Hemodynamic Conditions Alter Axial and Circumferential Remodeling of Arteries Engineered <Emphasis Type="Italic">Ex Vivo</Emphasis>

We previously demonstrated that growth and remodeling was stimulated in arteries elongated ex vivo using step increases in axial strain. Viability and vasoactivity were similar to fresh arteries, however there was a substantial decrease in the ultimate circumferential stress. To test the hypothesis that the subphysiological perfusion conditions (i.e., low pressure and flow) previously used caused the reduction, arteries were subjected to the identical elongation protocol (50% increase over 9 days) while being perfused with physiological levels of flow, viscosity and pulsatile pressure. A significant increase in unloaded length was achieved by elongation under both perfusion conditions, although the increase was less under physiological (7 ± 1%) than under subphysiological conditions (19 ± 2%, p < 0.005). When length at physiological stress was estimated using mechanical testing data the values were similar. The ultimate circumferential stress of arteries elongated under physiological conditions was increased (33%), whereas the ultimate axial stress was decreased (50%) as compared with arteries elongated under subphysiological conditions. Elongated arteries under both perfusion conditions showed significant increases in proliferation and collagen mass, and similar viability and appearance to fresh arteries. These data suggest that there is substantial cross-talk between perfusion conditions and axial strain that modulates arterial remodeling and length.     

Contractile Responses in Arteries Subjected to Hypertensive Pressure in Seven-Day Organ Culture

Early stage changes in hypertensive arteries have a significant effect on the long-term adaptation of the arteries. Compared to the long-term adaptation, little is known about the early dimensional and functional changes in hypertensive arteries in the first few days of hypertension. To study the early stage changes in hypertensive arteries, porcine common carotid arteries were cultured for seven days in a simplified ex vivo artery organ culture system with pulsatile flow under hypertensive (200±30 mm Hg) or normotensive (100±20 mm Hg) pressure conditions while maintaining a physiological mean wall shear stress of 15 dyn/cm².Vessel viability was demonstrated by contractile diameter responses to norepinephrine (NE), carbachol (CCh), and sodium nitroprusside (SNP) as well as staining for mitochondrial activity and cell apoptosis/necrosis. The results show that arteries demonstrated strong contractile responses to NE, CCh, and SNP, basal tone, and viable mitochondria in the organ culture system for seven days. Hypertensive arteries demonstrated a stronger contractile response than normotensive arteries (p < 0.05). Diameter enlargement was observed in hypertensive arteries as compared to arteries cultured under normotensive conditions. In conclusion, the pulsatile culture system can maintain arteries viable with active vasomotion tone for up to seven days. Hypertensive pressure causes arterial adaptation by significantly increasing arterial diameter and contractile response within the first seven days. © 2001 Biomedical Engineering Society. PAC01: 8719Uv, 8719Rr, 8780Rb     

Arterial Wall Adaptation under Elevated Longitudinal Stretch in Organ Culture

Arteries in vivo are subjected to large longitudinal stretch which may change significantly due to vascular disease and surgery. However, little is known about the effect of longitudinal stretch on vascular function and wall remodeling, although the effects of tensile and shear stress from blood pressure and flow have been well documented. To study the effect of longitudinal stretch on vascular function and wall remodeling, porcine carotid arteries were longitudinally stretched 20% more than in vivo for 5 days while being maintained in an ex vivo organ culture system under conditions of pulsatile flow at physiologic pressure. Vessel viability was demonstrated by strong vasomotor responses to norepinephrine (NE, 10^-6M), carbachol (10^-6M), and sodium nitroprusside (10^-5M), as well as by dense staining for mitochondrial activity and a low occurrence of cell necrosis. Cell proliferation was examined by incorporation of bromodeoxyuridine (BrdU). Results showed that arteries maintain normal structure and viability after 5 days in organ culture. Both the stretched and control arteries demonstrated significant contractile responses. For example, both stretched and control arteries showed approximately 10% diameter contraction in response to NE. Stretched arteries contained 8% BrdU-positive cells compared to 5% in controls (p < 0.05). These results indicate that longitudinal stretch promotes cell proliferation in arteries while maintaining arterial function. © 2003 Biomedical Engineering Society. PAC2003: 8719Rr, 8717Ee, 8719Uv     

Hemodynamics and axial strain additively increase matrix remodeling and MMP-9, but not MMP-2, expression in arteries engineered by directed remodeling

We previously demonstrated the ability to create engineered arteries by carefully controlling the mechanical environment of intact arteries perfused ex vivo, yielding engineered arteries with native appearance and vasoactive response. Increased axial strain was sufficient to increase length up to 20% in 9 days through a growth and remodeling response. The amount of the achievable length increase, however, was highly dependent on the hemodynamic conditions acting through unknown mechanisms. Because matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) activity is increased, and often required, in mechanically induced remodeling in vivo, MMP-2 and MMP-9 expression was investigated to elucidate the hemodynamic mediation of artery length. Carotid arteries from 30 kg pigs were perfused for 9 days ex vivo at either in situ axial strain or with a gradual 50% increase in axial strain, under either arterial or reduced hemodynamics ( approximately 10% of arterial hemodynamics). MMP-2 protein expression increased roughly twofold, while MMP-9 expression increased threefold under either reduced hemodynamics or increased axial strain (p < 0.05). The combination of reduced hemodynamics with increased axial strain demonstrated an additive increase in MMP-9 protein (p < 0.05) with no further change in MMP-2 expression. To investigate the mechanism by which axial strain and hemodynamics could additively increase MMP-9 expression, the expression of nuclear factor kappa B (NF-kappaB) subunits p50 and p65 was evaluated. Axial strain stimulated p65 expression and localization, while hemodynamics increased p50 expression, with both molecules being expressed only when both mechanical stimuli were applied. These data suggest that MMP-9 expression can be simultaneously stimulated by separate mechanical stimuli mediated by p50 and p65 expression, and that by using conditions that maximize MMP-9 expression, we can create an optimal remodeling environment to better direct the growth of engineered arteries and other tissues.     

Irreversible Changes in Glycosaminoglycan Composition of Anatomically Intact Bovine Articular Cartilage Induced by Intermittent Loading

The changes in matrix composition induced by 1 MPa intermittent (0.2 Hz) loading of anatomically intact bovine articular cartilage in vitro are studied. The kinetics of chondrocyte response was determined in experiments where sesamoid bones of adult cows were loaded for 0, 3, 5 and 7 days. The reversibility of the induced changes were studied in sesamoid bones that were loaded for 5 days and subsequently cultured without loading for another 1, 2 and 3 weeks. Water content was not affected by loading, nor by subsequent unloaded culture. Glycosaminoglycan content was not affected by loading, nor by subsequent unloaded culture for another 2 weeks. However, after 3 weeks of culture following 5 days of loading, a significant decrease in glycosaminoglycan content was found. Glycosaminoglycan synthesis was already increased after 3 days of loading. Loading for longer periods (5 and 7 days) further increased the glycosaminoglycan synthesis rate. Glycosaminoglycan synthesis decreased during the first week of subsequent culture without loading. In the third week it dropped to a lower level than observed for the control. The amount of 3-B-3(-) epitope was increased and the length of newly synthesized glycosaminoglycans was decreased by intermittent loading. Subsequent unloaded culture did not further increase the amount of 3-B-3(-) epitope. However, after 3 weeks of unloaded culture the newly synthesized glycosaminoglycans were as long as those synthesized in the control. The results suggest that the changes in glycosaminoglycan chain length were reversible. However, the overall chondrocyte response to our loading regime seems to be detrimental to the tissue: expression of 3-B-3(-) epitope induced by loading together with the drop in glycosaminoglycan content and synthesis observed at the end of the total culture period indicate that the cartilage is irreversibly damaged.     

Irreversible changes in glycosaminoglycan composition of anatomically intact bovine articular cartilage induced by intermittent loading

The changes in matrix composition induced by I MPa intermittent (0.2 Hz) loading of anatomically intact bovine articular cartilage in vitro are studied. The kinetics of chondrocyte response was determined in experiments where sesamoid bones of adult cows were loaded for 0, 3, 5 and 7 days. The reversibility of the induced changes were studied in sesamoid bones that were loaded for 5 days and subsequently cultured without loading for another 1, 2 and 3 weeks. Water content was not affected by loading, nor by subsequent unloaded culture. Glycosaminoglycan content was not affected by loading, nor by subsequent unloaded culture for another 2 weeks. However, after 3 weeks of culture following 5 days of loading, a significant decrease in glycosaminoglycan content was found. Glycosaminoglycan synthesis was already increased after 3 days of loading. Loading for longer periods (5 and 7 days) further increased the glycosaminoglycan synthesis rate. Glycosaminoglycan synthesis decreased during the first week of subsequent culture without loading. In the third week it dropped to a lower level than observed for the control. The amount of 3-B-3(-) epitope was increased and the length of newly synthesized glycosaminoglycans was decreased by intermittent loading. Subsequent unloaded culture did not further increase the amount of 3-B-3(-) epitope. However, after 3 weeks of unloaded culture the newly synthesized glycosaminoglycans were as long as those synthesized in the control. The results suggest that the changes in glycosaminoglycan chain length were reversible. However, the overall chondrocyte response to our loading regime seems to be detrimental to the tissue: expression of 3-B-3(-) epitope induced by loading together with the drop in glycosaminoglycan content and synthesis observed at the end of the total culture period indicate that the cartilage is irreversibly damaged.     

不同轴向伸长率下兔股动、静脉的顺应性变化

研究轴向应变对血管顺应性的影响 ,明确能否通过调节吻合张力建立顺应性一致的静脉移植修复动脉缺损模型。取一段做完轴向拉伸实验的血管 (兔股动、静脉分别为 13、12条 ) ,测量不同伸长率下的压力—容积曲线 ,换算为压力—标准容积曲线 ,用幂函数 P=M1 × [еM2 ( v- v0 ) - 1]进行拟合 ,用多项式 M=a1 λ5+a2 λ4 +a3λ3+aλ2 +a5λ+a6 拟合 M- λ数据。由 P=M1 × [еM2 ( v- v0 ) - 1]得出在动脉平均压 (11.78KPa)下血管顺应性 dv/ dp=1/ (M1 ×M2 +11.78M2 )。由张力 T与伸长率 λ的单值对应关系建立起 T与顺应性 dv/ dp的单值对应关系 ,发现在张力 1.19g时 ,在动脉平均压下 ,动静脉的顺应性一致 ,为 0 .0 31,其所对应的动静脉伸长率为 :1.6 7及 1.32     

Three-Dimensional Finite Element Analysis of Residual Stress in Arteries

Calculation of residual stress in arteries, using the analytical approach has been quite valuable in our understanding of its critical role in vascular mechanics. Stresses are calculated at the central section of an infinitely long tube by imposing a constant axial stretch while deforming the artery from the stress-free state to its unloaded state. However, segments used to perform opening-angle measurements have finite lengths. Further, the stress-free artery configuration is assumed to be circular. Experiments show that they are slightly noncircular. The numerical approach to residual stress calculation can allow us to study both these issues. Using 3D cylindrical geometries and an isotropic material model, we investigated how segment length can affect residual stress calculations and identified the appropriate segment length for experiments. Further, we recorded and used the true noncircular stress-free state of an artery segment, computed the residual stress distribution, and compared it to that from a similar, but circular segment. Our findings suggest that segment length must be ten times the wall thickness for it to be "long" enough. We also found that the circularity assumption may be a reasonable approximation for typical arteries.     

不同轴向伸长率下兔股动、静脉的顺应性变化

目的：探讨不同轴向伸长率下兔股动、静脉的顺应性变化,以及对临床修复血管损伤时方法选择的影响。方法：以兔正常股动、静脉血管标本为研究对象,通过血管压力－轴向应变试验及检测血管轴向伸长率,获取兔正常股动、静脉顺应性变化规律。结果：顺应性不仅与压力有关,而且同轴向伸长率有关,在内压强为动脉血压时,兔股动脉血管在伸长率为１．９时比其正常生理伸长率１．５８下的横截面积减少４０％。静脉也有相似变化规律。结论：     

The consequences of the mechanical environment of peripheral arteries for nitinol stenting

The use of stents in peripheral arteries has not been as successful as in coronary arteries, with high rates of restenosis and stent fracture common. Normal joint flexion induces a range of forces on the arteries, which has an unknown effect on the outcomes of stenting. The objective of this study is to determine how physiological levels of vessel bending and compression following stent implantation will influence the magnitude of stent stresses and hence the risks of fatigue fracture. A further objective is to compare how this mechanical environment will influence arterial stresses following implantation of either stainless steel or nitinol stents. To this end, models of both nitinol and stainless steel stents deployed in peripheral arteries were created, with appropriate loading conditions applied. At high levels of bending and compression, the strain amplitude threshold value for fatigue failure is exceeded for nitinol stents. Bending was predicted to induce high stresses in the artery following stenting, with higher arterial stresses predicted following implantation of a stainless steel stent compared to a nitinol stent. Both bending and compression may contribute to stent fracture by increasing the strain amplitude within the stent, with the dominant factor dependant on location within the arterial tree. For the specific stent types investigated in this study, the model predictions suggest that compression is the dominant mechanical factor in terms of stent fatigue in the femoral arteries, whereas bending is the most significant factor in the popliteal artery. To increase fatigue life and reduce arterial injury, location specific stent designs are required for peripheral arteries.     

Axial mechanical properties of arterial walls and their anisotropy

The axial deformation behaviour of arterial walls and their anisotropy were studied experimentally using abdominal aortas, common carotid arteries and femoral arteries obtained from mongrel dogs. These tubular specimens were stretched in the axial direction keeping the internal pressure at various levels. Main results obtained were: the strain rate dependency of axial mechanical behaviour is not observed in the range of 3×10⁻³ to 3×10⁻¹ per second; mechanical properties of arteries in the axial direction are dependent on the internal pressure applied; in the lower stress range, arterial walls are more extensible in the circumferential direction than in the axial direction, and an apposite trend occurs in the higher stress range; mechanical properties of arterial walls in the axial direction are expressed by the constitutive equations that we proposed in a previous paper.     

人体四肢正常动、静脉纵向残余应变与应力-应变关系

目的：探讨人体四肢正常动,静脉的纵向残余应变特性和应力－应变关系,以及对临床修复血管损伤时方法选择的影响。方法;以人体正常血管标本为研究对象,通过血管拉伸试验及检测血血管纵向伸长率,获取四肢正常的,动,静脉纵向残余应变及应力－应变变化规律。     

Arterial size determines the enhancement of contractile responses after suppression of endothelium-derived relaxing factor formation

We studied the effect of endothelium-derived relaxing factor (EDRF) on norepinephrine-induced contractile responses and on the tissue guanosine-3,5-phosphate (cGMP) concentration of isolated rabbit arteries with an increasing endothelium to smooth muscle cell ratio (aorta, femoral and mesenteric arteries). After suppression of EDRF formation (either by N ^G-nitro-l-arginine or, in mesenteric arteries, by saponin), contractions elicited by cumulative doses of norepinephrine were unaltered in aorta but were enhanced by 22.5% in femoral arteries and by 44.3% in mesenteric arteries (at the highest norepinephrine concentration). The cGMP concentration (pmol/mg protein) of unstimulated, endotheliumintact vessels decreased after suppression of EDRF formation from 1.09±0.24 to 0.74±0.28 in aortic, from 2.86±0.4 to 0.61±0.19 in femoral and from 6.3±0.9 to 0.7±0.15 in mesenteric arterial segments. The basal cGMP concentration did not differ in endothelium-denuded segments of these arteries, suggesting a similar basal activity of soluble guanylate cyclase (sGC). A higher sensitivity of sGC may have contributed to the higher cGMP concentration observed in the smaller arteries, since in the presence of sodium nitroprusside the cGMP concentration of endothelium-denuded segments increased 1.8-fold in aortic, 2.9-fold in femoral and 2.4 fold in mesenteric arterial segments. However, these differences in sGC activation cannot be solely responsible for the high basal cGMP concentration in endotheliumintact mesenteric arteries. The greater ratio of endothelium to smooth muscle cell layers in the smaller arteries might result in a higher EDRF concentration in the vascular wall and subsequently in a higher cGMP concentration. In conclusion, these data support the view of a greater importance of EDRF-mediated vascular control in small arteries than in large conduit arteries.     

Correlations between age, prestrain, diameter and atherosclerosis in the male abdominal aorta

The longitudinal prestrain of arteries facilitates their physiological function. Remodeling, adaptation and aging result in an age-dependent magnitude of the pretension. Although the phenomenon is known, detailed statistics, especially for human arteries, are lacking. This study was designed to propose the regression model capable of estimating the prestrain of the human abdominal aorta. The length of the abdominal aorta before, l, and after excision from the body, L, the diameter, heart weight, thickness of left ventricle and degree of atherosclerosis were collected in autopsies of 156 male cadavers of known age. Longitudinal prestrain was quantified by means of the stretch ratio λ=l/L. Statistical analysis revealed significant dependence between age, prestrain, diameter and atherosclerosis, which were best fitted to the power law equation. Longitudinal prestretch reduced with age significantly; λmean=1.30±0.07 for age<30 (n=29), whereas λmean=1.06±0.03 for age>59 (n=31) with p-value<0.0001. Raw data gave linear correlation coefficients as follows: λ-age (R=-0.842); l-age (R=0.023); L-age (R=0.476); (l-L)-age (R=-0.811). It was concluded that longitudinal prestrain decreases nonlinearly with age and both age and diameter are suitable predictors of the prestrain. Data suggests that unloaded length elongates with age in contrast to the elastic retraction.     

Augmented ventilatory activities after airway anaesthesia in humans

The effect of airway anaesthesia by nebulization of 4% lidocaine was studied in 14 healthy human subjects. After airway anaesthesia, a small but significant increase in forced vital capacity and a decrease in expiratory peak flow rate were observed in the pulmonary function test. Blood gas analysis revealed the appreciable depression in arterial oxygen tension. This change was accompanied by the increased alveolar/arterial oxygen tension difference (p less than 0.01) and increased oxygen uptake (p less than 0.01). Resting respiratory rate increased. Although minute ventilation was not changed, mouth occlusion pressure (P0.2) was significantly elevated. Hypercapnic ventilatory responses were augmented, both in terms of VE/PETCO2 and P0.2/PETCO2 slopes. The load compensation ratio, expressed as P0.2 loaded/P0.2 unloaded at rest, was reduced. These results suggested that preferential blockade of vagally mediated pulmonary stretch receptors by airway anaesthesia rather than the irritant receptors may have resulted in augmentation in ventilatory activities.     

Modifications by stretches of the mechanical response of isolated cerebral and extracerebral arteries to vasoactive agents

Summary Length-tension relationship was compared in helically cut strips of canine cerebral, coronary, mesenteric, renal, and femoral arteries. Tension developed progressively by increasing the stretch; with the same strain, a greater passive tension developed in cerebral than in extracerebral arteries. The peak active tension developed by serotonin (cerebral, coronary), norepinephrine (mesenteric, renal and femoral) or K⁺ (coronary) was obtained at a resting tension of 1.5 g (other than coronary) or 2.0 g (coronary). Papaverine (10^–4 M) caused a relaxation in cerebral arterial strips contracted with serotonin to a level lower than that prior to the addition of serotonin, the relexation from the initial level of tension being related directly to the stretch applied. The relaxing effect of adenosine was related directly to stretches of cerebral arterial strips. It seems likely that a rise of intra-arterial pressure effects a greater increase in the wall stiffness in cerebral than in extracerebral arteries. The responsiveness to vasoconstricting and vasodilating agents of both cerebral and extracerebral arteries appears to increase when the arteries are distended.     

正常大鼠不同动脉血管应力-应变分布的比较

通过充压实验和无载荷状态及零应力状态,我们研究了16只雄性大鼠的胸主动脉、腹主动脉、左颈总动脉、左股动脉和左肺动脉的形态学和应力－应变分布特征,并比较了不同血管间的差异。结果表明,血管的内外周长、管壁和管腔面积、管壁厚度、管壁厚度与内半径之比以及在不同压力负荷下血管外直径的变化,五条动脉之间有显著差异（P＜0.01）。展开角在肺动脉最大,而胸主动脉最小（P＜0.01）。残余应变绝对值和残余应变梯度在股动脉最大,而在胸主动脉最小（P＜0.01）。应力－应变关系分析证明,在周向上,股动脉最硬;在轴向上,胸主动脉最硬。而在这两个方向上,肺动脉最软。本实验表明,无论在形态学指数方面,还是在生物力学特征方面,五条动脉血管间都有显著差异。     

Should We Ignore What We Cannot Measure? How Non-Uniform Stretch,Non-Uniform Wall Thickness and Minor Side Branches Affect Computational Aortic Biomechanics in Mice

In order to advance the state-of-the-art in computational aortic biomechanics, we investigated the influence of (i) a non-uniform wall thickness, (ii) minor aortic side branches and (iii) a non-uniform axial stretch distribution on the location of predicted hotspots of principal strain in a mouse model for dissecting aneurysms. After 3 days of angiotensin II infusion, a murine abdominal aorta was scanned in vivo with contrast-enhanced micro-CT. The animal was subsequently sacrificed and its aorta was scanned ex vivo with phase-contrast X-ray tomographic microscopy (PCXTM). An automatic morphing framework was developed to map the non-pressurized, non-stretched PCXTM geometry onto the pressurized, stretched micro-CT geometry. The output of the morphing model was a structural FEM simulation where the output strain distribution represents an estimation of the wall deformation, not only due to the pressurization, but also due to the local axial stretch field. The morphing model also included minor branches and a mouse-specific wall thickness. A sensitivity study was then performed to assess the influence of each of these novel features on the outcome of the simulations. The results were supported by comparing the computed hotspots of principal strain to hotspots of early vascular damage as detected on PCXTM. Non-uniform axial stretch, non-uniform wall thickness and minor subcostal arteries significantly alter the locations of calculated hotspots of maximal principal strain. Even if experimental data on these features are often not available in clinical practice, one should be aware of the important implications that simplifications in the model might have on the final simulated result.     

Comparison of the effects of potassium and pH on the calibre of cerebral veins and arteries

The vasomotor responses of individual pial veins and arteries on the convexity of the cerebral cortex to perivascular microinjection of mock cerebrospinal fluid (CSF) containing various concentrations of potassium (K⁺) and of various pH (achieved by altering the bicarbonate, HCO ₃ ^– concentration) have been examined in cats anaesthetised with -chloralose.Microapplication of CSF containing 0 mM HCO ₃ ^– (pH 4.80) effected significant increases in calibre of pial veins and arteries of 9.3±2.4% and 38.2±4% respectively (mean calibre change ±SE), whereas CSF containing 22 mM HCO ₃ ^– (pH 7.45) which constricted pial arteries significantly (–18.5±2.9%) minimally altered venous calibre (–4.3 ±2.2%).Microapplication of CSF containing 0 mM potassium resulted in a significant reduction in pial arterial calibre (–11.4±2.8%) but failed to alter pial venous calibre (–0.3 ±0.6%). Perivascular microapplication of CSF containing moderately elevated potassium concentrations (10 mM) which effected marked, significant increases in pial arterial calibre (49.3±3.9%) did not significantly alter the calibre of the pial veins (mean response –1.6±2.4%). The perivascular administration of CSF containing a high concentration of potassium (40 mM) resulted in the significant constriction of both pial veins (–13.5±0.9%) and pial arteries (–47.2±6.3%). The magnitude of the response was significantly smaller in the pial veins.The relative insensitivity to K⁺ and pH of the pial veins as compared to pial arteries suggests that alteration in the chemical composition of the perivascular fluid are of lesser importance in the control of cerebrovascular capacitance than for the regulation of cerebrovascular resistance.