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The effect of the elongation of the proximal aorta on the estimation of the aortic wall distensibility

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Abstract
The compliance of the proximal aortic wall is a major determinant of cardiac afterload. Aortic compliance is often estimated based on cross-sectional area changes over the pulse pressure, under the assumption of a negligible longitudinal stretch during the pulse. However, the proximal aorta is subjected to significant axial stretch during cardiac contraction. In the present study, we sought to evaluate the importance of axial stretch on compliance estimation by undertaking both an in silico and an in vivo approach. In the computational analysis, we developed a 3-D finite element model of the proximal aorta and investigated the discrepancy between the actual wall compliance to the value estimated after neglecting the longitudinal stretch of the aorta. A parameter sensitivity analysis was further conducted to show how increased material stiffness and increased aortic root motion might amplify the estimation errors (discrepancies between actual and estimated distensibility ranging from - 20 to - 62%). Axial and circumferential aortic deformation during ventricular contraction was also evaluated in vivo based on MR images of the aorta of 3 healthy young volunteers. The in vivo results were in good qualitative agreement with the computational analysis (underestimation errors ranging from - 26 to - 44%, with increased errors reflecting higher aortic root displacement). Both the in silico and in vivo findings suggest that neglecting the longitudinal strain during contraction might lead to severe underestimation of local aortic compliance, particularly in the case of women who tend to have higher aortic root motion or in subjects with stiff aortas.
Keywords
ELASTIC PROPERTIES, ROOT MOTION, AGE, STIFFNESS, FRAMEWORK, SUPPORT, STRESS, Cross-sectional area compliance, Axial stretch, Proximal aorta, Finite, element analysis

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MLA
Pagoulatou, Stamatia Z., et al. “The Effect of the Elongation of the Proximal Aorta on the Estimation of the Aortic Wall Distensibility.” BIOMECHANICS AND MODELING IN MECHANOBIOLOGY, 2020, doi:10.1007/s10237-020-01371-y.
APA
Pagoulatou, S. Z., Ferraro, M., Trachet, B., Bikia, V., Rovas, G., Crowe, L. A., … Stergiopulos, N. (2020). The effect of the elongation of the proximal aorta on the estimation of the aortic wall distensibility. BIOMECHANICS AND MODELING IN MECHANOBIOLOGY. https://doi.org/10.1007/s10237-020-01371-y
Chicago author-date
Pagoulatou, Stamatia Z., Mauro Ferraro, Bram Trachet, Vasiliki Bikia, Georgios Rovas, Lindsey A. Crowe, Jean-Paul Vallee, Dionysios Adamopoulos, and Nikolaos Stergiopulos. 2020. “The Effect of the Elongation of the Proximal Aorta on the Estimation of the Aortic Wall Distensibility.” BIOMECHANICS AND MODELING IN MECHANOBIOLOGY. https://doi.org/10.1007/s10237-020-01371-y.
Chicago author-date (all authors)
Pagoulatou, Stamatia Z., Mauro Ferraro, Bram Trachet, Vasiliki Bikia, Georgios Rovas, Lindsey A. Crowe, Jean-Paul Vallee, Dionysios Adamopoulos, and Nikolaos Stergiopulos. 2020. “The Effect of the Elongation of the Proximal Aorta on the Estimation of the Aortic Wall Distensibility.” BIOMECHANICS AND MODELING IN MECHANOBIOLOGY. doi:10.1007/s10237-020-01371-y.
Vancouver
1.
Pagoulatou SZ, Ferraro M, Trachet B, Bikia V, Rovas G, Crowe LA, et al. The effect of the elongation of the proximal aorta on the estimation of the aortic wall distensibility. BIOMECHANICS AND MODELING IN MECHANOBIOLOGY. 2020;
IEEE
[1]
S. Z. Pagoulatou et al., “The effect of the elongation of the proximal aorta on the estimation of the aortic wall distensibility,” BIOMECHANICS AND MODELING IN MECHANOBIOLOGY, 2020.
@article{8671910,
  abstract     = {The compliance of the proximal aortic wall is a major determinant of cardiac afterload. Aortic compliance is often estimated based on cross-sectional area changes over the pulse pressure, under the assumption of a negligible longitudinal stretch during the pulse. However, the proximal aorta is subjected to significant axial stretch during cardiac contraction. In the present study, we sought to evaluate the importance of axial stretch on compliance estimation by undertaking both an in silico and an in vivo approach. In the computational analysis, we developed a 3-D finite element model of the proximal aorta and investigated the discrepancy between the actual wall compliance to the value estimated after neglecting the longitudinal stretch of the aorta. A parameter sensitivity analysis was further conducted to show how increased material stiffness and increased aortic root motion might amplify the estimation errors (discrepancies between actual and estimated distensibility ranging from - 20 to - 62%). Axial and circumferential aortic deformation during ventricular contraction was also evaluated in vivo based on MR images of the aorta of 3 healthy young volunteers. The in vivo results were in good qualitative agreement with the computational analysis (underestimation errors ranging from - 26 to - 44%, with increased errors reflecting higher aortic root displacement). Both the in silico and in vivo findings suggest that neglecting the longitudinal strain during contraction might lead to severe underestimation of local aortic compliance, particularly in the case of women who tend to have higher aortic root motion or in subjects with stiff aortas.},
  author       = {Pagoulatou, Stamatia Z. and Ferraro, Mauro and Trachet, Bram and Bikia, Vasiliki and Rovas, Georgios and Crowe, Lindsey A. and Vallee, Jean-Paul and Adamopoulos, Dionysios and Stergiopulos, Nikolaos},
  issn         = {1617-7959},
  journal      = {BIOMECHANICS AND MODELING IN MECHANOBIOLOGY},
  keywords     = {ELASTIC PROPERTIES,ROOT MOTION,AGE,STIFFNESS,FRAMEWORK,SUPPORT,STRESS,Cross-sectional area compliance,Axial stretch,Proximal aorta,Finite,element analysis},
  language     = {eng},
  pages        = {13},
  title        = {The effect of the elongation of the proximal aorta on the estimation of the aortic wall distensibility},
  url          = {http://dx.doi.org/10.1007/s10237-020-01371-y},
  year         = {2020},
}

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