Pulsatile blood flow in the entire coronary arterial tree: theory and experiment

The pulsatility of coronary circulation can be accurately simulated on the basis of the measured branching pattern, vascular geometry, and material properties of the coronary vasculature. A Womersley-type mathematical model is developed to analyze pulsatile blood flow in diastole in the absence of vessel tone in the entire coronary arterial tree on the basis of previously measured morphometric data. The model incorporates a constitutive equation of pressure and cross-section area relation based on our previous experimental data. The formulation enables the prediction of the impedance, the pressure distribution, and the pulsatile flow distribution throughout the entire coronary arterial tree. The model is validated by experimental measurements in six diastolic arrested, vasodilated porcine hearts. The agreement between theory and experiment is excellent. Furthermore, the present pulse wave results at low frequency agree very well with previously published steady-state model. Finally, the phase angle of flow is seen to decrease along the trunk of the major coronary artery and primary branches toward the capillary vessels. This study represents the first, most extensive validated analysis of Womersley-type pulse wave transmission in the entire coronary arterial tree down to the first segment of capillaries. The present model will serve to quantitatively test various hypotheses in the coronary circulation under pulsatile flow conditions.     

Atrioventricular plane displacement is the major contributor to left ventricular pumping in healthy adults, athletes, and patients with dilated cardiomyopathy

Previous studies using echocardiography in healthy subjects have reported conflicting data regarding the percentage of the stroke volume (SV) of the left ventricle (LV) resulting from longitudinal and radial function, respectively. Therefore, the aim was to quantify the percentage of SV explained by longitudinal atrioventricular plane displacement (AVPD) in controls, athletes, and patients with decreased LV function due to dilated cardiomyopathy (DCM). Twelve healthy subjects, 12 elite triathletes, and 12 patients with DCM and ejection fraction below 30% were examined by cine magnetic resonance imaging. AVPD and SV were measured in long- and short-axis images, respectively. The percentage of the SV explained by longitudinal function (SV(AVPD%)) was calculated as the mean epicardial area of the largest short-axis slices in end diastole multiplied by the AVPD and divided by the SV. SV was higher in athletes [140 +/- 4 ml (mean +/- SE), P = 0.009] and lower in patients (72 +/- 7 ml, P < 0.001) when compared with controls (116 +/- 6 ml). AVPD was similar in athletes (17 +/- 1 mm, P = 0.45) and lower in patients (7 +/- 1 mm, P < 0.001) when compared with controls (16 +/- 0 mm). SV(AVPD%) was similar both in athletes (57 +/- 2%, P = 0.51) and in patients (67 +/- 4%, P = 0.24) when compared with controls (60 +/- 2%). In conclusion, longitudinal AVPD is the primary contributor to LV pumping and accounts for approximately 60% of the SV. Although AVPD is less than half in patients with DCM when compared with controls and athletes, the contribution of AVPD to LV function is maintained, which can be explained by the larger short-axis area in DCM.     

Flush-mounted hot film anemometer accuracy in pulsatile flow

The accuracy of a flush-mounted hot film anemometer probe for wall shear stress measurements in physiological pulsatile flows was evaluated in fully developed pulsatile flow in a rigid straight tube. Measured wall shear stress waveform based on steady flow anemometer probe calibrations were compared to theoretical wall shear stress waveforms based on well-established theory and measured flow rate waveforms. The measured and theoretical waveforms were in close agreement during systole (average deviation of 14 percent at peak systole). As expected, agreement was poor during diastole because of flow reversal and diminished frequency response at low shear rate.     

Low haemolysis pulsatile impeller pump: design concepts and experimental results

A pulsatile fully implantable impeller pump with low haemolysis has been produced by developing a pulsatile impeller for a nonpulsatile pump also developed in this laboratory. The impeller was designed according to the 3-dimensional theory of fluid dynamics. The impeller shroud retains the same parabolic form and the vane has a form compacted by a radial logarithmic spiral and an axial helical spiral so that the absolute vibration velocity of the blood in a peripheral direction is a minimum as the impellar changes its speed periodically to generate a physiological pulsatile blood flow. Thus the Reynolds shear and the Newton shear are a minimum for the required pulse pressure. The mean volume and mean pressure are controlled by adjusting the voltage. The shape of the pressure pulse is determined by a square was of vollage and the systole/diastole ratio. In order to abolish regurgitation of the pump, a 40 per cent systole period and a 5 V voltage pulse are desirable for 40 mmHg pulse pressure (80–120 mmHg mean pressure). The pulse frequency has almost no effect on pump output. The pump can delivery 4 l/min mean volume and 100 mmHg mean pressure (40 mmHg pulse pressure), and these conditions result in an index of heamolysis (IH) for porcine blood of 0.020—only slighly more than the nonpulsatile pump (0.016). When the pulsatile impeller was used under nonpulsatile conditions its IH was almost doubled, but when the nonpulsatile impeller was used under pulsatile conditions the IH reached 0.13. The power consumption is approximately equal to that for the nonpulsatile pump: 3 W for 4 l/min and 100 mmHg output. The pump weights 240 g (including 190 g for the motor) and, because a commercial motor has been used, costs only a few hundred US dollars.     

Mechanism of puberty

The hypothalamo-pituitary-gonadal axis in children is fully functional in fetal life and immediately after birth. The reason why it declines with advancing years of childhood is not clear but gonadotropin pulsatility is at a nadir at 6 years of age. From that time pulsatile gonadotropin starts to reappear but, again, the reason why this happens is completely unknown. All of the events of puberty can be ascribed to pulsatile gonadotropin-releasing hormone stimulation causing pulsatile gonadotropin stimulation of sex steroids. The sex steroids explain the development of the pubertal characteristics; the fact that girls have an earlier growth spurt than boys is explained by the differential effect of oestradiol and testosterone on hypothalamic control of pituitary growth hormone secretion.     

Beat-to-beat stroke volume estimation from aortic pressure waveform in conscious rats: comparison of models

Several methods for estimating stroke volume (SV) were tested in conscious, freely moving rats in which ascending aortic pressure and cardiac flow were simultaneously (beat-to-beat) recorded. We compared two pulse-contour models to two new statistical models including eight parameters extracted from the pressure waveform in a multiple linear regression. Global as well as individual statistical models gave higher correlation coefficients between estimated and measured SV (model 1, r = 0.97; model 2, r = 0.96) than pulse-contour models (model 1, r = 0.83; model 2, r = 0.91). The latter models as well as statistical model 1 used the pulsatile systolic area and thus could be applied to only 47 +/- 17% of the cardiac beats. In contrast, statistical model 2 used the pressure-increase characteristics and was therefore established for all of the cardiac beats. The global statistical model 2 applied to data sets independent of those used to establish the model gave reliable SV estimates: r = 0.54 +/- 0.07, a small bias between -8% to +10%, and a mean precision of 7%. This work demonstrated the limits of pulse-contour models to estimate SV in conscious, unrestrained rats. A multivariate statistical model using eight parameters easily extracted from the aortic waveform could be applied to all cardiac beats with good precision.     

Hemodynamic effects of synchronous high-frequency jet ventilation during acute hypovolemia

We studied the effects of synchronous cardiac cycle-specific high-frequency jet ventilation (HFJV) in pentobarbital-anesthetized, splenectomized, closed-chest dogs to test the hypothesis that phasic inspiratory increases in intrathoracic pressure (ITP) selectively timed to specific periods of the cardiac cycle have different hemodynamic effects during both hypovolemia (acute hemorrhage, 20 ml/kg) and neurogenic vasomotor shock (hexamethonium, 10 mg/kg) than those observed during normovolemic control conditions. Ventricular stroke volumes (SV) were measured by electromagnetic flow probes. The influence of changes in venous return (VR) on the subsequent hemodynamic response to synchronous HFJV was analyzed using instantaneous VR curves (M. R. Pinsky, J. Appl. Physiol. 56:765-771, 1984). During hemorrhage the VR curve was shifted leftward with concomitant reductions in apneic SV (15.4 +/- 3.8 to 11.2 +/- 3.6 ml, mean +/- SD), (P less than 0.01) that were accentuated by HFJV (P less than 0.01), except when the phasic inspiratory increases in ITP during HFJV were timed to occur during late diastole (-4% apneic SV, NS). SV was greater with late diastolic pulses than with other timed synchronous ITP pulses during hypovolemia (P less than 0.01). During ganglionic blockade, arterial pressure decreased (139 +/- 14 to 76 +/- 18 Torr, P less than 0.001), but VR was preserved at control levels, and no significant cardiac cycle-specific HFJV effects occurred. We conclude that SV reductions associated with positive-pressure ventilation during acute hypovolemia are minimized by HFJV synchronized to late diastole but that this effect is preload dependent.     

Pulmonary capillaries are recruited during pulsatile flow.

Capillaries recruit when pulmonary arterial pressure rises. The duration of increased pressure imposed in such experiments is usually on the order of minutes, although recent work shows that the recruitment response can occur in <4 s. In the present study, we investigate whether the brief pressure rise during cardiac systole can also cause recruitment and whether the recruitment is maintained during diastole. To study these basic aspects of pulmonary capillary hemodynamics, isolated dog lungs were pump perfused alternately by steady flow and pulsatile flow with the mean arterial and left atrial pressures held constant. Several direct measurements of capillary recruitment were made with videomicroscopy. The total number and total length of perfused capillaries increased significantly during pulsatile flow by 94 and 105%, respectively. Of the newly recruited capillaries, 92% were perfused by red blood cells throughout the pulsatile cycle. These data provide the first direct account of how the pulmonary capillaries respond to pulsatile flow by showing that capillaries are recruited during the systolic pulse and that, once open, the capillaries remain open throughout the pulsatile cycle.     

Waveform dependence of pulsatile flow in a stenosed channel

Bloodflow in arteries often shows a rich variety of vortical flows, which are dominated by the complex geometry of blood vessels, the dynamic pulsation of blood flow, and the complicated boundary conditions. With a two-dimensional model of unsteady flow in a stenosed channel, the pulsatile influence on such vortical fluid dynamics has been numerically studied in terms of waveform dependence on physiological pulsation. Results are presented for unsteady flows downstream of the stenosed portion with variation in the wavefiorms of systole and diastole. Overall, a train of propagating vortex waves is observed for all the cases, but it shows great sensitivity to the waveforms. The generation and development of the vortex waves may be linked to the presence of an adverse pressure gradient within a specific interval between two points of inflection of the systolic waveform. The adverse pressure gradient consists of a global pressure gradient that is found to be closely related to the dynamnics of' the pulsation, and a local pressure gradient, which is obsented to be dominated by the nonlinear vortex dynamics.     

Experimental study of physiological pulsatile flow past valve prosthesis in a model of human aorta--II. Tilting disc valves and the effect of orientation

In Part II of this two paper sequence, pulsatile flow development past a tilting disc valve in a model human aorta has been studied using quantitative laser Doppler techniques. The valve was mounted in three different orientations with respect to the aortic root in this study. Under pulsatile flow, the region of flow reversal induced near the wall of the minor flow orifice extends to more than one tissue annulus diameter downstream from the valve into the ascending aorta. In a plane perpendicular to the tilt axis, a bi-helical secondary flow is induced distal to the valve. This secondary flow is further compounded by the multiple curvatures in the aorta. Hence the valve orientation affects the velocity profiles as far downstream as the mid-arch region as well as in the brachio-cephalic arterial branch. In the mid-arch region, a flow reversal along the entire cross-section is observed in early diastole for all the three orientations of the disc valve.     

The Vesicle Protein SAM-4 Regulates the Processivity of Synaptic Vesicle Transport

Axonal transport of synaptic vesicles (SVs) is a KIF1A/UNC-104 mediated process critical for synapse development and maintenance yet little is known of how SV transport is regulated. Using C. elegans as an in vivo model, we identified SAM-4 as a novel conserved vesicular component regulating SV transport. Processivity, but not velocity, of SV transport was reduced in sam-4 mutants. sam-4 displayed strong genetic interactions with mutations in the cargo binding but not the motor domain of unc-104. Gain-of-function mutations in the unc-104 motor domain, identified in this study, suppress the sam-4 defects by increasing processivity of the SV transport. Genetic analyses suggest that SAM-4, SYD-2/liprin-α and the KIF1A/UNC-104 motor function in the same pathway to regulate SV transport. Our data support a model in which the SV protein SAM-4 regulates the processivity of SV transport.     

Transient responses in cardiac function below, at, and above anaerobic threshold

Exercise-induced alterations in cardiac function during graded cycling with submaximal and maximal intensities were studied in 13 trained and 13 untrained young men. Stroke volume (SV) and stroke index (SI) at rest and during submaximal and maximal exercise, determined by impedance cardiography, were consistently greater in the trained than in the less fit group. Training-induced bradycardia was evident in the trained group at rest and during submaximal exercise. Even when SV and SI were compared at the same absolute heart rate and left ventricular ejection time, those for the trained group were markedly greater than those for the untrained. SV for the untrained group was relatively diminished above the work rate corresponding to the anaerobic threshold. The difference in SV during exercise may be attributed to inadequate filling due to the smaller stretch of myocardial fibers in diastole and/or lesser systolic emptying of the left ventricle due to the reduced myocardial contractility in systole of untrained individuals.     

Immunocytochemical Localization of Synaptic Proteins at Vesicular Organelles in PC12 Cells

The distribution of the three synaptic vesicle proteins SV2, synaptophysin and synaptotagmin, and of SNAP-25, a component of the docking and fusion complex, was investigated in PC12 cells by immunocytochemistry. Colloidal gold particle-bound secondary antibodies and a preembedding protocol were applied. Granules were labeled for SV2 and synaptotagmin but not for synaptophysin. Electron-lucent vesicles were labeled most intensively for synaptophysin but also for SV2 and to a lesser extent for synaptotagmin. The t-SNARE SNAP-25 was found at the plasma membrane but also at the surface of granules. Labeling of Golgi vesicles was observed for all antigens investigated. Also components of the endosomal pathway such as multivesicular bodies and multilamellar bodies were occasionally marked. The results suggest that the three membrane-integral synaptic vesicle proteins can have a differential distribution between electron-lucent vesicles (of which PC12 cells may possess more than one type) and granules. The membrane compartment of granules appears not to be an immediate precursor of that of electron-lucent vesicles.     

Class I major histocompatibility proteins are an essential component of the simian virus 40 receptor.

The class I molecules encoded by the major histocompatibility complex (MHC) present endogenously synthesized antigenic peptide fragments to cytotoxic T lymphocytes. We show here that these proteins are an essential component of the cell surface receptor for simian virus 40 (SV40). First, SV40 binding to cells can be blocked by two monoclonal antibodies against class I human lymphocyte antigen (HLA) proteins but not by monoclonal antibodies specific for other cell surface proteins. Second, SV40 does not bind to cells of two different human lymphoblastoid cell lines which do not express surface class I MHC proteins because of genetic defects in the beta 2-microglobulin gene in one line and in the HLA complex in the other. Transfection of these cell lines with cloned genes for beta 2-microglobulin and HLA-B8, respectively, restored expression of their surface class I MHC proteins and resulted in concomitant SV40 binding. Finally, SV40 binds to purified HLA proteins in vitro and selectively binds to class I MHC proteins in a cell surface extract.     

Unsteady near wall residence times and shear exposure in model distal arterial bypass grafts

Building on previous studies of unsteady flow within model distal bypass grafts we analyse the near wall residence times and shear exposure in a 45 degrees anastomosis under symmetrical and symmetry breaking geometric configurations. We define residence time as the minimum time for a particle to exit a spherical region and shear exposure as a temporal integral of the Huber-Henky-von-Mises criterion along a particle path over a fixed time interval. Decomposing the pulsatile cycle into four equal intervals we find that the interval of peak residence time in the host vessel is from mid-deceleration to peak diastole and peak diastole to mid-acceleration. The asymmetric model is shown to have a significantly lower residence time during these intervals. Considering the shear exposure prior to the residence time evaluation we determine that a higher average shear exposure exists in the asymmetric model associated with the upstream geometry modification. Analysis of the regions of high residence time and shear exposure suggests that the "toe" region and the interface between the "heel" and bulk flow are more significant than the bed and heel region. Although the asymmetric model considered in this study reduces residence times in the host artery, the product of the measure of shear exposure and residence time is not found to be preferable. If shear exposure were to be considered as an important factor in particle activation, the findings imply that for junction optimisation, greater consideration needs to be given both to the local junction asymmetry and upstream influence on the shear history.     

Structure of Replicating Simian Virus 40 Deoxyribonucleic Acid Molecules

Properties of replicating simian virus 40 (SV40) deoxyribonucleic acid (DNA) have been examined by sedimentation analysis and by direct observation during a lytic cycle of infection of African green monkey kidney cells. Two types of replicating DNA molecules were observed in the electron microscope. One was an open structure containing two branch points, three branches, and no free ends whose length measurements were consistent with those expected for replicating SV40 DNA molecules. A second species had the same features as the open structure, but in addition it contained a superhelix in the unreplicated portion of the molecule. Eighty to ninety per cent of the replicative intermediates (RI) were in this latter configuration, and length measurements of these molecules also were consistent with replicating SV40 DNA. Replicating DNA molecules with this configuration have not been described previously. RI, when examined in ethidium bromide-cesium chloride (EB-CsCl) isopycnic gradients, banded in a heterogeneous manner. A fraction of the RI banded at the same density as circular SV40 DNA containing one or more single-strand nicks (component II). The remaining radioactive RI banded at densities higher than that of component II, and material was present at all densities between that of supercoiled double-stranded DNA (component I) and component II. When RI that banded at different densities in EB-CsCl were examined in alkaline gradients, cosedimentation of parental DNA and newly replicated DNA did not occur. All newly replicated DNA sedimented more slowly than did intact single-stranded SV40 DNA, a finding that is inconsistent with the rolling circle model of DNA replication. An inverse correlation exists between the extent of replication of the SV40 DNA and the banding density in EB-CsCl. Under alkaline conditions, the parental DNA strands that were contained in the RI sedimented as covalently closed structures. The sedimentation rates in alkali of the covalently closed parental DNA decreased as replication progressed. Based on these observations, some possible models for replication of SV40 DNA are proposed.     

Pulsatile flow and oxygen transport past cylindrical fiber arrays for an artificial lung: computational and experimental studies

The influence of time-dependent flows on oxygen transport from hollow fibers was computationally and experimentally investigated. The fluid average pressure drop, a measure of resistance, and the work required by the heart to drive fluid past the hollow fibers were also computationally explored. This study has particular relevance to the development of an artificial lung, which is perfused by blood leaving the right ventricle and in some cases passing through a compliance chamber before entering the device. Computational studies modeled the fiber bundle using cylindrical fiber arrays arranged in in-line and staggered rectangular configurations. The flow leaving the compliance chamber was modeled as dampened pulsatile and consisted of a sinusoidal perturbation superimposed on a steady flow. The right ventricular flow was modeled to depict the period of rapid flow acceleration and then deceleration during systole followed by zero flow during diastole. Experimental studies examined oxygen transfer across a fiber bundle with either steady, dampened pulsatile, or right ventricular flow. It was observed that the dampened pulsatile flow yielded similar oxygen transport efficiency to the steady flow, while the right ventricular flow resulted in smaller oxygen transport efficiency, with the decrease increasing with Re. Both computations and experiments yielded qualitatively similar results. In the computational modeling, the average pressure drop was similar for steady and dampened pulsatile flows and larger for right ventricular flow while the pump work required of the heart was greatest for right ventricular flow followed by dampened pulsatile flow and then steady flow. In conclusion, dampening the artificial lung inlet flow would be expected to maximize oxygen transport, minimize work, and thus improve performance.     

Characterizing complex structural variation in germline and somatic genomes

Genome structural variation (SV) is a major source of genetic diversity in mammals and a hallmark of cancer. Although SV is typically defined by its canonical forms (duplication, deletion, insertion, inversion and translocation), recent breakpoint mapping studies have revealed a surprising number of 'complex' variants that evade simple classification. Complex SVs are defined by clustered breakpoints that arose through a single mutation but cannot be explained by one simple end-joining or recombination event. Some complex variants exhibit profoundly complicated rearrangements between distinct loci from multiple chromosomes, whereas others involve more subtle alterations at a single locus. These diverse and unpredictable features present a challenge for SV mapping experiments. Here, we review current knowledge of complex SV in mammals, and outline techniques for identifying and characterizing complex variants using next-generation DNA sequencing.     

Method of assessing the contribution of components of an anastomosing vascular network to total vascular impedance

The cerebral circulation has extensive communications between its four feeder arteries, their tributaries, and the extracerebral arteries. A theoretically derived method and its experimental verification is described by which the various impedances in a network can be quantified. It involved serial observations of pulsatile pressure, flow, and input impedance, in response to a pattern of input vessel occlusions. Fourier analysis permitted the response of the network to be studied for the component frequencies, so that linear and phasor algebra could be used to obtain a solution. Possible errors introduced by assumptions in the original model are minimal, and do not invalidate the method in practice.