peripheral pressure in younger children resembles central pressure. Furthermore, total arterial compliance, inertance and impedance are calculated. Findings indicate that the arterial tree can be simulated by using a three-element Windkessel system. Pulse wave velocity in the aorta was found to increase during development. The arterial system, modeled from newborn to adult bears clinical significance, both for the interpretation of peripheral measured pressure in younger and older children, and for using a Windkessel model to determine flow from pressure measurements.
动脉树的分布式模型有助于研究血管系统中生理和病理生理变化对血流动力学的影响。对于成年人,已有多种模型;然而,迄今为止还缺乏一个涵盖从新生儿到成年人整个年龄范围的模型。我们的目标是描述一个从新生儿到成年人正常发育的完整分布式血流动力学模型。动脉系统由121个节段建模,这些节段的特征包括长度、半径、壁厚、壁硬度和壁粘度。最后几个节段以三元Windkessel模型结束。所有参数均根据文献中所述的身高和体重随年龄变化的函数进行调整。压力和流量是沿动脉树各部位年龄的函数计算得出的。给出了中心到外周的传递函数。我们的结果表明,年幼儿童的外周压力类似于中心压力。此外,还计算了总动脉顺应性、惯性和阻抗。研究结果表明,动脉树可以用三元Windkessel系统进行模拟。发现主动脉中的脉搏波速度在发育过程中会增加。从新生儿到成年人建模的动脉系统具有临床意义,这对于解释年幼儿童和年长儿童的外周测量压力,以及使用Windkessel模型从压力测量中确定流量都具有重要意义。