Physiological Significance of Helical Flow in the Arterial System and its Potential Clinical Applications
Physiological Significance of Helical Flow in the Arterial System and its Potential Clinical Applications
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动脉系统螺旋流的生理意义及其潜在的临床应用
DOI：
10.1007/s10439-014-1097-2
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发表时间：
2015-01-01
影响因子：
3.8
通讯作者：
Deng, Xiaoyan
中科院分区：
文献类型：
--
作者：
Liu, Xiao;Sun, Anqiang;Deng, Xiaoyan
人类主动脉的螺旋流可能是血管系统中“形式追随功能”的典型例子。螺旋状血流可以保证升主动脉壁内表面被血液清洗得光滑均匀，使升主动脉区域不易形成动脉粥样硬化斑块。据文献记载，螺旋状血流现象不仅局限于升主动脉，也存在于一些大动脉和静脉中。初步研究表明，广泛存在的螺旋流可能在促进血流运输、抑制血流紊乱、防止致动脉粥样硬化低密度脂蛋白在动脉腔面积聚、增强血液向动脉壁的氧运输、减少血细胞在动脉表面的粘附等方面发挥积极的生理作用。螺旋血流的这些作用可以减轻动脉的负担，保护动脉免受动脉粥样硬化、血栓形成和内膜增生的病理影响。随着时间分辨三维相位对比MRI（血流敏感4D-MRI）技术的飞速发展，以及螺旋血流指数等无量纲指标的出现，使得临床量化人体大动脉螺旋血流成为可能。此外，研究人员还探讨了将螺旋流动机制应用于血管干预设计的可能性，以减少异常流动条件导致的血栓形成和内膜增生。
Helical flow in the human aorta is possibly a typical example of 'form follows function' in the vascular system. The helical blood flow may provide guaranties for the inner surface of the ascending aortic wall to get smooth and even washing by the blood so that atherosclerotic plaques can hardly form in the area of the ascending aorta. It has been documented that the phenomenon of helical flow of blood is not just localized in the ascending aorta, it also exists in several large arteries and veins as well. Preliminary studies demonstrated the widely existing helical flow might play positive physiological roles in facilitating blood flow transport, suppressing disturbed blood flow, preventing the accumulation of atherogenic low density lipoproteins on the luminal surfaces of arteries, enhancing oxygen transport from the blood to the arterial wall and reducing the adhesion of blood cells on the arterial surface. These roles of helical blood flow may lessen the burden of arteries and protect the arteries from the pathology of atherosclerosis, thrombosis, and intimal hyperplasia. The great development of time-resolved three-dimensional phase contrast MRI (flow-sensitive 4D-MRI) and the advent of dimensionless indices such as helical flow index proposed to characterize helical flow make clinic quantification of the helical flow in the human large arteries possible. Moreover, researchers probed into the possibility to apply the mechanism of helical flow to the design of vascular interventions to reduce thrombus formation and intimal hyperplasia caused by abnormal flow conditions.