A Mathematical Model of Maladaptive Inward Eutrophic Remodeling of Muscular Arteries in Hypertension
A Mathematical Model of Maladaptive Inward Eutrophic Remodeling of Muscular Arteries in Hypertension
复制标题
高血压肌动脉适应不良向内富营养化重塑的数学模型
DOI：
10.1115/1.4055109
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Shazly, Tarek
中科院分区：
文献类型：
--
作者：
Rachev, Alexander;Shazly, Tarek
本文从血管固体力学的角度，提出了一个相对简单的高血压患者阻力动脉适应不良性内向重构的二维数学模型。主要前提是：（i）适应不良的向内重塑表现为与在相等的高血压压力下的适应性重塑的情况相比，动脉质量的增加减少，以及（ii）动脉壁中的压力诱导的周向应力恢复到其基础目标值，如在适应性重塑的情况下所发生的。这些假设的基本原理是实验发现，与持续高血压相关的张力升高下调了血管平滑肌细胞从收缩型到合成型的正常分化，以及重塑完成前后计算的环向应力的数据。从说明性的模拟结果表明，随着高血压的增加，重塑引起的非单调变化的动脉质量，在动脉内径的减少，并在壁厚的增加。这些研究结果和模型预测，向内的富营养化重塑之前，向内的肥厚性重塑支持发表的意见。讨论了改进数学模型的局限性和前景。
We propose a relatively simple two-dimensional mathematical model for maladaptive inward remodeling of resistive arteries in hypertension in terms of vascular solid mechanics. The main premises are: (i) maladaptive inward remodeling manifests as a reduced increase in the arterial mass compared to the case of adaptive remodeling under equivalent hypertensive pressures and (ii) the pressure-induced circumferential stress in the arterial wall is restored to its basal target value as happens in the case of adaptive remodeling. The rationale for these assumptions is the experimental findings that elevated tone in association with sustained hypertensive pressure down-regulate the normal differentiation of vascular smooth muscle cells from contractile to synthetic phenotype and the data for the calculated hoop stress before and after completion of remodeling. Results from illustrative simulations show that as the hypertensive pressure increases, remodeling causes a nonmonotonic variation of arterial mass, a decrease in inner arterial diameter, and an increase in wall thickness. These findings and the model prediction that inward eutrophic remodeling is preceded by inward hypertrophic remodeling are supported by published observations. Limitations and perspectives for refining the mathematical model are discussed.