Abstract
Coronary artery diseases are a leading cause of mortality and are increasingly prevalent with age. However, the large number of age-increasing co-morbidities make difficult to understand the impact of cardiovascular ageing alone on the coronary flow pattern. The present study aims to shed light on the effect of arterial and ventricular ageing on the coronary circulation, which is here studied by means of a validated mathematical model. Forward and backward pressure and flow waves are analysed, as well as their intensity. Results highlight a complex spatiotemporal coronary wave pattern, where intense waves originate from the aorta (particularly in systole) and from the deep myocardium, during both the isovolumic compression and the diastolic phase. The subendocardial viability ratio decreases with age, the total coronary flow is slightly reduced, and the left-ventricular work increases. Consequently, the left-ventricular work per unit of blood flow increases, thus limiting the cell oxygen availability abundance, and therefore increasing the risk of myocardial infarction. Our results highlight a physiological age-induced supply/demand unbalance, which can augment the risk of myocardial ischemia and can contribute to pave the way to other typical coronary pathological processes.
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Aguado-Sierra J, Parker KH, Davies JE, Francis D, Hughes AD, Mayer J, Mayet J (2006) Arterial pulse wave velocity in coronary arteries. EMBS Ann Int Conf 1(1):867–870
Algranati D, Kassab GS, Lanir Y (2010) Mechanisms of myocardium–coronary vessel interaction. Am J Physiol Heart Circ Physiol 298(3):861–873
Benetos A, Laurent S, Hoeks A, Boutouyrie P, Safar M (1993) Arterial alterations with aging and high blood pressure. A noninvasive study of carotid and femoral arteries. Arterioscler Thromb Vasc Biol 13(1):90–97
Blanco P, Feijóo R (2013) A dimensionally-heterogeneous closed-loop model for the cardiovascular system and its applications. Med Eng Phys 35(5):652–667
Bortolotto L, Hanon O, Franconi G, Boutouyrie P, Legrain S, Girerd X (1999) The aging process modifies the distensibility of elastic but not muscular arteries. Hypertension 34(4):889–892
Cheitlin MD (2003) Cardiovascular physiology—changes with aging. Am J Geriatr Cardiol 12(1):9–13
Cunningham K, Gotlieb A (2005) The role of shear stress in the pathogenesis of atherosclerosis. Lab Invest 11(2):9–14
Davies JE, Whinnett Z, Francis DP, Manisty CH, Aguado-Sierra J, Willson K, Foale Ra, Malik IS, Hughes AD, Parker KH, Mayet J (2006) Evidence of a dominant backward-propagating “suction” wave responsible for diastolic coronary filling in humans, attenuated in left ventricular hypertrophy. Circulation 113(14):1768–1778
Franklin SS (2002) Do diabetes and hypertension interact to accelerate vascular ageing? J Hypertens 20(9):1693–6
Glagov S, Weisenberg E, Zarins C, Stankunavicius R, Kolettis G (1987) Compensatory enlargement of human atherosclerotic coronary arteries. N Engl J Med 316(22):1371–5
Greenwald S, Carter A, Berry C (1990) Effect of age on the in vitro reflection coefficient of the aortoiliac bifurcation in humans. Circulation 82(1):114–123
Guala A, Camporeale C, Ridolfi L (2015) Compensatory effect between aortic stiffening and remodelling during ageing. Under review: PLoS One
Guala A, Camporeale C, Tosello F, Canuto C, Ridolfi L (2015) Modelling and subject-specific validation of the heart-arterial tree system. Ann Biomed Eng 43(1):222–237
Guyton A, Hall J (2006) Textbook of medical physiology. Saunders, Philadelphia
Hickson S, Butlin M, Graves M, Taviani V, Avolio A, McEniery C, Wilkinson I (2010) The relationship of age with regional aortic stiffness and diameter. J Am Coll Cardiol Imaging 3(12):1247–1255
Hughes A, Parker K, Davies J (2008) Waves in arteries: a review of wave intensity analysis in the systemic and coronary circulations. Artery Res 2(2):51–59
Hummel S (2014) Heart failure with preserved ejection fraction. In: Safar M, O’Rourke M, Frohlich E (eds) Blood pressure and arterial wall mechanics in cardiovascular diseases. Springer, Berlin
Ishida S, Hamasak S, Kamekou M, Yoshitama T, Nakano F, Yoshikawa A, Kataoka T, Saihara K, Minagoe S, Tei C (2003) Advancing age is associated with diminished vascular remodeling and impaired vasodilation in resistance coronary arteries. Coron Artery Dis 6(14):443–9
Kok W, Peters R, Prins M, Piek J, Koch K, David G, Visser C (1995) Contribution of age and intimal lesion morphology to coronary artery wall mechanics in coronary artery disease. Clin Sci (Lond) 3(89):239–46
Korakianitis T, Shi Y (2006) Numerical simulation of cardiovascular dynamics with healthy and diseased heart valves. J Biomech 39(11):1964–1982
Lee HY, Oh BH (2010) Aging and arterial stiffness. Circ J 74(11):2257–2262
Mangoni A, Kinirons M, Swift C, Jackson S (2003) Impact of age on QT interval and QT dispersion in healthy subjects: a regression analysis. Age Ageing 32(3):326–331
McEniery C, Yasmin, Hall I, Qasem A, Wilkinson I, Cockcroft J (2005) Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial. J Am Coll Cardiol 46(9):1753–1760
Mynard JP, Penny DJ, Smolich JJ (2014) Scalability and in vivo validation of a multiscale numerical model of the left coronary circulation. Am J Physiol Heart Circ Physiol 306:517–528
Namasivayam M, McDonnell B, McEniery C, O’Rourke M (2009) Does wave reflection dominate age-related change in aortic blood pressure across the human life span? Hypertension 53(6):979–985
O’Rourke M, Safar M, Dzau V (2010) The cardiovascular continuum extended: aging effects on the aorta and microvasculature. Vasc Med 15(6):461–468
Ozolanta I, Tetere G, Purinya B, Kasyanov V (1998) Changes in the mechanical properties, biochemical contents and wall structure of the human coronary arteries with age and sex. Med Eng Phys 20(7):523–33
Parker K (2009) An introduction to wave intensity analysis. Med Biol Eng Comput 47(2):175–88
Redfield M, Jacobsen S, Borlaug B, Rodeheffer R, Kass D (2005) Age- and gender-related ventricular-vascular stiffening: a community-based study. Circulation 112(15):2254–2262
Reymond P, Bohraus Y, Perren F, Lazeyras F, Stergiopulos N (2011) Validation of a patient-specific one-dimensional model of the systemic arterial tree. Am J Physiol Heart C 301(3):H1173–H1182
Spaan JaE, Kolyva C, van den Wijngaard J, ter Wee R, van Horssen P, Piek J, Siebes M (2008) Coronary structure and perfusion in health and disease. Philos Trans R Soc 366(1878):3137–3153
Sugawara J, Hayashi K, Yokoi T, Tanaka H (2008) Age-associated elongation of the ascending aorta in adults. J Am Coll Cardiol Imaging 1(6):739–748
Tajaddini A, Kilpatrick D, Schoenhagen P, Tuzcu E, Lieber M, Vince D (2005) Impact of age and hyperglycemia on the mechanical behavior of intact human coronary arteries: an ex vivo intravascular ultrasound study. Am J Physiol Heart Circ Physiol 288(1):250–5
van der Horst A, Boogaard F, van’t Veer M, Rutten M, Pijls N, van de Vosse F (2013) Towards patient-specific modeling of coronary hemodynamics in healthy and diseased state. Comput Math Methods Med 2013:1748–6718
Vermeersch S (2010) Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: establishing normal and reference values. Eur Heart J 31(19):2338–2350
Virmani R, Avolio A, Mergner W, Robinowitz M, Herderick E, Cornhill J, Guo S, Liu T, Ou D, O’Rourke M (1991) Effect of aging on aortic morphology in populations with high and low prevalence of hypertension and atherosclerosis. Am J Pathol 139(5):1119–1129
Westerhof N, Stergiopulos N, Noble M (2010) Snapshots of hemodynamics. Springer, Berlin
Westerhof N, Sipkema P, Van Den Bos GC, Elzinga G (1972) Forward and backward waves in the arterial system. Cardiovasc Res 6(6):648–656
Wilens S, Plair C, Henderson D (1966) Size of the major epicardial coronary arteries at necropsy: relation to age, heart weight, and myocardial infarction. JAMA 198(13):1325–1329
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Guala, A., Scalseggi, M. & Ridolfi, L. Coronary fluid mechanics in an ageing cardiovascular system. Meccanica 52, 503–514 (2017). https://doi.org/10.1007/s11012-015-0283-0
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DOI: https://doi.org/10.1007/s11012-015-0283-0