Pressure wave propagation in fluid-filled co-axial elastic tubes. Part 2: Mechanisms for the pathogenesis of syringomyelia

Our aim in this paper is to use a simple theoretical model of the intraspinal cerebrospinal-fluid system to investigate mechanisms proposed for the pathogenesis of syringomyelia. The model is based on an inviscid theory for the propagation of pressure waves in co-axial, fluid-filled, elastic tubes. According to this model, the leading edge of a pressure pulse tends to steepen and form an elastic jump, as it propagates up the intraspinal cerebrospinal-fluid system. We show that when an elastic jump is incident on a stenosis of the spinal subarachnoid space, it reflects to form a transient, localized region of high pressure within the spinal cord that for a cough-induced pulse is estimated to be 50 to 70 mm Hg or more above the normal level in the spinal subarachnoid space. We propose this as a new mechanism whereby pressure pulses created by coughing or sneezing can generate syrinxes. We also use the same analysis to investigate Williams' suck mechanism. Our results do not support his concept, nor, in cases where the stenosis is severe, the differential-pressure-propagation mechanism recently proposed by Greitz et al. Our analysis does provide some support for the piston mechanism recently proposed by Oldfield et al. and Heiss et al. For instance, it shows clearly how the spinal cord is compressed by the formation of elastic jumps over part of the cardiac cycle. What appears to be absent for this piston mechanism is any means whereby the elastic jumps can be focused (e.g., by reflecting from a stenosis) to form a transient, localized region of high pressure within the spinal cord. Thus it would seem to offer a mechanism for syrinx progression, but not for its formation.     

Pulse Wave Propagation in Elastic Tubes Having Longitudinal Changes in Area and Stiffness

The behavior of both step waves and sinusoidal waves in fluid-filled elastic vessels whose area and distensibility vary with distance is explored theoretically. It is shown that the behavior of these waves may be explained, to a large extent, by considering the effect of the continuous stream of infinitesimal reflections that is set up whenever any wave travels in a region of vessel where the local impedance, (that is, the ratio of elastic wavespeed to tube area) is not constant. It is found that in such vessels the behavior of sinusoidal waves over distances which are a fraction of a wavelength can be quite different from their average behavior over several wavelengths. Both behaviors are described analytically. The results are applied to the mammalian circulatory system, one of the most interesting results being that a longitudinal variation in the pressure and velocity amplitudes which has a wavelength roughly one-half that of standing waves is predicted. The treatment is essentially a linearized quasi-one-dimensional one, the major assumptions being that the fluid is inviscid, the mean flow is zero, and the vessel is perfectly elastic and constrained from motion in the longitudinal direction. As in the physiological situation, the ratio of fluid velocity to pulse propagation speed is assumed small. For comparison with the analytical results, the linearized equations are also solved numerically by computer.     

Wave Propagation in a Viscous Fluid Contained in an Orthotropic Elastic Tube

The problem of pressure wave propagation through a viscous fluid contained in an orthotropic elastic tube is considered in connection with arterial blood flow. Solutions to the fluid flow and elasticity equations are obtained for the presence of a reflected wave. Numerical results are presented for both isotropic and orthotropic elastic tubes. In particular, the pressure pulse, flow rate, axial fluid velocity, and wall displacements are plotted vs. time at various stations along the ascending aorta of man. The results indicate an increase in the peak value of the pressure pulse and a decrease in the flow rate as the pulse propagates away from the heart. Finally, the velocity of wave propagation depends mainly on the tangential modulus of elasticity of the arterial wall, and anisotropy of the wall accounts in part for the reduction of longitudinal movements and an increase in the hydraulic resistance.     

Wave Propagation through a Viscous Fluid Contained in a Tethered, Initially Stressed, Orthotropic Elastic Tube

To give a realistic representation of the pulse propagation in arteries a theoretical analysis of the wave propagation through a viscous incompressible fluid contained in an initially stressed elastic tube is considered. The tube is assumed to be orthotropic and its longitudinal motion is constrained by a uniformly distributed additional mass, a dashpot and a spring. The fluid is assumed to be Newtonian. The analysis is restricted to propagation of small amplitude harmonic waves whose wavelength is large compared to the radius of the vessel. Elimination of arbitrary constants from the general solutions of the equations of motion of the fluid and the wall gives a frequency equation to determine the velocity of propagation. Two roots of this equation give the velocity of propagation of two distinct outgoing waves. One of the waves propagates slower than the other. The propagation properties of s lower waves are very slightly affected by the degree of anisotropy of the wall. The velocity of propagation of faster waves decreases as the ratio of the longitudinal modulus of elasticity to the circumferential modulus decreases; transmission of these waves is very little affected. The influence of the tethering on the propagation velocity of slower waves is negligibly small; transmission of these waves is seriously affected. In tethered tubes faster waves are completely attenuated.     

Wave Propagation through a Viscous Incompressible Fluid Contained in an Initially Stressed Elastic Tube

To have a better understanding of the flow of blood in arteries a theoretical analysis of the pressure wave propagation through a viscous incompressible fluid contained in an initially stressed tube is considered. The fluid is assumed to be Newtonian. The tube is taken to be elastic and isotropic. The analysis is restricted to tubes with thin walls and to waves whose wavelengths are very large compared with the radius of the tube. It is further assumed that the amplitude of the pressure disturbance is sufficiently small so that nonlinear terms of the inertia of the fluid are negligible compared with linear ones. Both circumferential and longitudinal initial stresses are considered; however, their origins are not specified. Initial stresses enter equations as independent parameters. A frequency equation, which is quadratic in the square of the propagation velocity is obtained. Two out of four roots of this equation give the velocity of propagation of two distinct outgoing waves. The remaining two roots represent incoming waves corresponding to the first two waves. One of the waves propagates more slowly than the other. As the circumferential and/or longitudinal stress of the wall increases, the velocity of propagation and transmission per wavelength of the slower wave decreases. The response of the fast wave to a change in the initial stress is on the opposite direction.     

One-dimensional model for propagation of a pressure wave in a model of the human arterial network: comparison of theoretical and experimental results

Pulse wave evaluation is an effective method for arteriosclerosis screening. In a previous study, we verified that pulse waveforms change markedly due to arterial stiffness. However, a pulse wave consists of two components, the incident wave and multireflected waves. Clarification of the complicated propagation of these waves is necessary to gain an understanding of the nature of pulse waves in vivo. In this study, we built a one-dimensional theoretical model of a pressure wave propagating in a flexible tube. To evaluate the applicability of the model, we compared theoretical estimations with measured data obtained from basic tube models and a simple arterial model. We constructed different viscoelastic tube set-ups: two straight tubes; one tube connected to two tubes of different elasticity; a single bifurcation tube; and a simple arterial network with four bifurcations. Soft polyurethane tubes were used and the configuration was based on a realistic human arterial network. The tensile modulus of the material was similar to the elasticity of arteries. A pulsatile flow with ejection time 0.3 s was applied using a controlled pump. Inner pressure waves and flow velocity were then measured using a pressure sensor and an ultrasonic diagnostic system. We formulated a 1D model derived from the Navier-Stokes equations and a continuity equation to characterize pressure propagation in flexible tubes. The theoretical model includes nonlinearity and attenuation terms due to the tube wall, and flow viscosity derived from a steady Hagen-Poiseuille profile. Under the same configuration as for experiments, the governing equations were computed using the MacCormack scheme. The theoretical pressure waves for each case showed a good fit to the experimental waves. The square sum of residuals (difference between theoretical and experimental wave-forms) for each case was <10.0%. A possible explanation for the increase in the square sum of residuals is the approximation error for flow viscosity. However, the comparatively small values prove the validity of the approach and indicate the usefulness of the model for understanding pressure propagation in the human arterial network.     

Measurements of wave speed and reflected waves in elastic tubes and bifurcations

Wave intensity analysis is a time domain method for studying waves in elastic tubes. Testing the ability of the method to extract information from complex pressure and velocity waveforms such as those generated by a wave passing through a mismatched elastic bifurcation is the primary aim of this research. The analysis provides a means for separating forward and backward waves, but the separation requires knowledge of the wave speed. The PU-loop method is a technique for determining the wave speed from measurements of pressure and velocity, and investigating the relative accuracy of this method is another aim of this research.We generated a single semi-sinusoidal wave in long elastic tubes and measured pressure and velocity at the inlet, and pressure at the exit of the tubes. In our experiments, the results of the PU-loop and the traditional foot-to-foot methods for determining the wave speed are comparable and the difference is on the order of 2.9+/-0.8%. A single semi-sinusoidal wave running through a mismatched elastic bifurcation generated complicated pressure and velocity waveforms. By using wave intensity analysis we have decomposed the complex waveforms into simple information of the times and magnitudes of waves passing by the observation site.We conclude that wave intensity analysis and the PU-loop method combined, provide a convenient, time-based technique for analysing waves in elastic tubes.     

Peaking of the Pressure Pulse in Fluid-Filled Tubes of Spatially Varying Compliance

Calculations are made for a fluid-filled tube with characteristics approximately those found physiologically. The pressure variation, diameter, and compliance at the input end are as measured by Lawton for the abdominal aorta of a dog. After a 30 cm-long input section of constant k (=dp/dA), the tube is taken to stiffen by approximately the amount measured by Patel et al., i.e., k increases by a factor of 5 over the next 40 cm. The cross-section remains constant. Pressure and velocity wave forms are calculated at 8 stations spaced at 10-cm intervals down the tube. The pressure pulse leading edge is found to become steeper in the stiffening section. The peak height of the pressure pulse is found to increase by about 50% and the velocity pulse to decrease by about 30% as the disturbance propagates over a distance of 70 cm. These values agree qualitatively with the experimental physiological values given by McDonald. Most of the pressure peaking takes place upstream of the stiffening section.     

Syrinx fluid transport: modeling pressure-wave-induced flux across the spinal pial membrane

Syrinxes are fluid-filled cavities of the spinal cord that characterize syringomyelia, a disease involving neurological damage. Their formation and expansion is poorly understood, which has hindered successful treatment. Syrinx cavities are hydraulically connected with the spinal subarachnoid space (SSS) enveloping the spinal cord via the cord interstitium and the network of perivascular spaces (PVSs), which surround blood vessels penetrating the pial membrane that is adherent to the cord surface. Since the spinal canal supports pressure wave propagation, it has been hypothesized that wave-induced fluid exchange across the pial membrane may play a role in syrinx filling. To investigate this conjecture a pair of one-dimensional (1-d) analytical models were developed from classical elastic tube theory coupled with Darcy's law for either perivascular or interstitial flow. The results show that transpial flux serves as a mechanism for damping pressure waves by alleviating hoop stress in the pial membrane. The timescale ratio over which viscous and inertial forces compete was explicitly determined, which predicts that dilated PVS, SSS flow obstructions, and a stiffer and thicker pial membrane-all associated with syringomyelia-will increase transpial flux and retard wave travel. It was also revealed that the propagation of a pressure wave is aided by a less-permeable pial membrane and, in contrast, by a more-permeable spinal cord. This is the first modeling of the spinal canal to include both pressure-wave propagation along the spinal axis and a pathway for fluid to enter and leave the cord, which provides an analytical foundation from which to approach the full poroelastic problem.     

A one-dimensional model of the spinal cerebrospinal-fluid compartment

Modeling of the cerebrospinal fluid (CSF) system in the spine is strongly motivated by the need to understand the origins of pathological conditions such as the emergence and growth of fluid-filled cysts in the spinal cord. In this study, a one-dimensional (1D) approximation for the flow in elastic conduits was used to formulate a model of the spinal CSF compartment. The modeling was based around a coaxial geometry in which the inner elastic cylinder represented the spinal cord, middle elastic tube represented the dura, and the outermost tube represented the vertebral column. The fluid-filled annuli between the cord and dura, and the dura and vertebral column, represented the subarachnoid and epidural spaces, respectively. The system of governing equations was constructed by applying a 1D form of mass and momentum conservation to all segments of the model. The developed 1D model was used to simulate CSF pulse excited by pressure disturbances in the subarachnoid and epidural spaces. The results were compared to those obtained from an equivalent two-dimensional finite element (FE) model which was implemented using a commercial software package. The analysis of linearized governing equations revealed the existence of three types of waves, of which the two slower waves can be clearly related to the wave modes identified in previous similar studies. The third, much faster, wave emanates directly from the vertebral column and has little effect on the deformation of the spinal cord. The results obtained from the 1D model and its FE counterpart were found to be in good general agreement even when sharp spatial gradients of the spinal cord stiffness were included; both models predicted large radial displacements of the cord at the location of an initial cyst. This study suggests that 1D modeling, which is computationally inexpensive and amenable to coupling with the models of the cranial CSF system, should be a useful approach for the analysis of some aspects of the CSF dynamics in the spine. The simulation of the CSF pulse excited by a pressure disturbance in the epidural space, points to the possibility that regions of the spinal cord with abnormally low stiffness may be prone to experiencing large strains due to coughing and sneezing.     

Experimental study of finite amplitude pulsatile pressure waves in elastic tubes

An experimental study of the propagation of pulsatile pressure waves in an elastic tube was made and results were compared to a theoretical analysis by Lou. The pressure waves were sinusoidally varying acting in a horizontal, longitudinally constrained tube containing water. The independent experimental parameters varied were the pressure wave frequency, pressure wave volume per cycle, static tube pressure and steady flow rate. The wave propagation speeds, measured by non-intrusive techniques, were found to be functions of the wave frequency and the phase angles of the wave elements as theoretically predicted by Lou.     

Anisotropic propagation of Ca2+ waves in isolated cardiomyocytes.

Digital imaging microscopy of fluor-3 fluorescence was used to study the propagation of intracellular Ca2+ waves in isolated adult rat cardiomyocytes from 17 to 37 degrees C. Ca2+ waves spread in both transverse and longitudinal direction of a myocyte. Transverse propagation was pronounced in waves starting from a focus at the edge of a myocyte and in waves following an irregular, curved path (spiral waves). For the former type of waves, propagation velocities were determined. Both transverse and longitudinal wave components propagated at constant velocity ranging from 30 to 125 micron/s. Myocytes were anisotropic with respect to wave propagation: waves propagated faster in the longitudinal than in the transverse direction. The ratio between longitudinal and transverse velocity increased from 1.30 at 17 degrees C to 1.55 at 37 degrees C. Apparent activation energies for transverse and longitudinal wave propagation were estimated to be -20 kJ/mol, suggesting that these processes are limited by diffusion of Ca2+. Direction-dependent propagation velocities are interpreted to result from the highly ordered structure of the myocytes, especially from the anisotropic arrangement of diffusion obstacles such as myofilaments and mitochondria.     

Mechanics of blood flow

The historical development of the mechanics of blood flow can be traced from ancient times, to Leonardo da Vinci and Leonhard Euler and up to the present times with increasing biological knowledge and mathematical analysis. In the last two decades, quantitative and numerical methods have steadily given more complete and precise understanding. In the arterial system wave propagation computations based on nonlinear one-dimensional modeling have given the best representation of pulse wave propagation. In the veins, the theory of unsteady flow in collapsible tubes has recently been extensively developed. In the last decade, progress has been made in describing the blood flow at junctions, through stenoses, in bends and in capillary blood vessels. The rheological behavior of individual red blood cells has been explored. A working model consists of an elastic membrane filled with viscous fluid. This model forms a basis for understanding the viscous and viscoelastic behavior of blood.     

Longitudinal elastic wave propagation in pulmonary parenchyma

Consideration of the lung as an elastic continuum led us to investigate the possible propagation of elastic waves. Here the relevant stiffness and density are given by the Lamé constants and density of the parenchyma. To test this hypothesis, we measured propagation velocities (c) in dog lobes by recording transit times of a velocity impulse on one side of the lobe and the subsequent arrival on the other side. We compared our measured values of c with elastic longitudinal wave velocities (c long) predicted by values of elastic moduli given by Lai-Fook et al. (J. Appl. Physiol. 40: 508-513, 1976) as a function of translobar pressure (PL) and our measured densities. Good agreement was found between c and c long. Typical values of c ranged from 250-1,500 cm/s as PL ranged from 2-20 cmH2O. No systematic difference in the c-c long relation was found between inflation and deflation, suggesting that the elastic moduli of lungs are essentially a function of pressure. No significant effect was observed by changing the physical properties of the gas within the lobe [air vs. He vs. sulfur hexafluoride (SF6)], suggesting that indeed we were observing waves associated with the coupling of parenchymal density to parenchymal stiffness.     

Wave propagation in a model of the arterial circulation

The propagation of the arterial pulse wave in the large systemic arteries has been calculated using a linearised method of characteristics analysis to follow the waves generated by the heart. The model includes anatomical and physiological data for the 55 largest arteries adjusted so that the bifurcating tree of arteries is well matched for forward travelling waves. The peripheral arteries in the model are terminated by resistance elements which are adjusted to produce a physiologically reasonable distribution of mean blood flow. In the model, the pressure and velocity wave generated by the contraction of the left ventricle propagates to the periphery where it is reflected. These reflected waves are re-reflected by each of the bifurcations that they encounter and a very complex pattern of waves is generated. The results of the calculations exhibit many of the features of the systemic arteries, including the increase of the pulse pressure with distance away from the heart as well as the initial decrease and then the large increase in the magnitude of back flow during late systole going from the ascending aorta to the abdominal aorta to the arteries of the leg. The model is then used to study the effects of the reflection or absorption of waves by the heart and the mechanisms leading to the incisura are investigated. Calculations are carried out with the total occlusion of different arterial segments in order to model experiments in which the effects of the occlusion of different arteries on pressure and flow in the ascending aorta were measured. Finally, the effects of changes in peripheral resistance on pressure and velocity waveforms are also studied. We conclude from these calculations that the complex pattern of wave propagation in the large arteries may be the most important determinant of arterial haemodynamics.     

Scaling phloem transport: elasticity and pressure-concentration waves

Earlier theoretical analyses of the rate of propagation of pressure-concentration waves in the phloem were performed without adequate attention to the elastic expansion of sieve tube walls. Here, it is shown that the rate of propagation of pressure-concentration waves in phloem sieve tubes is not significantly impeded by wall elasticity, but rather, as previously implicated, by the ratio of sap osmotic pressure to the axial drop in sap hydrostatic pressure. It is also shown that pressure-concentration waves move equally well in both the upstream and downstream directions. These results permit future models to ignore elastic effects, and lend additional theoretical support to the "osmoregulatory flow" hypothesis, which argues that efficient molecular control of the phloem is permitted by maintaining sieve sap hydrostatic pressure at a value that is spatially nearly constant, which in turn permits changes in sieve tube state to be rapidly transmitted throughout the sieve tube via pressure-concentration waves.     

Wave dissipation in flexible tubes in the time domain: in vitro model of arterial waves

Earlier work of wave dissipation in flexible tubes and arteries has been carried out predominantly in the frequency domain and most of the studies used the measured pressure waveform for presenting the results. In this work we investigate the pattern of wave dissipation in the time domain using the separated forward and backward travelling waves in flexible tubes. We tested four sizes of latex tubes of 2m in length each, where a single semi-sinusoidal in shape, pressure wave, was produced at the inlet of each tube. Simultaneous measurements of pressure and flow waveforms were recorded every 5cm along the tubes and wave speed was determined using the pressure-velocity loop method (PU-loop). The measured data and wave speed were used to separate the pressure waveform and wave intensity, into their forward and backward directions, using wave intensity analysis (WIA). Also, the energy carried by the wave was calculated by integrating the relevant area under the wave intensity curve. The peak of the measured pressure waveform increased downstream, however, the peak of the separated forward pressure waveform decreased exponentially along the tube. Wave intensity and energy also dissipated exponentially along the travelling distance. The peaks of the separated pressure and wave intensity decreased in the forward in a similar exponential way to that in the backward direction in all four tube sizes. Also, the smaller the size of the tube the greater wave dissipation it caused. We conclude that wave separation is useful in studying wave dissipation in elastic tubes, and WIA provides a convenient method for determining the dissipation of the energy carried by the wave along the travelled distance. The separated pressure waveform, wave intensity and wave energy dissipate exponentially with the travelling distance, and wave dissipation varies conversely with the diameter of elastic tubes.     

Linear propagation of pulsatile waves in viscoelastic tubes

An experimental and theoretical analysis is made of pulsatile wave propagation in deformable latex tubes as a model of the propagation of pressure pulses in arteries. A quasi one-dimensional linear model is used in which, in particular, attention is paid to the viscous phenomena in fluid and tube wall. The agreement between experimental and theoretical results is satisfactory. It appeared that the viscoelastic behaviour of the tube wall dominates the damping of the pressure pulse. Several linear models are used to describe the wall behaviour. No significant differences between the results of these models were found.     

Propagation of stress waves in inflated sheep lungs

If the lung is an elastic continuum, both longitudinal and transverse stress waves should be propagated in the medium with distinct velocities. In five isolated sheep lungs, we investigated the propagation of stress waves. The lungs were degassed and then inflated to a constant transpulmonary pressure (Ptp). We measured signals transmitted at locations approximately 1.5, 6, and 11 cm from an impulse surface distortion with the use of small microphones embedded in the pleural surface. Two transit times were computed from the first two significant peaks of the cross-correlation of microphone signal pairs. The "fast" wave velocities averaged 301 +/- 92, 445 +/- 80, and 577 +/- 211 (SD) cm/s for Ptp values of 5, 10, and 15 cmH2O, respectively. Corresponding "slow" wave velocities averaged 139 +/- 22, 217 +/- 36, and 255 +/- 89 cm/s. The fast waves were consistent with longitudinal waves of velocity [(K + 4G/3)/p]1/2, where bulk modulus K = 4 Ptp and shear modulus G = 0.7 Ptp. The slow waves were consistent with transverse (and/or Rayleigh) waves of velocity (G/p)1/2, with a G value of 0.9 Ptp. Measured values of K were 5 Ptp and values of G measured by indentation tests were 0.7 Ptp. Thus, stress wave velocities measured on pleural surface of isolated lungs correlated well with elastic moduli of lung parenchyma.