Annals of Biomedical Engineering

, Volume 31, Issue 6, pp 678–685 | Cite as

Correlation Between Negative Near-Wall Shear Stress in Human Aorta and Various Stages of Congestive Heart Failure

  • Morteza Gharib
  • Masoud Beizaie
Article

Abstract

The critical effect of advanced congestive heart failure is reduced blood flow in descending aorta resulting from mild to severe reduction in cardiac output, usually accompanying low ejection fraction. In these patients the heart tries to compensate by beating faster, but reduced blood flow combined with increased heart rate can lead to retrograde flow and negative shear stress along the vessel walls during each cardiac cycle. Our studies show that near-wall negative shear stress can result from an entire-retrograde flow at normal heart rates or a Womersley-type phase delayed near-wall retrograde flow at high heart rate and low ejection fraction conditions. In our experiments, a compliant aortic loop with appropriate pressure and flow instrumentation was used, running on either various aqueous glycerin solutions or property filtered, anticoagulated diluted bovine blood. The flow field was mapped using a General Electric Vingmed System 5 platform. The resulting images were analyzed with Caltech's digital ultrasound speckle image velocimetry technique. We showed the occurrence of near-wall retrograde flow under certain aortic flow rates and frequencies, charted via an empirical relationship between Reynolds and Womersley numbers. Also, we demonstrated a strong correlation between retrograde flow level and transition from preliminary to advanced congestive heart failure patients. © 2003 Biomedical Engineering Society.

PAC2003: 8719Hh, 8719Rr, 8719Uv, 4380Qf, 8763Df

Heart failure Retrograde Endothelium 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Agostoni, P. G.et al.Systemic to pulmonary bronchial blood flow in heart failure. Chest107:1247–1252, 1995.Google Scholar
  2. 2.
    Azevedo, E. R.et al.Reducing cardiac filling pressure lowers norepinephrine spillover in patients with chronic heart failure. Circulation101:2053–2059, 2000.Google Scholar
  3. 3.
    Bao, X. P., C. Y. Lu, and J. A. Frangos. Temporal gradient in shear but not steady shear stress induces PDGF-A and MCP-1 expression in endothelial cells—Role of NO, NF kappa B, and egr-1. Arterioscler., Thromb., Vasc. Biol.19:996–1003, 1999.Google Scholar
  4. 4.
    Berne, R. M., and M. N. Levy. Cardiovascular Physiology. St. Louis: Mosby, 1997.Google Scholar
  5. 5.
    Bharadvaj, B. K., R. F. Mabon, and D. P. Giddens. Steady flow in a model of the human carotid bifurcation, flow visualization. J. Biomech.15:349–362, 1982.Google Scholar
  6. 6.
    Blackman, R. B., L. E. Thibault, and K. A. Barbee. Selective modulation of endothelial cell [Ca2+]: Response to flow by the onset rate of shear stress. Trans. ASME122:274–282, 2000.Google Scholar
  7. 7.
    Bogren, H. G., and M. H. Buonocore. 4D magnetic resonance velocity mapping of blood flow patterns in young vs. elderly normal subjects. J. Magn. Reson. Imaging10:861–869, 1999.Google Scholar
  8. 8.
    Bonnefous, O., F. Luizy, and S. Kownator. Arterial wall motion imaging—A new ultrasound approach to vascular characterization. Med. Mundi44: 37–432000.Google Scholar
  9. 9.
    Caro, C. G., J. M. Fitz-Gerald, and R. C. Schroter. Atheroma and arterial wall shear—Observation, correlation and proposal of a shear dependent mass transfer mechanism for atherogenesis. Proc. R. Soc. London, Ser. B177:109–159, 1971.Google Scholar
  10. 10.
    Colucci, W. S. Atlas of Heart Failure—Cardiac Function and Dysfunction. Philadelphia: Blackwell Science, 1999.Google Scholar
  11. 11.
    Egelhoff, C. J.et al.Model studies of the flow in abdominal aortic aneurysms during resting and exercise conditions. J. Biomech.32:1319–1329, 1999.Google Scholar
  12. 12.
    Galbraith, C. G., R. Skalak, and S. Chien. Shear stress induces spatial reorganization of the endothelial cell cytoskeleton. Cell Motil. Cytoskeleton40:317–330, 1998.Google Scholar
  13. 13.
    Gnasso, A.et al. In vivo association between low wall shear stress and plaque in subjects with asymmetrical carotid atherosclerosis. Stroke28:993–998, 1997.Google Scholar
  14. 14.
    Gudi, S., J. P. Nolan, and J. A. Frangos. Modulation of GTPase activity of G proteins by fluid shear stress and phospholipid composition. Proc. Natl. Acad. Sci. U.S.A.95:2515–2519, 1998.Google Scholar
  15. 15.
    Guler, N.et al.Brachial artery blood flow velocity pattern in patients with congestive heart failure: Duplex Doppler ultrasonographic assessment. Angiology51:207–212, 2000.Google Scholar
  16. 16.
    Hallstrom, A.et al.Relations between heart failure, ejection fraction, arrhythmia suppression, and mortality: Analysis of the cardiac arrhythmia suppression trial. J. Am. Coll. Cardiol.25:1250–1257, 1995.Google Scholar
  17. 17.
    Hollenberg, S. M.et al.Simultaneous intracoronary ultrasound and Doppler flow studies distinguish flow-mediated from receptor-mediated endothelial responses. Cathet. Cardiovasc. Intervent.46:282–288, 1999.Google Scholar
  18. 18.
    Jensen, J. A. Estimation of Blood Velocities using Ultrasound—A Signal Processing Approach. Cambridge, U.K.: Cambridge University Press, 1996.Google Scholar
  19. 19.
    Juilliere, Y.et al.Beneficial cumulative role of both nitroglycerin and dobutamine on right ventricular systolic function in congestive heart failure patients awaiting heart transplantation. Int. J. Cardiol.52:17–22, 1995.Google Scholar
  20. 20.
    Kuchan, M. J., and J. A. Frangos. Role of calcium and calmodulin in flow-induced nitric oxide production in endothelial cells. Am. J. Physiol.266:C628–C636, 1994.Google Scholar
  21. 21.
    Linde, C.et al.Results of atrioventricular synchronous pacing with optimal delay in patients with severe congestive heart failure. Am. J. Cardiol.75:919–923, 1995.Google Scholar
  22. 22.
    Malek, A. M., S. L. Alper, and S. Izumo. Hemodynamic shear stress and its role in atherosclerosis. JAMA, J. Am. Med. Assoc.282:2035–2042, 1999.Google Scholar
  23. 23.
    Mills, C. J.et al.Pressure–flow relationships and vascular impedance in man. Cardiovasc. Res.4:405–417, 1970.Google Scholar
  24. 24.
    Milnor, R. M. Hemodynamics. Baltimore: Williams and Wilkins, 1989.Google Scholar
  25. 25.
    Moore, J. E.et al.Fluid wall shear stress measurements in a model of the human abdominal aorta—Oscillatory behavior and relationship to atherosclerosis. Atherosclerosis110:225–240, 1994.Google Scholar
  26. 26.
    Nichols, W. W., and M. F. O'Rourke. McDonald's Blood Flow in Arteries—Theoretical, Experimental, and Clinical Principles. London: Arnold, 1998.Google Scholar
  27. 27.
    Odenstedt, H.et al.Descending aortic blood flow and cardiac output—A clinical and experimental study of continuous oesophageal echo-Doppler flowmetry. Acta Anaesthesiol. Scand.45:180–187, 2001.Google Scholar
  28. 28.
    Orliaguet, G. A.et al.Noninvasive aortic blood flow measurement in infants during repair of craniosynostosis. Br. J. Anaesth.81:696–701, 1998.Google Scholar
  29. 29.
    Oyre, S.et al. In vivo wall shear stress measured by magnetic resonance velocity mapping in the normal human abdominal aorta. Eur. J. Endovasc. Surg.13: 263–271, 1997.Google Scholar
  30. 30.
    Pedersen, E. M.et al.Two-dimensional velocity measurements in a pulsatile flow model of the normal abdominal aorta simulating different hemodynamic conditions. J. Biomech.26:1237–1247, 1993.Google Scholar
  31. 31.
    Pedersen, E. M.et al.Quantitative abdominal aortic flow measurements at controlled levels of ergometer exercise. Magn. Reson. Imaging17:489–494, 1999.Google Scholar
  32. 32.
    Pullicino, P. M., J. L. Halperin, and J. L. Thompson. Stroke in patients with heart failure and reduced left ventricular ejection fraction. Neurology54:288–294, 2000.Google Scholar
  33. 33.
    Spinar, J.et al.Noninvasive prognostic factors in chronic heart failure. One-year survival of 300 patients with a diagnosis of chronic heart failure due to ischemic heart disease or dilated cardiomyopathy. Int. J. Cardiol.56:283–288, 1996.Google Scholar
  34. 34.
    Willert, C. E., and M. Gharib. Digital particle image velocimetry. Exp. Fluids10:181–193, 1991.Google Scholar
  35. 35.
    Yamabe, H.et al.The role of cardiac output response in blood flow distribution during exercise in patients with chronic heart failure. Eur. Heart J.16:951–960, 1995.Google Scholar
  36. 36.
    Zarins, C. K.et al.Carotid bifurcation atherosclerosis—Quantitative correlation of plaque localization with flow velocity profiles and wall shear stress. Circ. Res.53:502–514, 1983.Google Scholar

Copyright information

© Biomedical Engineering Society 2003

Authors and Affiliations

  • Morteza Gharib
    • 1
  • Masoud Beizaie
    • 2
  1. 1.California Institute of TechnologyPasadena
  2. 2.Orqis™ Medical CorporationLake Forest

Personalised recommendations