Adaptation of Conduit Artery Vascular Smooth Muscle Tone to Induced Hypertension

We studied the changes in vascular smooth muscle (VSM) cell tone during the adaptation of rat common carotids to induced hypertension. Hypertension was induced in 8 week old male Wistar rats by total ligation of the aorta between the two kidneys. Mean blood pressure increased abruptly from 92±2 mm Hg (mean±SE) to 145±4 mm Hg and remained constant thereafter. Rats were sacrificed 2, 4, 8, and 56 days after surgery and the left common carotid artery was excised for analysis. Pressure-diameter curves were measured in vitro under normal, maximally contracted, and totally relaxed VSM. The VSM tone was analyzed in terms of its basal tone (active stress at low strains) and its myogenic tone (increase in active stress at high strains). Our results show that the capacity of the VSM to develop maximal active stress is not altered in hypertension. Basal tone, however, increases rapidly in the acute hypertension phase (2-8 days postsurgery) and drops to nearly control values at 56 days postsurgery. Also, the onset of myogenic response decreases to lower strains following the step change in pressure, to be restored back to control levels at 56 days postsurgery. We conclude that VSM adaptation is most significant in the acute hypertension phase and acts as a first, rapid defense mechanism for the arterial wall. The VSM tone returns back to normal levels once the slower geometrical and structural remodeling is developed sufficiently to restore the biomechanical environment and function of the arterial wall to control levels. © 2002 Biomedical Engineering Society. PAC2002: 8719Rr, 8719Ff, 8719U

The non-circular shape of FloWatch-PAB prevents the need for pulmonary artery reconstruction after banding. Computational fluid dynamics and clinical correlations

OBJECTIVE: To evaluate the differences between non-circular shape of FloWatch-PAB and conventional pulmonary artery (PA) banding. METHODS: Geometrical analysis. Conventional banding and FloWatch-PAB perimeters were plotted against cross-sections. Computational fluid dynamics (CFD) model. CFD compared non-circular FloWatch-PAB cross-sections with conventional banding regarding pressure gradients. Clinical data. Seven children, median age 2 months (7 days to 3 years), median weight 4.2 kg (3.2-9.8 kg), with complex congenital heart defects underwent PA banding with FloWatch-PAB implantation. RESULTS: Geometrical analysis. Conventional banding: progressive reduction of cross-sections was accompanied by progressive reduction of PA perimeters. FloWatch-PAB: with equal reduction of cross-sections the PA perimeter remained constant. CFD model. Non-circular and circular banding provided same trans-banding pressure gradients for same cross-sections at any given flow. Clinical data. Mean PA internal diameter at banding was 13.3+/-4.5 mm. After a mean interval of 5.9+/-3.7 months, all children underwent intra-cardiac repair and simple FloWatch-PAB removal without PA reconstruction. Mean PA internal diameter with FloWatch-PAB removal increased from 3.0+/-0.8 to 12.4+/-4.5 mm (normal mean internal diameter for the age=9.9+/-1.6). No residual pressure gradient was recorded in correspondence of the site of the previous FloWatch-PAB implantation in 6/7 patients, 10 mmHg peak and 5 mmHg mean gradient in 1/7. CONCLUSIONS: The non-circular shape of FloWatch-PAB can replace conventional circular banding with the following advantages: (a) the pressure gradient will remain essentially the same as for conventional circular banding for any given cross-section, but with significantly smaller reduction of PA perimeter; and (b) PA reconstruction at the time of de-banding for intra-cardiac repair can be avoided

Adaptation of conduit artery vascular smooth muscle tone to induced hypertension

We studied the changes in vascular smooth muscle (VSM) cell tone during the adaptation of rat common carotids to induced hypertension. Hypertension was induced in 8 week old male Wistar rats by total ligation of the aorta between the two kidneys. Mean blood pressure increased abruptly from 92 +/- 2mm Hg (mean +/- SE) to 145 +/- 4 mm Hg and remained constant thereafter. Rats were sacrificed 2, 4, 8, and 56 days after surgery and the left common carotid artery was excised for analysis. Pressure-diameter curves were measured in vitro under normal, maximally contracted, and totally relaxed VSM. The VSM tone was analyzed in terms of its basal tone (active stress at low strains) and its myogenic tone (increase in active stress at high strains). Our results show that the capacity of the VSM to develop maximal active stress is not altered in hypertension. Basal tone, however, increases rapidly in the acute hypertension phase (2-8 days postsurgery) and drops to nearly control values at 56 days postsurgery. Also, the onset of myogenic response decreases to lower strains following the step change in pressure, to be restored back to control levels at 56 days postsurgery. We conclude that VSM adaptation is most significant in the acute hypertension phase and acts as a first, rapid defense mechanism for the arterial wall. The VSM tone returns back to normal levels once the slower geometrical and structural remodeling is developed sufficiently to restore the biomechanical environment and function of the arterial wall to control levels

A new implantable device for telemetric control of pulmonary blood flow.

The main problem encountered in pulmonary artery banding is the difficulty in determining the optimal perimeter of the band, and sometime repeated surgical operations are required to adjust the band perimeter in order to control the pulmonary blood flow. To overcome these difficulties EndoArt S.A. (Lausanne, Switzerland) developed an externally adjustable, telemetrically controlled device for pulmonary artery banding (FloWatch), which is wireless, battery free, easy to implant and use, and we here report on the technical characteristics of the device. The preliminary acute experimental studies demonstrated the feasibility of the implant and the good functioning of the device

Model of geometrical and smooth muscle tone adaptation of carotid artery subject to step change in pressure

Recent experimental studies have shown significant alterations of the vascular smooth muscle (VSM) tone when an artery is subjected to an elevation in pressure. Therefore, the VSM participates in the adaptation process not only by means of its synthetic activity (fibronectins and collagen) or proliferative activity (hypertrophy and hyperplasia) but also by adjusting its contractile properties and its tone level. In previous theoretical models describing the time evolution of the arterial wall adaptation in response to induced hypertension, the contribution of VSM tone has been neglected. In this study, we propose a new biomechanical model for the wall adaptation to induced hypertension, including changes in VSM tone. On the basis of Hill's model, total circumferential stress is separated into its passive and active components, the active part being the stress developed by the VSM. Adaptation rate equations describe the geometrical adaptation (wall thickening) and the adaptation of active stress (VSM tone). The evolution curves that are derived from the theoretical model fit well the experimental data describing the adaptation of the rat common carotid subjected to a step increase in pressure. This leads to the identification of the model parameters and time constants by characterizing the rapidity of the adaptation processes. The agreement between the results of this simple theoretical model and the experimental data suggests that the theoretical approach used here may appropriately account for the biomechanics underlying the arterial wall adaptation

Short-Term biomechanical adaptation of the rat carotid to acute hypertension: contribution of smooth muscle

The biomechanical adaptation of the arterial wall to hypertension has been studied extensively in recent years; however, the exact biomechanical contribution of vascular smooth muscle cells (VSMCs) during the adaptation process in conduit vessels is not known. We induced hypertension in 8 wk old Wistar rats by total ligation of the aorta between the two kidneys. Mean blood pressure increased from 92 +/- 2 (mean +/- SE) mm Hg to approximately 150 mmHg. Rats were sacrificed 2, 4, and 8 d after surgery and the left common carotid artery was excised for analysis. Wall thickness increased by 18% in 8 d and the opening angle by 32% in 4 d. The elastic properties were measured under normal VSMC tone (i.e., the amount of VSMC tone under normal conditions also called basal VSMC tone or normal resting VSMC tone), under maximally contracted VSMC (NE, 5 x 10(-7) mol/L) and under totally relaxed VSMC conditions (papaverine, 10(-4) mol/L). The most pronounced modifications were the changes in elastic properties related to normal VSMC tone. The functional contraction ratio at 100 mm Hg, defined as the relative contraction under normal conditions (normal VSMC tone), increased by 439% 4 d after the induction of hypertension. The total contraction capacity of the VSMC increased by 38% within 8 d. The changes in normal VSMC tone led to important changes in the mechanical properties of the arterial wall. Under normal VSMC conditions, compliance at mean pressure (148 mm Hg) increased by 159% within 8 d, whereas in the absence of VSMC tone, compliance did not increase significantly. We conclude that in conduit vessels, the VSMC, which is the sensing and effecting element of the adaptation process, is subjected to large-scale changes during the early phase of arterial adaptation to acute hypertension.LCBLHT