Blood velocity profiles in the origin of the canine renal artery and their relevance in the localization and development of atherosclerosis

The renal artery ostium flow diverter: structure and potential role in atherosclerosis

Initiation of renal atherosclerosis occurs primarily at the caudal region of the renal artery ostium. To date, no mechanism for initiation of atherosclerosis at this site has been substantiated. Herein, we identify a renal artery flow diverter on the caudal wall of the renal artery ostium that directs flow into the renal artery and selectively retains LDL, an initial step in atherosclerosis. High-resolution ultrasound revealed the generation of flow eddies by the caudal diverter in vivo, consistent with a role in directing aortic flow to the renal artery. Two-photon excitation en face microscopy of the diverter revealed a substantial reduction in the elastic lamina exposing potential retention sites for LDL. Fluorescent LDL was selectively retained by the renal artery diverter, consistent with its molecular structure. We propose that the rigid macromolecular structure of the renal artery ostium diverter is required for its vascular function and contributes to the initiation of renal atherosclerosis by the retention of LDL.

[Numerical simulation of the cardiovascular system]

In this article, we aim at giving a non-technical overview of some mathematical models currently used in the numerical simulation of the cardiovascular system. A hierarchy of models for blood flows in large arteries is briefly described as well as an electromechanical model for the heart. We discuss some possible applications of the numerical simulations of such models, for example the optimization of prostheses. We also address the issue of the data assimilation for the calibration of the models.

The influence of out-of-plane geometry on pulsatile flow within a distal end-to-side anastomosis

We present an experimental and computational investigation of time-varying flow in an idealized fully occluded 45 degrees distal end-to-side anastomosis. Two geometric configurations are assessed, one where the centerlines of host and bypass vessels lie within a plane, and one where the bypass vessel is deformed out of the plane of symmetry, respectively, termed planar and non-planar. Flow experiments were conducted by magnetic resonance imaging in rigid wall models and computations were performed using a high order spectral/hp algorithm. Results indicate a significant change in the spatial distribution of wall shear stress and a reduction of the time-averaged peak wall shear stress magnitude by 10% in the non-planar model as compared to the planar configuration. In the planar geometry the stagnation point follows a straight-line path along the host artery bed with a path length of 0.8 diameters. By contrast in the non-planar case the stagnation point oscillates about a center that is located off the symmetry plane intersection with the host artery bed wall, and follows a parabolic path with a 0.7 diameter longitudinal and 0.5 diameter transverse excursion. A definition of the oscillatory shear index (OSI) is introduced that varies between 0 and 0.5 and that accounts for a continuous range of wall shear stress vector angles. In both models, regions of elevated oscillatory shear were spatially associated with regions of separated or oscillating stagnation point flow. The mean oscillatory shear magnitude (considering sites where OSI>0.1) in the non-planar geometry was reduced by 22% as compared to the planar configuration. These changes in the dynamic behavior of the stagnation point and the oscillatory shear distribution introduced by out-of-plane graft curvature may influence the localization of vessel wall sites exposed to physiologically unfavorable flow conditions.

The influence of out-of-plane geometry on the flow within a distal end-to-side anastomosis

This paper describes a computational and experimental investigation of flow in a proto-type model geometry of a fully occluded 45 deg distal end-to-side anastomosis. Previous investigations have considered a similar configuration where the centerlines of the bypass and host vessels lie within a plane, thereby producing a plane of symmetry within the flow. We have extended these investigations by deforming the bypass vessel out of the plane of symmetry, thereby breaking the symmetry of the flow and producing a nonplanar geometry. Experimental data were obtained using magnetic resonance imaging of flow within perspex models and computational data were obtained from simulations using a high-order spectral/hp element method. We found that the nonplanar three-dimensional flow notably alters the distribution of wall shear stress at the bed of the anastomosis, reducing the peak wall shear stress peak by approximately 10 percent when compared with the planar model. Furthermore, an increase in the absolute flux of velocity into the occluded region, proximal to the anastomosis, of 80 percent was observed in the nonplanar geometry when compared with the planar geometry.

Relation between the structural asymmetry of coronary branch vessels and the angle at their origin

The relationship between the geometry of branch points on the left anterior descending coronary artery, and the morphometry of the proximal portions of the daughter vessels, was examined. The geometry at 23 branch points on 15 human hearts was derived from multiplane contrast angiograms, and the morphometry at 29 sites along the daughter vessels was obtained from transverse sections using computerized techniques. The angle of the branch at which the daughter originated was positively correlated with the maximum thicknesses of the intima and media, and with their circumferential asymmetry. The results suggest that large branch angles may favor eccentric intimal thickening, a phenomenon which may predispose to lipid accumulation and atherosclerosis.

Effect of flow direction on the morphological responses of cultured bovine aortic endothelial cells

The effect of flow direction on the morphology of cultured bovine aortic endothelial cells is studied. Fully confluent endothelial cells cultured on glass were subjected to a fluid-imposed shear stress of 2 Pa for 20 min and 24 h using a parallel plate flow chamber. Experiments on shear flow exposure were performed for (i) one-way flow, (ii) reciprocating flow with a 30 min interval and (iii) alternating orthogonal flows with a 30 min interval. After flow exposure, the endothelial cells were fixed and F-actin filaments were stained with rhodamine phalloidin. Endothelial cells were observed and photographed by means of a microscope equipped with epifluorescence optics. The shape index (SI) and angle of cell orientation were measured, and F-actin distributions in the cells were statistically studied. Endothelial cells under the one-way flow condition showed marked elongation (SI = 0.39 +/- 0.16, mean +/- S.D.) and aligned with the flow direction. In the case of the reciprocating (SI = 0.63 +/- 0.14) and the alternating orthogonal flows (0.64 +/- 0.14), cells did not elongate so strongly as in the case of one-way flow. Although most cells in the reciprocating flow aligned with the flow direction, the cell axes in the alternate orthogonal flow distributed around a mean value of -45.1 degrees with a large S.D. value. Endothelial cells can be expected to recognise the flow direction, and change their shape and F-actin structure.

Correlation between the presence of an immature smooth muscle cell population in tunica media and the development of atherosclerotic lesion. A study on different-sized rabbit arteries from cholesterol-fed and Watanabe heritable hyperlipemic rabbits

Mapping the distribution of an immature smooth muscle cell (SMC) subpopulation in large- and small-sized arterial vessels was carried out in normocholesterolemic rabbits and compared with the mapping atherosclerotic lesions in endogenously (Watanabe heritable hyperlipemic, WHHL) and exogenously derived (cholesterol-fed, CT) hypercholesterolemic rabbits. This cell subset is identified by a specific myosin isoform content and displays an intermediate degree of differentiation between fetal- and adult-type SMC. Monoclonal anti-myosin antibodies, immunofluorescence procedures, and different arterial segments of a rabbit vessel tree, i.e. from aorta to dental pulp (common carotid, external carotid, lingual, facial, maxillary, inferior alveolar arteries, and dental branches of alveolar arteries) were studied. WHHL of different ages (3 to 12 months), and two different concentrations of CT (2% and 0.2%) in the diet for 3 and 12 months, respectively, were used. The results of the present study indicate that: (1) using a diet with a higher percentage of CT (rabbits fed 2% CT-diet for 3 months) there is maximum expansion of atherosclerotic lesions from the aorta up to the maxillary artery; (2) localization of atherosclerotic lesions with a lower CT content in the diet is dependent on the duration of feeding and may involve the aorta up to the external carotid artery; (3) the development of the atherosclerotic lesion in hypercholesterolemic rabbit is strictly related to the appearance of an intermediate SMC subtype; (4) atherosclerotic lesions occur only in those arterial sites which, in corresponding normocholesterolemic rabbit, contain intermediate-type SMC; and (5) no differences can be found in the distribution of SMC subpopulations present in the lesions from WHHL, CT-fed animals, or at various arterial levels, whereas some discrepancies can be shown in aortic atherogenesis.

Effect of stenosis inlet geometry on shear rates of blood flow in the upstream region

Abnormal shear rates of blood flow have been implicated in the processes of thrombosis, atherosclerosis, and restenosis after angioplasty. However, no study has quantitated the effect of stenosis inlet geometry on the shear rates in the region upstream to the stenosis. To quantitate this effect, we measured the velocity profiles of blood flow at Reynolds numbers 175 and 350 upstream to different axisymmetric model stenoses in an excised canine aorta. Two 40% and two 75% stenoses were tested, one each with a 45-degree inlet angulation and one each with a 90-degree angulation. For the velocity measurements we used a specially developed external single-channel Doppler ultrasound system capable of resolving blood flow velocity at 91 microns radial intervals across the aorta. We found that increasing the severity of stenosis narrowing and angulation resulted in a significant decrease in shear rate at the endothelial surface (40%/45-degree stenosis: 189 +/- 46 sec-1 vs 75%/90-degree stenosis: 49 +/- 12 sec-1 at Reynolds number 350; p < 0.002) and a significant increase in the maximum shear rate within the vessel lumen (189 +/- 46 sec-1 vs 295 +/- 8 sec-1, respectively; p < 0.05) in the region immediately upstream to the stenosis. These effects were less pronounced for Reynolds number 175. We conclude that stenosis inlet geometry has a significant impact on the flow conditions in the region immediately upstream to the stenosis, which is dependent on the Reynolds number. This may be an important determinant of thrombosis and atherogenesis in this particular region.