Hemodynamics induced after acute reduction of proximal thoracic aorta compliance

被引:64
作者
Ioannou, CV
Stergiopulos, N
Katsamouris, AN
Startchik, I
Kalangos, A
Licker, MJ
Westerhof, N
Morel, DR
机构
[1] Univ Hosp Crete, Div Vasc Surg, Iraklion, Greece
[2] Swiss Fed Inst Technol, Lab Hemodynam & Vasc Technol, CH-1015 Lausanne, Switzerland
[3] Univ Hosp Geneva, Div Anestesiol Invest, Geneva, Switzerland
[4] Univ Hosp Geneva, Dept Cardiovasc Surg, Geneva, Switzerland
[5] Vrije Univ Amsterdam, Inst Cardiovasc Res, Physiol Lab, Amsterdam, Netherlands
关键词
arterial compliance; arterial impedance; hypertension; vascular prosthesis; synthetic grafts; compliance mismatch;
D O I
10.1053/ejvs.2002.1917
中图分类号
R61 [外科手术学];
学科分类号
摘要
Objective: to investigate the affect of reduced aortic compliance on cardiovascular hemodynamics. Materials and Method: fourteen Yucatan miniature swine were divided into two equal groups, a Sham Operated Group and a Banding Group. A Teflon prosthesis was wrapped around the aortic arc in order to limit proximal aortic compliance (Banding Group). Data were recorded operatively (after implantation of a pressure sensor and a flow probe in the ascending aorta), after banding (only in the Banding Group) and at 2 days postoperatively. Results: after banding, compliance decreased by 52 + 13% ((X) over bar +/- SEM) (p < 0.01) while systolic and pulse pressure increased by 37 +/- 8% (p < 0.05) and 87 +/- 31% (p < 0.01), respectively. Diastolic pressure, mean blood pressure, cardiac output and systemic vascular resistance did not change significantly. Aortic characteristic impedance increased nearly 2.5 times. Amplitudes of forward and reflected pressure waves (derived from the aortic pressure wave) increased by 96 +/- 41% and 174 +/- 46%, respectively (p < 0.05), while the time delay between the two decreased by 36 +/- 7% (p < 0.05) Conclusions: about half of the total arterial compliance is located in the proximal thoracic aorta. Arterial reconstruction Of the proximal aorta with a non-compliant graft results in a significant decrease in systemic arterial compliance, which in turn increases systolic and pulse pressure. The development of more compliant prosthesis, which matches the host artery compliance, is expected to reduce the hemodynamic changes induced after their implantation.
引用
收藏
页码:195 / 204
页数:10
相关论文
共 31 条
[1]   DYNAMIC COMPLIANCE OF ARTERIAL GRAFTS [J].
BAIRD, RN ;
KIDSON, IG ;
LITALIEN, GJ ;
ABBOTT, WM .
AMERICAN JOURNAL OF PHYSIOLOGY, 1977, 233 (05) :H568-H572
[2]  
Ballyk PD, 1998, J BIOMECH, V31, P229, DOI 10.1016/S0197-3975(97)00111-5
[3]   Simulation of arterial hemodynamics after partial prosthetic replacement of the aorta [J].
Bauernschmitt, R ;
Schulz, S ;
Schwarzhaupt, A ;
Kiencke, U ;
Vahl, CF ;
Lange, R ;
Hagl, S .
ANNALS OF THORACIC SURGERY, 1999, 67 (03) :676-682
[4]   Arterial elastic properties and cardiovascular risk/event [J].
Cheng, KS ;
Baker, CR ;
Hamilton, G ;
Hoeks, APG ;
Seifalian, AM .
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, 2002, 24 (05) :383-397
[5]   PRESSURE AND FLOW GENERATED BY LEFT VENTRICLE AGAINST DIFFERENT IMPEDANCES [J].
ELZINGA, G ;
WESTERHOF, N .
CIRCULATION RESEARCH, 1973, 32 (02) :178-186
[6]  
Greenwald SE, 2000, J PATHOL, V190, P292, DOI 10.1002/(SICI)1096-9896(200002)190:3<292::AID-PATH528>3.0.CO
[7]  
2-S
[8]  
Guyton AC, 1991, TXB MED PHYSL, P222
[9]   Adverse influence of systemic vascular stiffening on cardiac dysfunction and adaptation to acute coronary occlusion [J].
Kass, DA ;
Saeki, A ;
Tunin, RS ;
Recchia, FA .
CIRCULATION, 1996, 93 (08) :1533-1541
[10]   EFFECT OF REDUCED AORTIC COMPLIANCE ON CARDIAC EFFICIENCY AND CONTRACTILE FUNCTION OF INSITU CANINE LEFT-VENTRICLE [J].
KELLY, RP ;
TUNIN, R ;
KASS, DA .
CIRCULATION RESEARCH, 1992, 71 (03) :490-502