P5.5 COMPENSATORY EFFECT BETWEEN AORTIC STIFFENING AND REMODELLING DURING AGEING

DOI

10.1016/j.artres.2015.10.270How to use a DOI?

Abstract

The arterial tree exhibits a complex spatio-temporal wave pattern, whose healthy behaviour depends on a balance between mechanical and geometrical properties. Several clinical studies demonstrated that this balance progressively breaks down during ageing, when the aorta stiffens and remodels. This dual mechanism is investigated by a validated multi-scale model aiming to elucidate how aortic stiffening and remodelling quantitatively impact the waves pattern in the aorta.

The detrimental increase of maximum pressure and left-ventricular work during ageing is here shown to results from the impairment of fluid dynamic balance between generation-propagation of forward waves and reflections- damping of backward waves. Our quantitative outcomes confirm several clinical studies results. Our results shed light on how ageing-induced aortic stiffening and remodelling affect this balance: the former enhances first pressure pulse at ventricular-aortic interface during ejection, while the latter damps it; although stiffening tends to decrease reflection coefficients at bifurcations, their remodelling-induced growth prevails; aortic remodelling undermines the protective wave-trapping mechanism while stiffening enhances it; aortic stiffening reduces pulse pressure amplification while remodelling augments it; by contrast, both stiffening and remodelling contribute to limit the growth of left-ventricle work with age.

These results suggest that an excessive imbalance between aortic stiffness and geometric remodelling during clinical treatment of elderly subjects should be avoided. Our results show how a dramatic reduction of the pulse wave velocity in a dilated aorta can lead to an increase of pulse pressure amplification, with potential detrimental effects on organs such as the kidneys.

Open Access

This is an open access article distributed under the CC BY-NC license.

Download article (PDF)
View full text (HTML)

TY  - JOUR
AU  - Andrea Guala*
AU  - Carlo Camporeale
AU  - Luca Ridolfi
PY  - 2015
DA  - 2015/11/23
TI  - P5.5 COMPENSATORY EFFECT BETWEEN AORTIC STIFFENING AND REMODELLING DURING AGEING
JO  - Artery Research
SP  - 21
EP  - 21
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.270
DO  - 10.1016/j.artres.2015.10.270
ID  - Guala*2015
ER  -