Biomedical Engineering Reference
In-Depth Information
Chapter 15
Hemodynamic Alterations Associated
with Coronary and Cerebral Arterial
Remodeling Following a Surgically-Induced
Aortic Coarctation
C. Alberto Figueroa, Jessica S. Coogan, and Jay D. Humphrey
Abstract
Computational models promise to aid in the interpretation of the cou-
pled interactions between evolving wall geometry, structure, material properties and
hemodynamics seen in arterial adaptations. Motivated by recent aortic coarctation
models in animals, we used a computational fluid-solid-interaction model to study
possible local and systemic effects on the hemodynamics within the thoracic aorta
and coronary, carotid, and cerebral arteries due to a distal aortic coarctation and
subsequent spatial variations in wall adaptation. In particular, we studied an initial
stage of acute cardiac compensation (maintenance of cardiac output) followed by
early arterial wall remodeling (spatially varying wall thickening and stiffening).
15.1 Introduction
Although elevated mean arterial pressure (MAP) has traditionally been considered
to be an important indicator or initiator of cardiovascular risk in hypertension,
mounting evidence suggests that increased pulse pressure is as or more important
(Safar,
2000
; Dart and Kingwell,
2001
; Safar and Boudier,
2005
). Data from surgi-
cally created aortic coarctations in animals reveal striking evolutions of wall geom-
etry, structure, and properties (Xu et al.,
2000
;Huetal.,
2008
; Eberth et al.,
2010
)
that appear to be driven primarily by increased pulse pressure, not MAP (Eberth et
al.,
2009
). It also appears that the associated arterial adaptations progress at different
rates and to different extents both temporally (first at basal rates, then rapidly, then
C.A. Figueroa (
J.D. Humphrey
Department of Biomedical Engineering, Yale University, New Haven, CT 06520, USA
e-mail:
jay.humphrey@yale.edu
