Estimation of the supplementary axial wall stress generated at peak flow by an arterial stenosis
Estimation of the supplementary axial wall stress generated at peak flow by an arterial stenosis
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DOI：
10.1088/0031-9155/48/1/309
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发表时间：
2003-01-07
影响因子：
3.5
通讯作者：
Doriot, PA
中科院分区：
文献类型：
--
作者：
Doriot, PA
动脉壁的机械应力被认为与动脉粥样硬化的发展有关。虽然剪应力和周向应力受到了很大的关注，但轴向应力却没有得到很大的关注。然而，可以直观地预计，狭窄在血流收缩时会在紧邻收缩锥的区域产生补充的轴向应力。本文提出了一种估算这一效应的模型，并计算了10个数值算例。这些例子表明，在严重的狭窄(通常是正常应力值的120%或更多)中，轴向应力的循环增加可能相当可观。这一结果与已知的狭窄进展和再狭窄的机械或形态危险因素(高血压、脉压升高、狭窄程度、狭窄几何形状、残余狭窄等)非常一致。狭窄所产生的补充轴向应力可能会对血管内皮细胞和弹力膜造成损伤，从而加强其他危险因素(高脂血症、糖尿病等)的作用。因此，它可能是狭窄进展和再狭窄的重要原因。
Mechanical stresses in arterial walls are known to be implicated in the development of atherosclerosis. While shear stress and circumferential stress have received a lot of attention, axial stress has not. Yet, stenoses can be intuitively expected to produce a supplementary axial stress during flow systole in the region immediately proximal to the constriction cone. In this paper, a model for the estimation of this effect is presented, and ten numerical examples are computed. These examples show that the cyclic increase in axial stress can be quite considerable in severe stenoses (typically 120% or more of the normal stress value). This result is in best agreement with the known mechanical or morphological risk factors of stenosis progression and restenosis (hypertension, elevated pulse pressure, degree of stenosis, stenosis geometry, residual stenosis, etc). The supplementary axial stress generated by a stenosis might create the damages in the endothelium and in the elastic membranes which potentiate the action of the other risk factors (hyperlipidaemia, diabetes, etc). It could thus be an important cause of stenosis progression and of restenosis.