MECHANICAL FACTORS ASSOCIATED WITH THE DEVELOPMENT OF INTIMAL AND MEDIAL THICKENING IN VEIN GRAFTS SUBJECTED TO ARTERIAL-PRESSURE - A MODEL OF ARTERIES EXPOSED TO HYPERTENSION
MECHANICAL FACTORS ASSOCIATED WITH THE DEVELOPMENT OF INTIMAL AND MEDIAL THICKENING IN VEIN GRAFTS SUBJECTED TO ARTERIAL-PRESSURE - A MODEL OF ARTERIES EXPOSED TO HYPERTENSION
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DOI：
10.1161/01.hyp.26.1.38
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发表时间：
1995-07-01
期刊：
影响因子：
8.3
通讯作者：
DOBRIN, PB
中科院分区：
文献类型：
--
作者：
DOBRIN, PB
暴露于持续性高血压的动脉有中等程度的内膜增厚和明显的中膜增厚。用作搭桥术的自体静脉经历了类似的组织学变化。在这项研究中，自体静脉移植物被用作动脉暴露于持续性高血压的间接模型。据推测，这不是压力本身，而是暴露在增加的压力下所带来的机械性变化，作为一种刺激导致组织学变化。暴露在动脉压力下会增加以下九个力学因素：周向、纵向和径向的变形；这三个方向上的应力；脉动变形和脉动应力；以及流速。所有这些机械变化同时发生。因此，设计了一个三步算法来分离九个机械因素中的每一个，并将它们与组织学变化相关联。根据该算法，对38只狗进行了三次序贯实验研究。这些实验表明，内膜增厚与低血流速度、低切应力相关最好，而中膜增厚与周向变形最相关。
Arteries exposed to sustained hypertension undergo a moderate degree of intimal thickening and a marked amount of medial thickening. Autogenous veins that are used as bypass grafts undergo similar histological changes. In this study autogenous vein grafts were used as an indirect model of arteries exposed to sustained hypertension. It was hypothesized that it is not pressure per se but rather mechanical changes brought about by exposure to increased pressures that act as a stimulus inducing histological changes. Exposure to arterial pressure increases the following nine mechanical factors: deformation in the circumferential, longitudinal, and radial directions; stresses in each of these three directions; pulsatile deformations and pulsatile stresses; and flow velocity. All of these mechanical changes occur simultaneously. Accordingly, a three-step algorithm was devised to separate each of the nine mechanical factors and correlate them with histological changes. Three sequential experimental studies were performed in 38 dogs following the algorithm. These experiments demonstrated that intimal thickening was best correlated with low flow velocity, a correlate of low shear stress, whereas medial thickening was best correlated with deformation in the circumferential direction.