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