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  4. Acute and Long-Term Effects of Aortic Compliance Decrease on Central Hemodynamics: A Modeling Analysis
 
research article

Acute and Long-Term Effects of Aortic Compliance Decrease on Central Hemodynamics: A Modeling Analysis

Pagoulatou, Stamatia  
•
Adamopoulos, Dionysios
•
Rovas, Georgios  
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July 26, 2021
Frontiers In Physiology

Aortic compliance is an important determinant of cardiac afterload and a contributor to cardiovascular morbidity. In the present study, we sought to provide in silico insights into the acute as well as long-term effects of aortic compliance decrease on central hemodynamics. To that aim, we used a mathematical model of the cardiovascular system to simulate the hemodynamics (a) of a healthy young adult (baseline), (b) acutely after banding of the proximal aorta, (c) after the heart remodeled itself to match the increased afterload. The simulated pressure and flow waves were used for subsequent wave separation analysis. Aortic banding induced hypertension (SBP 106 mmHg at baseline versus 152 mmHg after banding), which was sustained after left ventricular (LV) remodeling. The main mechanism that drove hypertension was the enhancement of the forward wave, which became even more significant after LV remodeling (forward amplitude 30 mmHg at baseline versus 60 mmHg acutely after banding versus 64 mmHg after remodeling). Accordingly, the forward wave's contribution to the total pulse pressure increased throughout this process, while the reflection coefficient acutely decreased and then remained roughly constant. Finally, LV remodeling was accompanied by a decrease in augmentation index (AIx 13% acutely after banding versus -3% after remodeling) and a change of the central pressure wave phenotype from the characteristic Type A ("old") to Type C ("young") phenotype. These findings provide valuable insights into the mechanisms of hypertension and provoke us to reconsider our understanding of AIx as a solely arterial parameter.

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Type
research article
DOI
10.3389/fphys.2021.701154
Web of Science ID

WOS:000682890100001

Author(s)
Pagoulatou, Stamatia  
Adamopoulos, Dionysios
Rovas, Georgios  
Bikia, Vasiliki  
Stergiopulos, Nikolaos  
Date Issued

2021-07-26

Publisher

FRONTIERS MEDIA SA

Published in
Frontiers In Physiology
Volume

12

Article Number

701154

Subjects

Physiology

•

banding

•

lv remodeling

•

augmentation index

•

hypertension

•

wave separation analysis

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left-ventricular hypertrophy

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end-systolic elastance

•

single-beat estimation

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one-dimensional model

•

arterial stiffness

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input impedance

•

wave reflection

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advancing age

•

pressure

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replacement

Editorial or Peer reviewed

REVIEWED

Written at

EPFL

EPFL units
LHTC  
Available on Infoscience
August 14, 2021
Use this identifier to reference this record
https://infoscience.epfl.ch/handle/20.500.14299/180592
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