Abstract: INTRODUCTION AND OBJECTIVES: The incidence of cardiovascular events is related to the sleep-wakefulness cycle. In particular, the magnitude and speed of the changes in hemodynamic variables that occur during transitions between wakefulness and sleep and between sleep and wakefulness are regarded as factors that either predict or determine target organ damage and cardiovascular risk. Although increased arterial stiffness (AS) is associated with the development of cardiovascular abnormalities, it is not known whether there exist any changes in AS that are associated with circadian variations in the incidence of cardiovascular events. The aims of this study were to assess AS in healthy subjects over a 24-hour period, to characterize any differences that occur between sleep and wakefulness, and to investigate any changes in AS that occur during the transition from wakefulness to sleep or from sleep to wakefulness. METHODS: Twenty healthy volunteers with a dipper circadian blood pressure pattern underwent 24-hour ambulatory monitoring of blood pressure, heart rate and AS. In practice, AS was determined using the aorta-brachial pulse transit time and fractional pulsatility indices. Myocardial oxygen consumption was quantified using the double product (DP). An average was calculated for all variables for periods of sleep (23:00 to 06:00) and wakefulness (8:00 to 21:00) and for transitions from wakefulness to sleep (20:00 vs. 02:00) and from sleep to wakefulness (06:00 vs. 10:00 hours). RESULTS: In complete contrast to DP, AS was greater during sleep than wakefulness (P< .05). Moreover, the changes in AS that occurred during transitions from wakefulness to sleep and from sleep to wakefulness were the opposite of those observed in DP (P< .05). CONCLUSIONS: Arterial stiffness was greater during sleep than wakefulness, increased during the transition from wakefulness to sleep, and decreased during the transition from sleep to wakefulness.
Abstract: AIMS: The intra-aortic balloon pumping (IABP) changes pressure and increases the aorta shear stress reversal (SS(R)) and oscillatory (SS(O)) components. Hence, IABP-dependent changes in aortic biomechanics would be expected, because of vascular smooth muscle (VSM) tone (i.e. flow-induced endothelium-dependent response, related to SS(R) and SS(O) variations) and/or pressure changes. To characterize: (i) the IABP effects on the aortic and global (systemic circulation) biomechanics, analysing their dependence on pressure and VSM basic tone changes and (ii) the relation between the SS(R) and SS(O) and the aortic biomechanical changes associated with the VSM tone variations. METHODS: Aortic flow, pressure and diameter were measured in eight sheep during basal, augmented and assisted beats (1 : 1 and 1 : 2 IABP modalities). Calculations: (i) aortic effective and isobaric elasticity, viscosity, circumferential stress, pulse wave velocity, shear stress and buffer and conduit functions, (ii) peripheral resistance, global compliance, reflection coefficient and wave propagation times and (iii) the relation between SS(R) and SS(O) and biomechanical changes associated with variations in the aortic VSM tone. RESULTS: Augmented and assisted beats showed: global VSM relaxation pattern (reduced peripheral resistance and reflection coefficient; increased propagation times) and local VSM contraction pattern (increased viscosity; reduced diameter, elasticity and circumferential stress), associated with SS(R) and SS(O), levels and changes. The vascular changes reduced the ventricle afterload determinants, increased the vascular buffer performance and kept the conduit capability. CONCLUSION: In addition to pressure-dependent changes, IABP determined biomechanical changes related to variations in the VSM tone. The increased SS(R) and SS(O) were associated with the aortic VSM contraction pattern and biomechanical changes.
Abstract: Intra-aortic balloon pumping (IABP) could modify the arterial biomechanics; however, its effects on arterial wall properties have not been fully explored. This dynamical study was designed to characterize the pressure-dependent and smooth muscle-dependent effects of IABP on aortic wall energetics in an in vivo animal model. Intra-aortic balloon pumping (1:2) was performed in six anesthetized sheep in which aortic pressure and diameter signals were measured in basal, augmented (during balloon inflation), and assisted (postaugmented) beats. Energy dissipation values in augmented and assisted beats were significantly higher than those observed in basal state (p < 0.05). Assisted beats showed a significant increase of wall damping with respect to basal and augmented beats (p < 0.05). Intra-aortic balloon pumping resulted in a significant increase of pulse wave velocity (p < 0.05) in augmented beats with respect to basal state (6.3 +/- 0.8 vs. 5.2 +/- 0.5 m x s(-1)); whereas values observed in assisted beats were significantly (p < 0.05) lower than those observed in augmented beats (4.9 +/- 0.5 vs. 6.3 +/- 0.8 m x s(-1)). Our findings show that IABP determined the pressure and smooth muscle-dependent changes in arterial wall energetics and damping properties in this animal model.
Abstract: INTRODUCTION AND OBJECTIVES: Ventricular dynamic afterload depends on arterial viscoelastic and geometric properties. Vasoactive factors produced in the adventitia modulate arterial tone. However, it is still not known whether the adventitia is involved in determining the magnitude of the dynamic afterload. The aim of this study was to investigate the role played by the adventitia, via smooth muscle-dependent mechanisms, in determining dynamic afterload. METHODS: The diameter, pressure and flow in brachiocephalic trunks from sheep were measured before and after removal of the adventitia, both in vivo with muscular reactivity preserved (n=8) and in vitro with muscular reactivity abolished (n=8). All studies were performed under similar hemodynamic conditions. Dynamic afterload was determined from elastic and viscous arterial responses, elastic and viscous work, arterial characteristic impedance, and pulse wave velocity. Comparison of in vivo and in vitro findings enabled smooth muscle-dependent changes to be evaluated. RESULTS: Only in vivo, did removal of the adventitia lead to a reduction in vessel diameter (17.32 [2.02] vs 15.46 [1.28] mm) and to increases in elastic (7.21 [1.39] vs 15.59 [3.00] x 10(6) dyn.cm(-2)) and viscous (5.16 [2.04] vs 9.87 [2.00] x 10(5) dyn.s.cm(-2)) arterial responses, elastic (6.15 [1.08] vs 9.20 [0.76] x 10(-2) J/m2) and viscous work (11.61 [2.25] vs 15.20 [2.37] x 10(-3) J/m2), impedance (223.97 [136.11] vs 396.33 [182.27] dyn x s x cm(-3)), and pulse wave velocity (397.70 [31.21] vs 598.78 [28.04] cm.s(-1)) (P<.05). The reduction in diameter and the increases in elastic and viscous responses are evidence of muscular activation. CONCLUSIONS: The adventitia may contribute to the control of ventricular dynamic afterload by means of mechanisms dependent on muscular tone.
Abstract: Each artery conduces blood (conduit function, CF) and smoothes out the pulsatility (buffering function, BF), while keeping its wall protected against the high oscillations of the pulse waves (damping function, ksi). These functions depend on each segment visco-elasticity and capability to store and dissipate energy. When a graft/prosthesis is implanted, the physiological gradual transition in the visco-elasticity and functionality of adjacent arterial segments is disrupted. It remains to be elucidated if the cryografts would allow keeping the physiological biomechanical transition. Aim: to evaluate the cryografts capability to reproduce the functional, energetic and reflection properties of patients' arteries and fresh-homografts. Common carotid's pressure, diameter and wall-thickness were recorded in vivo (15 patients) and in vitro (15 cryografts and 15 fresh-homografts from donors). Calculus: elastic (E(pd)) and viscous (V(pd)) indexes, CF, BF, dissipated (W(D)) and stored (W(PS)) energy and ksi. The graft-patient's artery matching was evaluated using the reflection coefficient (gama) and reflected power (W(gama)). Cryografts did not show differences in E(pd), V(pd), BF, CF, W(D), W(PS), and ksi, respect to fresh-homografts and patients' arteries, ensuring a reduced gama and W(gama). Cryografts could be considered alternatives in arterial reconstructions since they ensure the gradual transition of patients' arteries biomechanical and functional behavior.
Abstract: The causes of the regional differences in venous grafts patency rates are partially understood. Differences in vein dynamics during physiological situations could determine differences in veins' capability to face arterial conditions and could contribute to the dissimilar performance of veins as arterial grafts. In vitro pressure and diameter were measured in four different veins during physiological and arterial (graft) pressure conditions. A diameter-pressure transfer function was designed. Compliance, viscous and inertial properties; circumferential stresses and deformation; and buffering function were calculated. Regional differences in veins' dynamics, but not in buffering function were found during physiological and arterial conditions. The back vein (femoral) showed the least changes when submitted to arterial conditions. Arterial conditions represent different changes in vein dynamics depending on the segment considered. The regional differences in vein dynamics, both at physiological and graft conditions, could contribute to explain the dissimilar results of venous grafts.
Abstract: The aim of this study was to characterize and compare human great saphenous veins (HGSVs), HGSV cryoallografts, expanded polytetrafluoroethylene (ePTFE) segments, and elastic and muscular arteries' biomechanics, so as to identify if the biomechanical coupling and the HGSV advantages with respect to ePTFE depend on the arterial type and/or on the biomechanical property considered. Pressure and diameter were measured in vitro, under arterial hemodynamic conditions, in elastic and muscular arteries, and in vascular substitutes: fresh and cryopreserved HGSV and ePTFE segments. The wall's dynamics (compliance, viscosity, and inertia), energy dissipation, and buffering were calculated. The coupling was quantified for each biomechanical parameter. Cryopreservation preserved HGSV biomechanics. The HGSV cryoallografts' dynamics, energetics, and buffering were lesser with respect to both arteries, but were higher than the ePTFE. The coupling differed, depending on the arterial type and property considered. The biomechanical coupling depended on the artery and property considered. HGSV cryoallograft advantages over ePTFE were arterial type and property independent.
Abstract: While the effects of increases in forward blood flow on the arterial diameter and elasticity are known, the effects of reversal flow on the arterial properties remain to be characterized. The intra-aortic balloon pumping (IABP), the device most frequently used in circulatory support, acts generating changes in aortic flow (i.e. increasing reversal flow). Recently, in vitro studies showed that flow reversion reduces the endothelial release of relaxing factors. Hence, vascular smooth muscle (VSM) dependent changes in the aortic properties would be expected during IABP. The aim was to analyze the changes in flow during IABP and to characterize the potential effects of reversal blood flow on the aortic biomechanics. Pressure, flow and diameter were measured in sheep, before and during IABP circulatory support. Potential effects of IABP-dependent high reversal flow conditions on viscous and elastic aortic modulus were analyzed, using isobaric analysis. Flow and pressure waveforms were analyzed in the time domain, and the contribution of oscillatory forward and backward waves to the IABP-dependent changes in flow patterns were evaluated. We found that IABP changed mainly diastolic blood flow, with an increase in the reversal flow, secondary to an increase in the oscillatory backward wave amplitude. The acute increase in reversal flow during IABP was associated with vasoconstriction and changes in the aortic mechanics, possibly due to VSM activation.
Abstract: Recently, it has been proposed the use of speckle-tracking echography (STE) to study the left ventricle (LV) torsion dynamics, which would make LV torsion assessment more available in clinical and research cardiology. LV torsion has been described during exercise and in some sportsmen, but so far, its dynamics has not been studied in soccer players. The aims were to characterize and to compare LV apical and basal rotation, and to analyze LV torsion in professional soccer players using STE, and to determine the main differences in torsion between soccer players and age-matched non-trained individuals. The STE allowed characterizing LV rotation and torsion in both groups. LV torsion level and velocities were lesser in soccer players than in non-trained individuals. Changes in torsion in soccer players could represent physiological adaptations to training.
Abstract: Right ventricular adaptation to pulmonary hypertension (PH) is an important prognostic factor. Pulmonary artery (PA) smooth muscle activation attenuates arterial dysfunction during acute PH. We investigated the role of the pulmonary artery vascular smooth muscle activation on the right ventricular-vascular coupling during acute PH. PA flow, pressure, and diameter, right ventricular and aortic pressures were recorded in six anesthetized sheep. Acute PH was induced by phenylephrine (APH) and PA mechanical constriction (PPH). We calculated the PA buffering function, the incremental elastic modulus and pulmonary vascular compliance. Pulmonary vascular impedance and right ventricular hydraulic power were calculated through Fourier approach. We also quantified the magnitude and timing of the reflected wave. Right ventricular-vascular coupling was assessed by the energy transmission ratio. Pulmonary buffering function and vascular compliance increased (P<0.05) and arterial wall stiffness decreased (P<0.05) during APH with respect to PPH. Although total input resistance increased and reflected wave came back earlier during PH states (P<0.05), only PPH produced a rightward shift of the pulmonary impedance and a more prominent reflected wave. Accordingly, APH determined a minor increase of total hydraulic power with a smaller pulsatile to total power ratio and energy transmission ratio (P<0.05). In conclusion, isobaric PA vasoconstriction prevents the pulsatile hydraulic load to increase by preserving the PA buffering function and the reflected wave magnitude. Thus, vascular smooth muscle activation of the main PA improves the energy transfer from the right ventricle to the hypertensive pulmonary circulation, and this may play relevant role in the right ventricular adaptation to acute PH.
Abstract: The surgical options in arterial reconstruction are: the use of autologous arteries; autologous veins; or expanded polytetrafluoroethylene (ePTFE) grafts. However, the development of intimal hyperplasia when using veins or ePTFE grafts has been associated with graft failure. Since autologous arteries are not always available, the use of cryopreserved arteries has to be considered. The aims of this study were: (a) to compare the viscoelastic properties of stored cryopreserved arteries and fresh arteries by in vitro analysis; and (b) to compare the viscoelastic properties of arteries measured non-invasively in normotensive patients, with fresh arteries, cryopreserved arteries, and ePTFE segments. The viscoelastic studies were performed in normotensive patients using stress-strain analysis with non-invasive measurement of pressure and diameter in the common carotid artery, and in vitro measurements of pressure and diameter in arteries and prostheses. The in vitro studies showed that the elastic modulus (E), viscous modulus (eta), Stiffness Index (SI), Peterson modulus (Ep), and the pulse wave velocity (PWV) values for human cryopreserved carotid arteries were similar to the values obtained non-invasively in normotensive subjects (P>0.05) and to human fresh vessels (P>0.05). In vitro, the SI, Ep, PWV, and E values of ePTFE were significantly higher than the observed values in subjects and with fresh and cryopreserved arteries (P<0.05); on the other hand the ePTFE eta values were the lowest (P<0.05). We concluded that cryopreserved arteries have similar viscoelastic properties to those obtained in vivo in the arteries of normotensive subjects and in vitro in fresh arteries. Consequently, we conclude that the cryopreservation procedure does not modify the mechanical properties of the arterial wall.
Abstract: The ideal arterial graft must share identical functional properties with the host artery. Surgical reconstruction of the common carotid artery (CA) is performed in several clinical situations, using expanded polytetrafluoroethylene prosthesis (ePTFE) or saphenous vein (SV) grafts. At date there is interest in obtaining an arterial graft that improves the results of that nowadays available. The use of a fresh or cryopreserved/defrosted artery appears as an interesting alternative. However, if the fresh and cryopreserved/defrosted arteries allow an adequate viscoelastic and functional matching with the host arteries needs to be established. The aims were to compare the viscoelastic and functional performance of: (1) conduits used in CA reconstruction (SV and ePTFE) with those of the fresh and cryopreserved/defrosted CA and femoral arteries (FA), and (2) normotensive and hypertensive patients' arteries with those of the arterial substitutes in vitro analyzed. Pressure, diameter and wall thickness of the CA were recorded in 15 normotensive and 15 hypertensive patients (in vivo studies), and in SV, fresh and cryopreserved/defrosted CA and FA (obtained from 15 donors), and ePTFE segments (in vitro studies). From stress-strain relationship we calculated elastic and viscous modulus, and the characteristic impedance. The local buffer and conduit functions were quantified as the viscous/elastic quotient and the inverse of the characteristic impedance. Fresh and cryopreserved/defrosted CA and FA were more alike, both in viscoelastic and functional levels, respect to normotensive and hypertensive patients' arteries, than the ePTFE and SV grafts. CA and FA cryografts could be considered an important alternative for carotid reconstruction.
Abstract: INTRODUCTION: The prosthesis nowadays used in the vascular access for haemodialysis have low patency rates, mainly due to the luminal obstruction, determined by the intimal hyperplasia. Several factors have been related to de development of intimal hyperplasia and graft failure. Among them are the differences in the biomechanical properties between the prosthesis and the native vessels. In the searching for vascular prosthesis that overcomes the limitations of the currently used, the cryopreserved vessels (cryografts) appear as an alternative of growing interest. However, it is unknown if the mechanical differences or mismatch between prosthesis and native vessels are lesser when using cryografts. OBJECTIVE: To characterize and compare the biomechanical behaviour of native vessels used in vascular access and cryografts. Additionally, segments of expanded polytetrafluoroethylene (ePTFE) were also evaluated, so as to evaluate the potential biomechanical advantages of the cryografts respect to synthetic prosthesis used in vascular access. METHODS: Segments from human humeral (n = 12), carotid (n = 12) and femoral (n = 12) arteries, and saphenous vein (n = 12), were obtained from 6 multiorgan donors. The humeral arteries were studied in fresh state. The other segments were divided into two groups, and 6 segments from each vessel were studied in fresh state, while the remaining 6 segments were evaluated after 30 days of criopreservation. For the mechanical evaluation the vascular segments and 6 segments of ePTFE were mounted in a circulation mock and submitted to haemodynamic conditions similar to those of the in vivo. Instantaneous pressure (Konigsberg) and diameter (Sonomicrometry) were measured and used to calculate the viscous and elastic indexes, the compliance, distensibility and characteristic impedance. For each mechanical parameter studied, the mismatch between the prosthesis and the native vessel was evaluated. RESULTS: The ePTFE was the prosthesis with the higher mechanical mismatch (p < 0.05). The venous and arterial cryografts showed the least mismatch with native veins and arteries, respectively. The prosthesis with the least mechanical mismatch was different, depending on the native vessel evaluated, and for a native vessel, on the parameter considered. CONCLUSION: The mechanical mismatch between the native vessel and the vascular prosthesis used in a vascular access could be reduced using cryografts.
Abstract: Damping is the conversion of mechanical energy of a structure into thermal energy, and it is related to the material viscous behavior. To evaluate the role of damping in the common carotid artery (CCA) wall in human hypertension and the possible improvement of angiotensin-converting enzyme (ACE) inhibition, we used noninvasive CCA pressure (tonometry) and diameter (B-mode echography) waveforms in normotensive subjects (NT group; n=12) and in hypertensive patients (HT group; n=22) single-blind randomized into HT-placebo (n=10) or HT-treated (ramipril, 5 to 10 mg/d during 3 months; n=12). Vascular smooth muscle (VSM) null tonus condition was achieved from in vitro pressure and diameter waveforms (Konigsberg microtransducer and sonomicrometry) measured in explanted human CCA (n=14). Arterial wall dynamics was described by viscous (eta), inertial (M), and compliance (C) parameters, mean circumferential wall stress, viscous energy dissipation (WD), peak strain energy (WSt), damping ratio (xi=WD/WSt), and modeling isobaric indexes CIso and WSt(Iso). The lack of VSM tonus isobarically increased wall stress and reduced eta, CIso, and damping (P<0.01). Wall stress, eta, and WD were greater in HT than in NT (P<0.015) and arrived near normal in HT-treated (P<0.032 respect to HT), with no changes in HT-placebo. Whereas CIso increased in HT-treated (P<0.01) approaching the NT level, xi did not vary among groups. During hypertension, because of the WSt increase, the arterial wall reacts increasing WD to maintain xi. ACE inhibition modulates VSM activation and vessel wall remodeling, significantly improving wall energetics and wall stress. This protective vascular action reduces extra load to the heart and maintains enhanced arterial wall damping.
Abstract: The viscoelastic and inertial properties of the arterial wall are responsible for the arterial functional role in the cardiovascular system. Cryopreservation is widely used to preserve blood vessels for vascular reconstruction but it is controversially suspected to affect the dynamic behaviour of these allografts. The aim of this work was to assess the cryopreservation's effects on human arteries mechanical properties. Common carotid artery (CCA) segments harvested from donors were divided into two groups: Fresh (n = 18), tested for 24-48 h after harvesting, and Cryopreserved (n = 18) for an average time of 30 days in gas-nitrogen phase, and finally defrosted. Each segment was tested in a circulation mock, and its pressure and diameter were registered at similar pump frequency, pulse and mean pressure levels, including those of normotensive and hypertensive conditions. A compliance transfer function (diameter/pressure) derived from a mathematical adaptive modelling was designed for the on line assessment of the arterial wall dynamics and its frequency response. Assessment of arterial wall dynamics was made by measuring its viscous (eta), inertial (M) and elastic (E) properties, and creep and stress relaxation time constant (tauC and tauSR, respectively). The frequency response characterization allowed to evaluate the arterial wall filter or buffer function. Results showed that non-significant differences exist between wall dynamics and buffer function of fresh and cryopreserved segments of human CCA. In conclusion, our cryopreservation method maintains arterial wall functional properties, close to their fresh values.
Abstract: Factors that explain the different results among veins, and causes of the superior performance of vein grafts for small arterial reconstructions, remain unclear. The aim was to compare the biomechanical behavior of veins and arteries from different regions and sizes under arterial conditions. In vitro pressure and diameter were measured in four different veins and three different ovine arteries. A diameter-pressure transfer function was designed, and compliance, viscous, and inertial indexes, and viscous energy and buffering function were calculated. Regional differences in vein mechanical behavior and energy dissipation were found. Veins and arteries vary in mechanical properties and buffering, but the differences were lesser when considering the smallest artery. The differences among veins' viscosity, compliance, and energy dissipation, but not in the buffering capability, could be related to different performances of veins when used as arterial grafts. The major biomechanical matching could contribute to explain veins with better results in small arteries reconstruction.
Abstract: AIM: An adventitia dependent regulation of the vascular smooth muscle tone has been described. However, if the adventitia plays an active role on arterial wall biomechanical behaviour and functions remains to be established. Our aim was to characterize the influence of adventitia on arterial wall mechanical properties and the arterial conduit and buffer functions. METHODS: Ovine brachiocephalic arteries were studied in vivo (n = 8) and in vitro (with null tone) in a circulation mock (n = 8). Isobaric, isoflow and isofrequency studies were performed. In each segment, pressure and diameter waves were assessed before and after adventitia removal. From the arterial stress-strain relationship, we derived the elastic and the viscous modulus. The buffering and conduit functions were calculated using the Kelvin-Voigt's time constant and the inverse of the characteristic impedance, respectively. RESULTS: In in vivo studies arterial diameter decreased after adventitia removal (P < 0.05). Elastic and viscous modulus in in vivo studies were significantly higher in adventitia-removed arteries, compared with values in intact vessels (P < 0.05). This behaviour was not observed in in vitro experiments. An impairment of buffer and conduit functions was observed in vivo after adventitia removal (P < 0.05), while both functions remain unchanged in in vitro studies (P > 0.05). CONCLUSIONS: Arterial wall viscosity and elasticity were influenced by adventitia removal in in vivo studies, possibly by a smooth muscle-dependent mechanism, since it was not present in in vitro experiments. Adventitia would be involved in a physiological mechanism of arterial wall viscous and elastic properties regulation, that could influence arterial buffering and conduit functions.
Abstract: INTRODUCTION AND OBJECTIVES: It is not yet known whether cryopreservation enables vessels to retain their viscoelastic properties or whether cryopreserved homografts are biomechanically more like native arteries than currently used vascular prostheses. The study objectives were: a) to determine whether our cryopreservation methodology enables arterial and venous homografts to retain their viscoelastic and functional properties; and b) to assess similarities between patients' femoral arteries, homografts, and other vascular prostheses in common use. METHODS: The pressure and the diameter and parietal thickness of 15 muscular (femoral) arteries were measured in patients using tonometry and echography, both noninvasive techniques. In addition, the pressure in and diameter and parietal thickness of 15 fresh and 15 cryopreserved human muscular (femoral) artery segments, saphenous veins, and 15 expanded polytetrafluoroethylene (ePTFE) vascular prostheses were measured in vitro under hemodynamic conditions similar to those in patients. A Kelvin-Voigt model of the segment wall was used to derive elastic (Epd, mm Hg/mm) and viscous (Vpd, mm Hg x s/mm) pressure-diameter indices, the buffering function (Vpd/Epd), and the conduit function (1/Zc, where Zc is the characteristic impedance). The incremental Young modulus, the pressure-strain elastic modulus, and pulse wave velocity were also calculated. RESULTS: No difference was observed between either the viscoelastic or functional properties of fresh and cryopreserved homografts. Arterial homografts were the most similar to the patient's arteries. CONCLUSIONS: Cryopreservation enabled venous and arterial homografts to retain their viscoelastic and functional properties. Of all the grafts investigated, arterial homografts were most similar, both biomechanically and functionally, to the patient's femoral arteries.
Abstract: The aim was to evaluate our cryopreservation method effects on the mechanical properties and filtering function of human superficial femoral arteries (SFA). SFA segments from 10 multiorgan donors were divided into two groups: fresh, tested 24-48 h after harvesting, and cryopreserved/defrosted, tested after 1 month of cryopreservation. The cooling process was carried out in three steps: 2 degrees C/min until -40 degrees C; 5 degrees C/min until -90 degrees C and finally a rapid cooling by transferring the bag to vapour phase of liquid nitrogen (-142 degrees C). Thawing was made in two steps, a slow warming time by exposing the bag to 20 degrees C during 20 min, followed by a rapid warming by immersion in a 40 degrees C warm bath until defrost. In a circulation mock, arterial pressure [Pressure signal (P)] and diameter [Diameter (D)] were registered at similar stretch-frequency, P and flow levels. A compliance transfer function (D/P) was used for the on-line assessment of the arterial wall elastic (E), viscous (eta), and inertial (M) properties. To evaluate the arterial wall filter function, the arterial wall D/P frequency response was characterized, the cut-off frequency (fc) was quantified, and the viscous energy dissipation (Weta) was calculated. After cryopreservation, there were not significant changes in E, eta, M, Weta, and fc.
Abstract: INTRODUCTION AND OBJECTIVES: Regional variations in the incidence of vascular diseases have been related to regional differences in arterial viscoelasticity. The aim of this study was to characterize the differences in the elastic and viscous modulus and in wall buffering function between central and peripheral systemic arteries, through a time-series analysis of the pressure-diameter relationship. MATERIAL AND METHOD: Pressure and diameter were measured in seven arterial segments (carotid, brachiocephalic trunk, ascending aorta, proximal, middle and distal descending thoracic aorta, and femoral artery) from six sheep. Each segment was mounted on an in vitro mock circulatory system and perfused with Tyrode solution, with a pulse frequency of 1.8 Hz and systemic pressure levels. We used the Kelvin-Voigt model to calculate the pressure-diameter elastic (Epd, mmHg/mm) and viscous (Vpd, mmHg.s/mm) modulus, and to quantify the local wall buffering function (Vpd/Epd). We also calculated the incremental Young's and pressure-strain elastic modulus and pulse wave velocity for each segment. RESULTS: The elastic and viscous modulus increased from proximal to distal segments. The wall buffering function did not differ significantly between arteries. The lower rigidity of the central arteries compared to the distal ones may indicate that the systolic arterial compliance function is concentrated in the central arterial segments. On the other hand, the greater viscosity in the distal segments may indicate that viscous energy loss is concentrated in these segments. CONCLUSIONS: Arterial elasticity and viscosity can be interpreted as properties that are dependent on the region of the vessel, whereas wall buffering function can be considered region-independent.
Abstract: Acute pulmonary hypertension (PH) may arise with or without an increase in vascular smooth muscle (VSM) tone. Our objective was to determine how VSM activation affects both the conduit (CF) and wall buffering (BF) functions of the pulmonary artery (PA) during acute PH states. PA instantaneous flow, pressure, and diameter of six sheep were recorded during normal pressure (CTL) and different states of acute PH: 1) passively induced by PA mechanical occlusion (PPH); 2) actively induced by intravenous administration of phenylephrine (APH); and 3) a combination of both (APPH). To evaluate the direct effect of VSM activation, isobaric (PPH vs. APH) and isometric (CTL vs. APPH) analyses were performed. We calculated the local BF from the elastic (EPD) and viscous (etaPD) indexes as etaPD/EPD and the characteristic impedance (ZC) from pressure and flow to evaluate CF as 1/ZC. We also calculated the absolute and normalized cross-sectional pulsatility (PCS and NPCS, respectively), the dynamic compliance (CDYN), the cross-sectional distensibility (DCS), and the pressure-strain elastic modulus (EP). The isobaric analysis showed increase of CF, BF, and etaPD (P < 0.01) and decrease of EPD (P < 0.05) during APH in respect to PPH (concomitant with isobaric VSM activation-induced vasoconstriction, P < 0.01). The isometric analysis showed increase of E(PD) and etaPD (P < 0.01), nonsignificant difference in BF (even in the presence of a significant mean PA pressure rise, from 14 (SD 6) to 25 (SD 8) mmHg, P < 0.01), and decrease in CF (P < 0.01) during APPH respect to CTL. Mechanical occlusions (PPH and APPH) reduced BF (P < 0.01) and increased EPD (P < 0.05) with regard to their previous steady states (CTL and APH). Nonsignificant differences were found in EPD between PPH and APPH. VSM activation (APH and APPH) increased etaPD (P < 0.01) respect to their previous passive states (CTL and PPH), but no significant differences were found within similar levels of VSM activation. In conclusion, VSM plays a relevant role in main pulmonary artery function during acute pulmonary hypertension, because isobaric vasoconstriction induced by VSM activation improves both BF and CF, mainly due to the increase in etaPD concomitant with the arterial compliance. CDYN and DCS were the more pertinent clinical indexes of arterial elasticity. Additionally, the etaPD-mediated preservation of the BF could be evaluated by the geometric related indexes (PCS and NPCS), which appear to be qualitative markers of arterial wall viscosity status.
Abstract: BACKGROUND: Wall shear stress, arterial wall elasticity, and intimal hyperplasia are related. The aim of this study was to investigate the in vitro mechanical properties of ovine femoral arteries, jugular veins, and expanded polytetrafluoroethylene conduits, and to evaluate postoperative intimal hyperplasia. METHODS: Arterial, venous, and ePTFE mechanical properties were studied in a circulating loop at isobaric systemic pressures. Histological studies of intimal hyperplasia in ePTFE-bypassed femoral arteries with and without Miller cuffs were performed at the 40th and 120th day. RESULTS: The incremental elastic modulus of veins was significantly higher than that of femoral arteries (P < 0.05), but significantly lower than that of ePTFE graft conduits (P < 0.05). Intimal hyperplasia was significantly less in Miller-cuff-bypassed arteries both at the 40th and 120th day (P < 0.01). CONCLUSIONS: The Miller cuff acts as a mechanical adapter enhancing wall shear stress and the elastic matching between ePTFE and the native artery, resulting in an early decrease of intimal hyperplasia.
Abstract: AIM: We determined the wall mechanical response of the pulmonary artery (PA) to acute pulmonary hypertension induced pharmacologically and by an occlusion maneuver, to study the vascular response of the local segment and its influence in the whole pulmonary circulation. METHODS: Pulmonary pressure and diameter were measured in six anaesthetized sheep under steady-state conditions. Transient hypertension in the PA was induced by phenylephrine (PHE) and a high pressure (HP) mechanical occlusion aimed at producing the same pulse and mean pressure responses. A viscoelastic arterial wall model was applied and the elastic (E(pd)) and viscous (micro) indexes were obtained. The micro/E(pd) ratio was adopted to quantify the damping performance of the arterial wall segment. The diastolic time constant was used as an indicator of the whole pulmonary buffering function. The systemic pressure was always measured. RESULTS: The pulmonary mean, systolic and pulse pressure increases (P < 0.05) were similar during PHE and HP, with respect to control. PHE also induced a systemic pressure rise (P < 0.05). The E(pd) elastic index increased during HP (P < 0.05) and tended to increase during PHE with respect to control. The viscous index micro only increased with PHE (P < 0.05) with respect to control and occlusion. The diastolic time constant increased with PHE with respect to control (P < 0.05). CONCLUSIONS: A pressure rise in the PA, induced by an occlusion maneuver, increased local stiffness. Similar pressure rises with smooth muscle activation (PHE), produced both a stiffness and viscous index increase. In PHE resistance increases more than compliance decreases so that the global net effect is a longer decay time. Smooth-muscle activation enhances the local damping effect (micro/E(pd)), concomitant with the buffering function improvement.
Abstract: The viscoelastic properties of the arterial wall are responsible for their functional role in the arterial system. Cryopreservation is widely used to preserve blood vessels for vascular reconstruction but is controversially suspected to affect the dynamic behaviour of these allografts. The aim of this study was to determine whether differences in the dynamic behaviour exist or not between fresh and cryopreserved human common carotid arteries (CCA). Using a previously developed mock circulation system, dynamic pressure-diameter tests were performed on segments of human fresh (n=10) and cryopreserved arteries (n=7). A diameter-pressure transfer function was designed to evaluate the wall dynamics. An adaptive model was fit to obtain its frequency response. Three models were tested. Results show that non-significant differences exist between wall dynamics of fresh and cryopreserved segments of human CCA.
Abstract: AIM: To characterize the buffering function of the pulmonary artery in vivo and to determine the role of vascular smooth muscle (VSM) activation in vessel wall elasticity. MATERIAL AND METHOD: Pulmonary artery pressure and diameter were measured in 9 anesthetized sheep. Pulmonary artery hypertension was induced by mechanical occlusion of the pulmonary artery and by phenylephrine infusion (5 microg/kg/min) (PHE). Once the pressure-diameter loop was obtained, hysteresis was reduced to a minimum by increasing the modulus of viscosity. Elasticity was calculated as the first derivative of mean diastolic pressure assuming a purely elastic relation. Pulse wave velocity (PWV) and time constant (tau) were also obtained. RESULTS: Systolic, diastolic, mean and pulse pressures were similar during pulmonary artery hypertension and PHE infusion, but significantly higher in comparison to baseline conditions. Elasticity and diameter of the pulmonary artery increased significantly. In contrast, during VSM activation elasticity remained unchanged and diastolic diameter was reduced. PWV increased during both pulmonary artery hypertension and PHE infusion (p < 0.05); however, the increase during PHE infusion was smaller (15%) than during induced hypertension (33%). tau was significantly reduced during hypertension, but did not change during VSM activation. CONCLUSIONS: VSM activation may offset the deleterious effect of pulmonary artery hypertension on arterial wall stiffness by reducing elasticity and PWV. The VSM may modulate the Windkessel function in the pulmonary artery, preserving elasticity indexes during pulmonary artery hypertension.
Abstract: INTRODUCTION AND OBJECTIVES: To characterize the viscoelastic properties of the aorta and pulmonary arteries and the effects of vascular smooth muscle activation on arterial buffering function. MATERIAL AND METHOD: Aortic and pulmonary artery pressure and diameter were measured in six anesthetized sheep under baseline conditions, and during arterial hypertension induced by mechanical vascular occlusion (passive), and i.v. phenylephrine (active). Arterial wall elasticity and viscosity were calculated, and buffering function was characterized: a) locally as the viscosity/elasticity ratio, and b) globally for each circuit, as the time-constant of ventricular relaxation. RESULTS: Viscoelasticity was higher in the aorta than in the pulmonary artery (p < 0.05), however, parietal buffering function was similar in both. Global buffering function was highest in the systemic circuit (p < 0.05). During passive hypertension, elasticity was significantly increased with no change in viscosity; this led to a significant reduction in local buffering function, and in global buffering function in each circuit. During active hypertension, viscosity increased (p < 0.05), while local and global buffering functions returned to baseline values. CONCLUSIONS: The viscosity/elasticity ratio was higher in the aorta than in the pulmonary artery, and arterial wall buffering function was similar in both vessels. Systemic global buffering function was higher than pulmonary circuit buffering function. Elasticity depends on intravascular pressure, whereas viscosity is a marker of the degree of smooth muscle activation. Smooth muscle activation may benefit the cardiovascular system by maintaining local and global buffering functions.
Abstract: The goal of this study was to determine the in vivo pulmonary arterial buffering function (BF) during acute and moderate pulmonary hypertension achieved by phenylephrine-induced smooth muscle activation. Pulmonary pressure (Konigsberg P7) and diameter (sonomicrometry) were measured in nine anesthetized sheep. Transit pulmonary arterial hypertension was induced by mechanical occlusion of the pulmonary artery (HP) and by phenylephrine infusion (5 microg/kg/min) (PHE). A viscoelastic Kelvin-Voigt model was used. By increasing the values of the viscous modulus, the pressure-diameter hysteresis area was reduced to a minimum in order to obtain the purely elastic pressure-diameter relationship. The elastic index (E) was calculated as the first derivative of the exponential model of the purely elastic pressure-diameter relationship at the mean pressure point. Systolic, diastolic, mean and pulse pressures were similar during HP and PHE, but significantly higher with regard to control steady state. In HP, E and arterial diameter (both its minimum and maximum values) increased significantly. In contrast, when pulmonary hypertension was induced by VSM activation, E was maintained concomitantly with pulmonary artery vasoconstriction. Pulmonary hypertension produced by occlusion of the pulmonary artery increases elasticity. Smooth muscle activation may offset the deleterious effect of pulmonary hypertension on arterial wall elasticity by reducing E and impeding arterial dilatation and collagen recruitment, maintaining BF during pulmonary hypertension.