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Low pulse pressure with high pulsatile external left ventricular power: Influence of aortic waves

Pahlevan, Niema M. and Gharib, Morteza (2011) Low pulse pressure with high pulsatile external left ventricular power: Influence of aortic waves. Journal of Biomechanics, 44 (11). pp. 2083-2089. ISSN 0021-9290 . https://resolver.caltech.edu/CaltechAUTHORS:20110826-145408884

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Abstract

Elevated pulse pressure (pp) is considered to be a risk factor for adverse cardiovascular events since it is directly related to an elevated myocardial workload. Information about both pressure and flow wave must be provided to assess hemodynamic complexity and true level of external left ventricular power (ELVP). pp value as a single feature of aortic waves cannot identify true level of ELVP. However, it is generally presumed that ELVP (and consequently LV workload) is positively correlated with pp. This study examined this positive correlation. The aim of this study was to test the hypothesis that aortic wave dynamics can create destructive hemodynamic conditions that increase the ELVP even though pp appears to be normal. To test this hypothesis, a computational model of the aorta with physiological properties was used. A Finite Element Method with fluid–structure interaction was employed to solve the equations of the solid and fluid. The aortic wall was assumed to be elastic and isotropic. The blood was assumed to be an incompressible Newtonian fluid. Simulations were performed for various heart rates (HR) and different aortic compliances while keeping the shape of the inlet flow and peripheral resistance constant. As expected, in most of the cases studied here, higher pp was associated with higher LV power demand. However, for a given cardiac output, mean pressure, and location of total reflection site, we have found cases where the above-mentioned trend does not hold. Our results suggest that using pp as a single index can result in an underestimation of the LV power demand under certain conditions related to the altered wave dynamics. Hence, in hypertensive patients, a full analysis of aortic wave dynamics is essential for the prevention and management of left ventricular hypertrophy (LVH) and congestive heart failure.


Item Type:Article
Related URLs:
URLURL TypeDescription
http://dx.doi.org/10.1016/j.jbiomech.2011.05.016DOIUNSPECIFIED
http://www.sciencedirect.com/science/article/pii/S0021929011004106PublisherUNSPECIFIED
Additional Information:© 2011 Elsevier Ltd. Accepted 11 May 2011. Available online 15 June 2011.
Group:GALCIT
Subject Keywords:Pulse pressure; Aorta; Wave dynamics; Pulsatile load; Wave intensity
Issue or Number:11
Record Number:CaltechAUTHORS:20110826-145408884
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20110826-145408884
Official Citation:Niema M. Pahlevan, Morteza Gharib, Low pulse pressure with high pulsatile external left ventricular power: Influence of aortic waves, Journal of Biomechanics, Volume 44, Issue 11, 28 July 2011, Pages 2083-2089, ISSN 0021-9290, DOI: 10.1016/j.jbiomech.2011.05.016. (http://www.sciencedirect.com/science/article/pii/S0021929011004106)
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:25133
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:07 Sep 2011 17:53
Last Modified:03 Oct 2019 03:03

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