A Bio-Inspired Approach for the Reduction of Left Ventricular Workload

Previous studies have demonstrated the existence of optimization criteria in the design and development of mammalians cardiovascular systems. Similarities in mammalian arterial wave reflection suggest there are certain design criteria for the optimization of arterial wave dynamics. Inspired by these natural optimization criteria, we investigated the feasibility of optimizing the aortic waves by modifying wave reflection sites. A hydraulic model that has physical and dynamical properties similar to a human aorta and left ventricle was used for a series of in-vitro experiments. The results indicate that placing an artificial reflection site (a ring) at a specific location along the aorta may create a constructive wave dynamic that could reduce LV pulsatile workload. This simple bio-inspired approach may have important implications for the future of treatment strategies for diseased aorta.

[1]  S. Louis,et al.  The Washington manual of surgery , 2013 .

[2]  Alun D. Hughes,et al.  Evidence of a Dominant Backward-Propagating “Suction” Wave Responsible for Diastolic Coronary Filling in Humans, Attenuated in Left Ventricular Hypertrophy , 2006, Circulation.

[3]  W. Laskey,et al.  Arterial wave reflection in heart failure. , 1987, Circulation.

[4]  M. Zamir,et al.  The Physics of Pulsatile Flow , 2000, Biological Physics Series.

[5]  Amir Haghighat,et al.  Snapshots of Hemodynamics: An Aid for Clinical Research and Graduate Education , 2005 .

[6]  John K-J. Li,et al.  Dynamics of the vascular system , 2004 .

[7]  D. Mozaffarian,et al.  Executive summary: heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[8]  F. Yin,et al.  Aortic Compliance in Human Hypertension , 1989, Hypertension.

[9]  M. Pfeffer,et al.  Pulsatile Hemodynamics in Congestive Heart Failure , 2001, Hypertension.

[10]  N Westerhof,et al.  Normalized input impedance and arterial decay time over heart period are independent of animal size. , 1991, The American journal of physiology.

[11]  M. Gharib,et al.  Aortic Wave Dynamics and Its Influence on Left Ventricular Workload , 2010, PloS one.

[12]  M. O'Rourke,et al.  Mechanical factors in arterial aging: a clinical perspective. , 2007, Journal of the American College of Cardiology.

[13]  Idit Avrahami,et al.  Resonant pumping in a multilayer impedance pump , 2008 .

[14]  N Westerhof,et al.  Matching between ventricle and arterial load. An evolutionary process. , 1991, Circulation research.

[15]  Idit Avrahami,et al.  Computational studies of resonance wave pumping in compliant tubes , 2008, Journal of Fluid Mechanics.

[16]  D. Mozaffarian,et al.  Heart disease and stroke statistics--2010 update: a report from the American Heart Association. , 2010, Circulation.

[17]  M. Safar,et al.  Arterial stiffness in hypertension , 2006 .

[18]  Anna I Hickerson,et al.  Experimental study of the behavior of a valveless impedance pump , 2005 .

[19]  L. Wurfel.  Mcdonald S Blood Flow In Arteries Theoretical Experimental And Clinical Principles , 2016 .

[20]  W. Milnor,et al.  Pulsatile blood flow. , 1972, The New England journal of medicine.

[21]  M. O'Rourke,et al.  Physiological and pathophysiological implications of ventricular/vascular coupling , 2006, Annals of Biomedical Engineering.

[22]  M Zamir,et al.  Mechanics of blood supply to the heart: wave reflection effects in a right coronary artery , 1998, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[23]  A Noordergraaf,et al.  Similar pressure pulse propagation and reflection characteristics in aortas of mammals. , 1991, The American journal of physiology.

[24]  M. O'Rourke,et al.  TOWARDS OPTIMIZATION OF WAVE REFLECTION: THERAPEUTIC GOAL FOR TOMORROW? , 1996, Clinical and experimental pharmacology & physiology.

[25]  A Noordergraaf,et al.  Constructive and destructive addition of forward and reflected arterial pulse waves. , 2001, American journal of physiology. Heart and circulatory physiology.

[26]  N Westerhof,et al.  Haemodynamic basis for the development of left ventricular failure in systolic hypertension and for its logical therapy. , 1995, Journal of hypertension.

[27]  M. O'Rourke.  Steady and pulsatile energy losses in the systemic circulation under normal conditions and in simulated arterial disease. , 1967, Cardiovascular research.

[28]  N. Westerhof,et al.  Aortic Input Impedance in Normal Man: Relationship to Pressure Wave Forms , 1980, Circulation.

[29]  K. Kario,et al.  Increased aortic wave reflection and longitudinal regional diastolic dysfunction in patients with left ventricular hypertrophy , 2012 .

[30]  W. Milnor,et al.  Aortic wavelength as a determinant of the relation between heart rate and body size in mammals. , 1979, The American journal of physiology.

[31]  H. Okino.  [Pulsatile blood flow]. , 1972, Kokyu to junkan. Respiration & circulation.

[32]  Jamil Mayet,et al.  Wave reflection predicts cardiovascular events in hypertensive individuals independent of blood pressure and other cardiovascular risk factors: an ASCOT (Anglo-Scandinavian Cardiac Outcome Trial) substudy. , 2010, Journal of the American College of Cardiology.

[33]  W. Nichols,et al.  McDonald's Blood Flow in Arteries: Theoretical, Experimental and Clinical Principles , 1998 .