Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jul 26:12:701154.
doi: 10.3389/fphys.2021.701154. eCollection 2021.

Acute and Long-Term Effects of Aortic Compliance Decrease on Central Hemodynamics: A Modeling Analysis

Stamatia Pagoulatou  1 , Dionysios Adamopoulos  2 , Georgios Rovas  1 , Vasiliki Bikia  1 , Nikolaos Stergiopulos  1
Affiliations

Acute and Long-Term Effects of Aortic Compliance Decrease on Central Hemodynamics: A Modeling Analysis

Stamatia Pagoulatou et al. Front Physiol. .

Abstract

Aortic compliance is an important determinant of cardiac afterload and a contributor to cardiovascular morbidity. In the present study, we sought to provide in silico insights into the acute as well as long-term effects of aortic compliance decrease on central hemodynamics. To that aim, we used a mathematical model of the cardiovascular system to simulate the hemodynamics (a) of a healthy young adult (baseline), (b) acutely after banding of the proximal aorta, (c) after the heart remodeled itself to match the increased afterload. The simulated pressure and flow waves were used for subsequent wave separation analysis. Aortic banding induced hypertension (SBP 106 mmHg at baseline versus 152 mmHg after banding), which was sustained after left ventricular (LV) remodeling. The main mechanism that drove hypertension was the enhancement of the forward wave, which became even more significant after LV remodeling (forward amplitude 30 mmHg at baseline versus 60 mmHg acutely after banding versus 64 mmHg after remodeling). Accordingly, the forward wave's contribution to the total pulse pressure increased throughout this process, while the reflection coefficient acutely decreased and then remained roughly constant. Finally, LV remodeling was accompanied by a decrease in augmentation index (AIx 13% acutely after banding versus -3% after remodeling) and a change of the central pressure wave phenotype from the characteristic Type A ("old") to Type C ("young") phenotype. These findings provide valuable insights into the mechanisms of hypertension and provoke us to reconsider our understanding of AIx as a solely arterial parameter.

Keywords: LV remodeling; augmentation index; banding; hypertension; wave separation analysis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Acute and long-term changes of central aortic pressure and flow due to aortic banding as measured invasively by Ioannou et al. (2009) in the swine. Figure reproduced with permission.
FIGURE 2
FIGURE 2
Simulation setup for the three hemodynamic states. (A) Schematic representation of the arterial tree, taken from Reymond et al. (2009) and reproduced with permission. (B) Simulation of aortic banding. (C) Simulation of LV remodeling. TPR, total peripheral resistance; Pfill, filling pressure; Ees, end-systolic elastance; β, diastolic stiffness.
FIGURE 3
FIGURE 3
Comparison of the pressure-volume loops at the three different phases. (A) Baseline versus acutely after banding. (B) Acutely after banding versus after LV remodeling under the form of concentric hypertrophy.
FIGURE 4
FIGURE 4
The simulation-generated aortic pressure and flow waves for the three hemodynamic states. (left) Baseline, (center) acutely after banding, and (right) after LV remodeling.
FIGURE 5
FIGURE 5
Analysis of the pressure wave into its forward (continuous line) and backward component (dashed line) for the three generated hemodynamic states.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Boutouyrie P., Laurent S., Benetos A., Girerd X. J., Hoeks A. P., Safar M. E. (1992). Opposing effects of ageing on distal and proximal large arteries in hypertensives. J. Hypertens. Suppl. Off. J. Int. Soc. Hypertens. 10 S87–S91. - PubMed
    1. Brinke E. A., ten Bertini M., Klautz R. J., Antoni M. L., Holman E. R., Veire N. R., et al. (2010). Noninvasive estimation of left ventricular filling pressures in patients with heart failure after surgical ventricular restoration and restrictive mitral annuloplasty. J. Thorac. Cardiovasc. Surg. 140 807–815. 10.1016/j.jtcvs.2009.11.039 - DOI - PubMed
    1. Burkhoff D., Mirsky I., Suga H. (2005). Assessment of systolic and diastolic ventricular properties via pressure-volume analysis: a guide for clinical, translational, and basic researchers. Am. J. Physiol.-Heart Circ. Physiol. 289 H501–H512. 10.1152/ajpheart.00138.2005 - DOI - PubMed
    1. Cecelja M., Chowienczyk P. (2012). Role of arterial stiffness in cardiovascular disease. JRSM Cardiovasc. Dis. 1:cvd.2012.012016. 10.1258/cvd.2012.012016 - DOI - PMC - PubMed
    1. Chen C.-H., Fetics B., Nevo E., Rochitte C. E., Chiou K.-R., Ding P.-A., et al. (2001). Noninvasive single-beat determination of left ventricular end-systolic elastance in humans. J. Am. Coll. Cardiol. 38 2028–2034. 10.1016/S0735-1097(01)01651-5 - DOI - PubMed

LinkOut - more resources

  NODES
twitter 2