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- American Journal of Physiology. Heart and Circulatory Physiology
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- American Journal of Physiology. Heart and Circulatory Physiology
- Biomechanics and Modeling in Mechanobiology
- Annals of Biomedical Engineering
- Lab on a Chip
- Journal of Biomechanics
- Biomechanics and Modeling in Mechanobiology
- European Journal of Obstetrics, Gynecology, and Reproductive Biology
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- Respiratory Physiology & Neurobiology
- Annals of Biomedical Engineering
- Annals of Biomedical Engineering
- Journal of Biomechanics
- American Journal of Physiology. Heart and Circulatory Physiology
- American Journal of Physiology. Heart and Circulatory Physiology
- The International Journal of Developmental Biology
- Journal of Applied Physiology (Bethesda, Md. : 1985)
- Pulmonary Circulation
- Journal of Biomechanics
- Biomechanics and Modeling in Mechanobiology
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Articles by Naomi C. Chesler in JoVE
JoVE General
Karakterisering van de geïsoleerde, geventileerde en Instrumented Mouse Lung geperfuseerd met pulsatiele flow
Department of Biomedical Engineering, University of Wisconsin – Madison
Het volgende protocol schetst het proces van isoleren, ventileren en instrumenteren muis longen stabiel of pulsatiele pulmonale vasculaire druk-flow relaties maatregel om de effecten van de bloedstroom, luchtstroom, luchtweg veranderingen en vasculaire veranderingen op rechter ventrikel afterload kwantificeren.
Other articles by Naomi C. Chesler on PubMed
Effects of Ischemia and Myogenic Activity on Active and Passive Mechanical Properties of Rat Cerebral Arteries
Passive (papaverine induced) and active (spontaneous pressure induced) biomechanical properties of ischemic and nonischemic rat middle cerebral arteries (MCAs) were studied under pressurized conditions in vitro. Ischemic (1 h of occlusion), contralateral, and sham-operated control MCAs were isolated from male Wistar rats (n = 22) and pressurized using an arteriograph system that allowed control of transmural pressure (TMP) and measurement of lumen diameter and wall thickness. Three mechanical stiffness parameters were computed: overall passive stiffness (beta), pressure-dependent modulus changes (E(inc,p)), and smooth muscle cell (SMC) activity-dependent changes (E(inc,a)). The beta-value for ischemic vessels was increased compared with sham vessels (13.9 +/- 1.7 vs. 9.1 +/- 1.4, P < 0.05), indicating possible short-term remodeling due to ischemia. E(inc,p) increased with pressure in the passive vessels (P < 0.05) but remained relatively constant in the active vessels for all vessel types, indicating that pressure-induced SMC contractile activity (i.e., myogenic reactivity) in cerebral arteries leads to the maintenance of a constant elastic modulus within the autoregulatory pressure range. E(inc,a) increased with pressure for all conditions, signifying that changes in stiffness are influenced by SMC activity and vascular tone.
Particle Deposition in Arteries Ex Vivo: Effects of Pressure, Flow, and Waveform
The goal of this study was to quantify the effect of hemodynamic pressure, flow and waveform perturbations on the deposition of protein-sized particles in porcine carotid arteries ex vivo. An ex vivo perfusion system was used to control the pressure and flow environment for excised arterial tissue. Confocal laser microscopy images revealed that 200 nm particles were deposited intimally and that more spheres were evident along vessels perfused under oscillatory waveform conditions than all others. Under all pressure, flow and waveform conditions, particles were excluded from the media and adventitia of the vessel wall. The steady flow data support the use of Darcy's Law with pressure-dependent hydraulic permeability to model arterial tissue.
Mechanical Properties of Rat Middle Cerebral Arteries with and Without Myogenic Tone
The inner diameter and wall thickness of rat middle cerebral arteries (MCAs) were measured in vitro in both a pressure-induced, myogenically-active state and a drug-induced, passive state to quantify active and passive mechanical behavior. Elasticity parameters from the literature (stiffness derived from an exponential pressure-diameter relationship, beta, and elasticity in response to an increment in pressure, Einc-p) and a novel elasticity parameter in response to smooth muscle cell (SMC) activation, Einc-a, were calculated. beta for all passive MCAs was 9.11 +/- 1.07 but could not be calculated for active vessels. The incremental stiffness increased significantly with pressure in passive vessels; Einc-p (10(6) dynes/cm2) increased from 5.6 +/- 0.5 at 75 mmHg to 14.7 +/- 2.4 at 125 mmHg, (p < 0.05). In active vessels, Einc-p (10(6) dynes/cm2) remained relatively constant (5.5 +/- 2.4 at 75 mmHg and 6.2 +/- 1.0 at 125 mmHg). Einc-a (10(6) dynes/cm2) increased significantly with pressure (from 15.1 +/- 2.3 at 75 mmHg to 49.4 +/- 12.6 at 125 mmHg, p < 0.001), indicating a greater contribution of SMC activity to vessel wall stiffness at higher pressures.
Measurements of Mouse Pulmonary Artery Biomechanics
Robust techniques for characterizing the biomechanical properties of mouse pulmonary arteries will permit exciting gene-level hypotheses regarding pulmonary vascular disease to be tested in genetically engineered animals. In this paper, we present the first measurements of the biomechanical properties of mouse pulmonary arteries.
Linked Mechanical and Biological Aspects of Remodeling in Mouse Pulmonary Arteries with Hypoxia-induced Hypertension
Right heart failure due to pulmonary hypertension causes significant morbidity and mortality. To study the linked vascular mechanical and biological changes that are induced by pulmonary hypertension, we mechanically tested isolated left main pulmonary arteries from mice exposed to chronic hypobaric hypoxia and performed histological assays on contralateral vessels. In isolated vessel tests, hypoxic vessels stretched less in response to pressure than controls at all pressure levels. Given the short length and large diameter of the pulmonary artery, the tangent Young's modulus could not be measured; instead, an effective elastic modulus was calculated that increased significantly with hypoxia [(280 kPa (SD 53) and 296 kPa (SD 50) for 10 and 15 days, respectively, vs. 222 kPa (SD 35) for control; P < 0.02)]. Hypoxic vessels also had higher damping coefficients [(0.063 (SD 0.017) and 0.054 (SD 0.014) for 10 and 15 days, respectively, vs. 0.033 (SD 0.016) for control; P < 0.002)], indicating increased energy dissipation. The increased stiffness with hypoxia correlated with an increase in collagen thickness (percent collagen multiplied by wall thickness) as well as the sum of elastin and collagen thicknesses measured histologically in the artery wall. These results highlight the mechanobiological changes in the pulmonary vasculature that occur in response to hypoxia-induced pulmonary hypertension. Furthermore, they demonstrate significant vascular mechanical and biological changes that would increase pulmonary vascular impedance, leading to right heart failure.
The Mechanobiology of Pulmonary Vascular Remodeling in the Congenital Absence of ENOS
Primary pulmonary hypertension is a rare but deadly disease. Lungs extracted from PPH patients are deficient in endothelial nitric oxide synthase (eNOS), making the eNOS-null mouse a potentially useful model of the disease. To better understand the progression of pulmonary vascular remodeling in the congenital absence of eNOS, we induced pulmonary hypertension in eNOS-null mice using hypobaric hypoxia, and then quantified large artery structure and function in contralateral vessels. In particular, to assess structure we quantified diameter, wall thickness, and collagen, elastin and smooth muscle cell content; to quantify function we performed pressure-diameter tests. After remodeling, the pulmonary arteries had increased wall, collagen and elastin thicknesses compared to controls (P<0.05). The remodeled pulmonary arteries also had increased elastic moduli at low and high strains compared to controls (P<0.05). The increases in moduli at low and high strain correlated with increases in elastin and collagen thickness, respectively (P<0.05). These results provide insight into the mechanobiology of pulmonary vascular remodeling in the congenital absence of eNOS, and the coupled nature of these changes.
Pulmonary Vascular Resistance and Impedance in Isolated Mouse Lungs: Effects of Pulmonary Emboli
To study pulsatile pressure-flow rate relationships in the intact pulmonary vascular network of mice, we developed a protocol for measuring pulmonary vascular resistance and impedance in isolated, ventilated, and perfused mouse lungs. We used pulmonary emboli to validate the effect of vascular obstruction on resistance and impedance. Main pulmonary artery and left atrial pressures and pulmonary vascular flow rate were measured under steady and pulsatile conditions in the lungs of C57BL/6J mice (n = 6) before and after two infusions with 25 microm-diameter microspheres (one million per infusion). After the first and second embolizations, pulmonary artery pressures increased approximately two-fold and three and a half-fold, respectively, compared to baseline, at a steady flow rate of 1 ml/min (P < 0.05). Pulmonary vascular resistance and 0 Hz impedance also increased after the first and second embolizations for all flow rates tested (P < 0.05). Frequency-dependent features of the pulmonary vascular impedance spectrum were suggestive of shifts in the major pulmonary vascular reflection sites with embolization. Our results demonstrate that pulmonary artery pressure, resistance, and impedance magnitude measured in this isolated lung setup changed in ways consistent with in vivo studies in larger animals and humans and demonstrate the usefulness of the isolated, ventilated, and perfused mouse lung for investigating steady and pulsatile pressure-flow rate relationships.
A Method for Dynamic System Characterization Using Hydraulic Series Resistance
The pressure required to drive flow through a microfluidic device is an important characteristic of that device. We present a method to measure the flow rate through microfluidic components and systems, including micropumps and microvalves. The measurement platform is composed of two pressure sensors and a glass tube, which provides series resistance. The principle of the measurement is the fluid dynamical equivalent of Ohm's law, which defines the relationship between current, resistance, and voltage that are analogues to flow rate, hydraulic resistance, and pressure drop, respectively. Once the series resistance is known, it is possible to compute the flow rate through a device based on pressure alone. In addition, the dynamic system characteristics of the device-resistance and capacitance-can be computed. The benefits of this method are its simple configuration, capability of measuring flow rate accurately from the more easily measured pressure, and the ability to predict the dynamic response of microfluidic devices.
Pulmonary Vascular Remodeling in Isolated Mouse Lungs: Effects on Pulsatile Pressure-flow Relationships
Chronic hypoxia causes pulmonary vasoconstriction and pulmonary hypertension, which lead to pulmonary vascular remodeling and right ventricular hypertrophy. To determine the effects of hypoxia-induced pulmonary vascular remodeling on pulmonary vascular impedance, which is the right ventricular afterload, we exposed C57BL6 mice to 0 (control), 10 and 15 days of hypobaric hypoxia (n=6, each) and measured pulmonary vascular resistance (PVR) and impedance ex vivo. Chronic hypoxia led to increased pulmonary artery pressures for flow rates between 1 and 5ml/min (P<0.01), and increased PVR, 0-Hz pulmonary vascular impedance and the index of wave reflection (P<0.05) as well as a more negative impedance phase angle for low frequencies (P<0.05). The increases in resistance and 0-Hz impedance correlated with increased muscularization of small arterioles measured with quantitative immunohistochemistry (P<0.01). The increases in wave reflection and decreases in phase angle are likely due to increased proximal artery stiffness. These results confirm that chronic hypoxia causes significant changes in steady and pulsatile pressure-flow relationships in mouse lungs and does so via structural remodeling. They also provide important baseline data for experiments with genetically engineered mice, with which molecular mechanisms of pulmonary vascular remodeling can be investigated.
Collagen-related Gene and Protein Expression Changes in the Lung in Response to Chronic Hypoxia
Collagen accumulation likely contributes to increased vascular and airway impedance in hypoxia-induced pulmonary hypertension (HPH). Collagen exists in multiple subtypes and can accumulate via increased synthesis or decreased degradation. To better understand the individual contributions of fibrillar (FB) and basement membrane (BM) collagen, matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) to pulmonary vascular and airway remodeling in HPH, we investigated the temporal changes in gene and protein expression in the lungs of mice exposed to hypoxia for 0, 3, 6, 10 and 15 days. The earliest and largest change in gene expression was of type I FB collagen, which was significantly increased over control levels at 6, 10 and 15 days of hypoxia (p < 0.05). Type III FB and type IV BM collagen were increased at 10 and 15 days of hypoxia (p < 0.05); MMP and TIMP gene expression levels were typically higher but sometimes lower than control levels at various time points. Collagen protein content was increased in whole lungs as early as 6 days of hypoxia and increased monotonically with longer exposures. However, neither qualitative nor semi-quantitative analysis of immunohistochemistry demonstrated accumulation of type I FB collagen in compartments of the lung other than large airways, suggesting that other collagen subtypes may be important contributors to collagen protein accumulation. These results provide insight into the patterns of gene and protein expression relevant to collagen accumulation in the lung in response to chronic hypoxia, through which we can develop a better understanding of the time course of changes in matrix biology and biomechanics that occur in HPH.
The Effects of the Ovarian Cycle and Pregnancy on Uterine Vascular Impedance and Uterine Artery Mechanics
Uterine vascular resistance (UVR) is the ratio of systemic mean arterial pressure to mean uterine blood flow and is sensitive to changes in small arteries and arterioles. However, it provides little or no insight into changes in large, conduit arteries. Fluctuations in estrogen (E2) and progesterone (P4) levels during the ovarian cycle are thought to cause uterine resistance artery vasodilation; the effects on large arteries are unknown. Herein, our objective was to use the uterine vascular impedance, which is sensitive to changes in small and large arteries, to determine the effects of the ovarian cycle and pregnancy on the entire uterine vasculature.
Transmission Line Models to Simulate the Impedance of the Uterine Vasculature During the Ovarian Cycle and Pregnancy
Changes in uterine vascular impedance may yield diagnostic insight into physiological and pathological changes in uterine vascular resistance and compliance during the ovarian cycle and pregnancy. Herein, our objectives were to develop models to simulate uterine vascular impedance in order to gain insight into the vascular size and stiffness changes that occur during ovarian cycling and pregnancy.
How to Measure Peripheral Pulmonary Vascular Mechanics
Pulmonary hypertension (PH) is initially a disease of the small, peripheral resistance arteries. Changes in these vessels are best assessed by measurement of pulmonary artery pressure at several levels of flow to generate multi-point pressure-flow curves. This approach is superior to the traditional single-point measurement of pulmonary vascular resistance (PVR) because it allows a flow-independent definition of the resistive properties of that portion of the pulmonary vascular bed and also provides information on its distensibility. In animal models, multi-point pressure-flow curves can be obtained using an isolated, ventilated, perfused lung system. Clinically, cardiopulmonary exercise testing (CPET) with non-invasive echocardiography is feasible and provides realistic values of the resistance and peripheral compliance. Together, these values can be used to better understand and screen for PH and exercise-induced PH.
How to Measure Pulmonary Vascular and Right Ventricular Function
Long-standing pulmonary hypertension causes significant peripheral and proximal arterial remodeling and right ventricular dysfunction. The clinical metric most often used to assess the progression of PH is the pulmonary vascular resistance (PVR). However, even when measured from multipoint pressure-flow curves, PVR provides information only on the peripheral arterial function, not the proximal arterial function and gives only an incomplete description of all the forces that oppose right ventricular (RV) flow output. Pulmonary vascular impedance spectra (PVZ) capture the impact of proximal and peripheral arterial structure and function on RV function. Analyses of ventricular-vascular coupling give insight into the efficiency of mechanical and metabolic interactions between the right ventricle and the pulmonary vasculature. Here we review techniques for measuring PVZ in humans and animal models and for determining RV function.
Time Course of Intermittent Hypoxia-induced Impairments in Resistance Artery Structure and Function
We previously demonstrated that chronic exposure to intermittent hypoxia (CIH) impairs endothelium-dependent vasodilation in rats. To determine the time course of this response, rats were exposed to CIH for 3, 14, 28, or 56 days. Then, we measured acetylcholine- and nitroprusside-induced vasodilation in isolated gracilis arteries. Also, we measured endothelial and inducible nitric oxide synthase, nitrotyrosine, and collagen in the arterial wall and urinary isoprostanes. Endothelium-dependent vasodilation was impaired after 2 weeks of CIH. Three days of CIH was not sufficient to produce this impairment and longer exposures (i.e. 4 and 8 weeks) did not exacerbate it. Impaired vasodilation was accompanied by increased collagen deposition. CIH elevated urinary isoprostane excretion, whereas there was no consistent effect on either isoform of nitric oxide synthase or nitrotyrosine. Exposure to CIH produces functional and structural deficits in skeletal muscle resistance arteries. These impairments develop within 2 weeks after initiation of exposure and they are accompanied by systemic evidence of oxidant stress.
Impedance in Isolated Mouse Lungs for the Determination of Site of Action of Vasoactive Agents and Disease
Hypoxic pulmonary hypertension is a disease of the lung vasculature that is usually quantified by pulmonary vascular resistance (PVR). However, a more complete description of lung vascular function and right ventricular afterload is provided by pulmonary vascular impedance (PVZ) from spectral analysis of pulsatile pressure-flow relationships. We studied pulsatile pressure-flow relationships in isolated, perfused lungs of mice in normoxia, after induction of hypoxic pulmonary hypertension by 10 days of hypoxic exposure, and after the administration of the vasoactive agents sodium nitroprusside and serotonin in order to gain insight into the effects of disease and vasoactive agents on afterload. Chronic hypoxia exposure increased 0 Hz impedance (Z(0)) from 2.0 +/- 0.2 to 3.3 +/- 0.2 mmHg min/mL but decreased characteristic impedance (Z(C)) from 0.21 +/- 0.02 to 0.18 +/- 0.01 mmHg min/mL (both p < 0.05). Sodium nitroprusside only slightly decreased Z(0) but increased Z(C) in normal lungs (p < 0.05) and did not affect Z(C) and decreased Z(0) in hypertensive lungs (p < 0.05). Serotonin increased Z(C) in normal and hypertensive lungs but decreased Z(0) in hypertensive lungs (p < 0.05). There was an inverse correlation between mean pulmonary artery pressure and Z(C) in all circumstances. These findings demonstrate that vasoactive interventions can have different sites of action (i.e., proximal vs. distal segments) in the normal and chronically hypoxic pulmonary vasculature, and the pressure-dependency of Z(C) and R(W). The measurement of PVZ in isolated lungs allows for an improved understanding of the modes of action of drugs and hypoxia on the pulmonary circulation.
The Pipeline Still Leaks and More Than You Think: a Status Report on Gender Diversity in Biomedical Engineering
While the percentage of women in biomedical engineering is higher than in many other technical fields, it is far from being in proportion to the US population. The decrease in the proportion of women and underrepresented minorities in biomedical engineering from the bachelors to the masters to the doctoral levels is evidence of a still leaky pipeline in our discipline. In addition, the percentage of women faculty members at the assistant, associate and full professor levels remain disappointingly low even after years of improved recruitment of women into biomedical engineering at the undergraduate level. Worse, the percentage of women graduating with undergraduate degrees in biomedical engineering has been decreasing nationwide for the most recent three year span for which national data are available. Increasing diversity in biomedical engineering is predicted to have significant research and educational benefits. The barriers to women's success in biomedical engineering and strategies for overcoming these obstacles-and fixing the leaks in the pipeline-are reviewed.
The Effects of Vasoactivity and Hypoxic Pulmonary Hypertension on Extralobar Pulmonary Artery Biomechanics
Loss of large artery compliance is an emerging novel predictor of cardiovascular mortality. Hypoxia-induced pulmonary hypertension (HPH) has been shown to decrease extralobar pulmonary artery (PA) compliance in the absence of smooth muscle cell (SMC) tone and to increase SMC tone in peripheral PAs. We sought to determine the impact of HPH on extralobar PA tone and the impact of SMC activation on extralobar PA biomechanics. To do so, C57BL6 mice were exposed to 0 (CTL) or 10 days (HPH) of hypoxia and isolated vessel tests were performed on extralobar PAs using either a physiological saline solution (PSS), a vasoconstrictor (U46619), two vasodilators (SNP and Y27632) or calcium free medium (relaxant solution; VBRS). The vasodilators and relaxant solution had no effect on extralobar artery diameter suggesting that basal SMC tone is essentially zero in CTL conditions and does not increase with HPH. HPH caused narrowing, decreased circumferential stretch (lambda; p<0.0001), decreased local area compliance (C(A); p<0.0005) and increased incremental elastic modulus (E(inc); p<0.05) in the normal tone state (with PSS). In both CTL and HPH conditions, SMC activation decreased E(inc) (p<0.0005) but also increased wall thickness (p<0.05) such that changes in C(A) with SMC constriction were minimal; only in HPH PAs was a significant decrease with SMC constriction observed (p<0.05). Our results demonstrate that 10 days of hypoxia does not increase extralobar PA SMC tone and that HPH-induced decreases in compliance are caused by narrowing, wall thickening and increases in modulus, not persistent vasoconstriction.
The Role of Collagen in Extralobar Pulmonary Artery Stiffening in Response to Hypoxia-induced Pulmonary Hypertension
Hypoxic pulmonary hypertension (HPH) causes extralobar pulmonary artery (PA) stiffening, which potentially impairs right ventricular systolic function. Changes in the extracellular matrix proteins collagen and elastin have been suggested to contribute to this arterial stiffening. We hypothesized that vascular collagen accumulation is a major cause of extralobar PA stiffening in HPH and tested our hypothesis with transgenic mice that synthesize collagen type I resistant to collagenase degradation (Col1a1(R/R)). These mice and littermate controls that have normal collagen degradation (Col1a1(+/+)) were exposed to hypoxia for 10 days; some were allowed to recover for 32 days. In vivo PA pressure and isolated PA mechanical properties and collagen and elastin content were measured for all groups. Vasoactive studies were also performed with U-46619, Y-27632, or calcium- and magnesium-free medium. Pulmonary hypertension occurred in both mouse strains due to chronic hypoxia and resolved with recovery. HPH caused significant PA mechanical changes in both mouse strains: circumferential stretch decreased, and mid-to-high-strain circumferential elastic modulus increased (P < 0.05 for both). Impaired collagen type I degradation prevented a return to baseline mechanical properties with recovery and, in fact, led to an increase in the low and mid-to-high-strain moduli compared with hypoxia (P < 0.05 for both). Significant changes in collagen content were found, which tended to follow changes in mid-to-high-strain elastic modulus. No significant changes in elastin content or vasoactivity were observed. Our results demonstrate that collagen content is important to extralobar PA stiffening caused by chronic hypoxia.
Measuring Right Ventricular Function in the Normal and Hypertensive Mouse Hearts Using Admittance-derived Pressure-volume Loops
Mice are a widely used animal model for investigating cardiovascular disease. Novel technologies have been used to quantify left ventricular function in this species, but techniques appropriate for determining right ventricular (RV) function are less well demonstrated. Detecting RV dysfunction is critical to assessing the progression of pulmonary vascular diseases such as pulmonary hypertension. We used an admittance catheter to measure pressure-volume loops in anesthetized, open-chested mice before and during vena cava occlusion. Mice exposed to chronic hypoxia for 10 days, which causes hypoxia-induced pulmonary hypertension (HPH), were compared with control (CTL) mice. HPH resulted in a 27.9% increase in RV mass (P < 0.005), a 67.5% increase in RV systolic pressure (P < 0.005), and a 61.2% decrease in cardiac output (P < 0.05). Preload recruitable stroke work (PRSW) and slope of the maximum derivative of pressure (dP/dt(max))-end-diastolic volume (EDV) relationship increased with HPH (P < 0.05). Although HPH increased effective arterial elastance (E(a)) over fivefold (from 2.7 ± 1.2 to 16.4 ± 2.5 mmHg/μl), only a mild increase in the ventricular end-systolic elastance (E(es)) was observed. As a result, a dramatic decrease in the efficiency of ventricular-vascular coupling occurred (E(es)/E(a) decreased from 0.71 ± 0.27 to 0.35 ± 0.17; P < 0.005). Changes in cardiac reserve were evaluated by dobutamine infusion. In CTL mice, dobutamine significantly enhanced E(es) and dP/dt(max)-EDV but also increased E(a), causing a decrease in E(es)/E(a). In HPH mice, slight but nonsignificant decreases in E(es), PRSW, dP/dt(max)-EDV, and E(a) were observed. Thus 10 days of HPH resulted in RV hypertrophy, ventricular-vascular decoupling, and a mild decrease in RV contractile reserve. This study demonstrates the feasibility of obtaining RV pressure-volume measurements in mice. These measurements provide insight into ventricular-vascular interactions healthy and diseased states.
Shear Stress Regulation of Nitric Oxide Production in Uterine and Placental Artery Endothelial Cells: Experimental Studies and Hemodynamic Models of Shear Stresses on Endothelial Cells
Hemodynamic shear stress is the most powerful physiological regulator of endothelial Nitric Oxide Synthase (eNOS), leading to rapid rises in nitric oxide (NO). The substantial increases in uterine and placental blood flows throughout gestation rely heavily on the action of NO. We and others have investigated endothelial function in response to shear stress with cell culture models of shear stress. In order to apply the results of these studies more effectively, we need a more complete understanding of the origin and coupling of the hemodynamic forces and vascular tissue behavior. For example, equations commonly used to calculate in vivo shear stress incorporate assumptions of steady (non-pulsatile) blood flow and constant viscosity of blood (Newtonian fluid). Using computational models, we can estimate a waveform of shear stress over a cardiac cycle and the change in blood viscosity with shear rate and hematocrit levels, two variables that often change with size of vessel and location within a vascular tree. This review discusses hemodynamics as they apply to blood flow in vessels, in the hope that an integration of these fields can lead to improved in vitro shear stress experiments and understanding of NO production in uterine and placental vascular physiology during gestation.
Effects of Acute Rho Kinase Inhibition on Chronic Hypoxia-induced Changes in Proximal and Distal Pulmonary Arterial Structure and Function
Hypoxic pulmonary hypertension (HPH) is initially a disease of the small pulmonary arteries. Its severity is usually quantified by pulmonary vascular resistance (PVR). Acute Rho kinase inhibition has been found to reduce PVR toward control values in animal models, suggesting that persistent pulmonary vasoconstriction is the dominant mechanism for increased PVR. However, HPH may also cause proximal arterial changes, which are relevant to right ventricular (RV) afterload. RV afterload can be quantified by pulmonary vascular impedance, which is obtained via spectral analysis of pulsatile pressure-flow relationships. To determine the effects of HPH independent of persistent pulmonary vasoconstriction in proximal and distal arteries, we quantified pulsatile pressure-flow relationships before and after acute Rho kinase inhibition and measured pulmonary arterial structure with microcomputed tomography. In control lungs, Rho kinase inhibition decreased 0 Hz impedance (Z₀), which is equivalent to PVR, from 2.1 ± 0.4 to 1.5 ± 0.2 mmHg·min·ml⁻¹ (P < 0.05) and tended to increase characteristic impedance (Z(C)) from 0.21 ± 0.01 to 0.22 ± 0.01 mmHg·min·ml⁻¹. In HPH lungs, Rho kinase inhibition decreased Z₀ (P < 0.05) without affecting Z(C). Microcomputed tomography measurements performed on lungs after acute Rho kinase inhibition demonstrated that HPH significantly decreased the unstressed diameter of the main pulmonary artery (760 ± 60 vs. 650 ± 80 μm; P < 0.05), decreased right pulmonary artery compliance, and reduced the frequency of arteries of diameter 50-100 μm (both P < 0.05). These results demonstrate that acute Rho kinase inhibition reverses many but not all HPH-induced changes in distal pulmonary arteries but does not affect HPH-induced changes in the conduit arteries that impact RV afterload.
Pulmonary Vascular Wall Stiffness: An Important Contributor to the Increased Right Ventricular Afterload with Pulmonary Hypertension
Pulmonary hypertension (PH) is associated with structural and mechanical changes in the pulmonary vascular bed that increase right ventricular (RV) afterload. These changes, characterized by narrowing and stiffening, occur in both proximal and distal pulmonary arteries (PAs). An important consequence of arterial narrowing is increased pulmonary vascular resistance (PVR). Arterial stiffening, which can occur in both the proximal and distal pulmonary arteries, is an important index of disease progression and is a significant contributor to increased RV afterload in PH. In particular, arterial narrowing and stiffening increase the RV afterload by increasing steady and oscillatory RV work, respectively. Here we review the current state of knowledge of the causes and consequences of pulmonary arterial stiffening in PH and its impact on RV function. We review direct and indirect techniques for measuring proximal and distal pulmonary arterial stiffness, measures of arterial stiffness including elastic modulus, incremental elastic modulus, stiffness coefficient β and others, the changes in cellular function and the extracellular matrix proteins that contribute to pulmonary arterial stiffening, the consequences of PA stiffening for RV function and the clinical implications of pulmonary vascular stiffening for PH progression. Future investigation of the relationship between PA stiffening and RV dysfunction may facilitate new therapies aimed at improving RV function and thus ultimately reducing mortality in PH.
Persistent Vascular Collagen Accumulation Alters Hemodynamic Recovery from Chronic Hypoxia
Pulmonary arterial hypertension (PAH) is caused by narrowing and stiffening of the pulmonary arteries that increase pulmonary vascular impedance (PVZ). In particular, small arteries narrow and large arteries stiffen. Large pulmonary artery (PA) stiffness is the best current predictor of mortality from PAH. We have previously shown that collagen accumulation leads to extralobar PA stiffening at high strain (Ooi et al. 2010). We hypothesized that collagen accumulation would increase PVZ, including total pulmonary vascular resistance (Z(0)), characteristic impedance (Z(C)), pulse wave velocity (PWV) and index of global wave reflections (P(b)/P(f)), which contribute to increased right ventricular afterload. We tested this hypothesis by exposing mice unable to degrade type I collagen (Col1a1(R/R)) to 21 days of hypoxia (hypoxia), some of which were allowed to recover for 42 days (recovery). Littermate wild-type mice (Col1a1(+/+)) were used as controls. In response to hypoxia, mean PA pressure (mPAP) increased in both mouse genotypes with no changes in cardiac output (CO) or PA inner diameter (ID); as a consequence, Z(0) (mPAP/CO) increased by ∼100% in both genotypes (p<0.05). Contrary to our expectations, Z(C), PWV and P(b)/P(f) did not change. However, with recovery, Z(C) and PWV decreased in the Col1a1(+/+) mice and remained unchanged in the Col1a1(R/R) mice. Z(0) decreased with recovery in both genotypes. Microcomputed tomography measurements of large PAs did not show evidence of stiffness changes as a function of hypoxia exposure or genotype. We conclude that hypoxia-induced PA collagen accumulation does not affect the pulsatile components of pulmonary hemodynamics but that excessive collagen accumulation does prevent normal hemodynamic recovery, which may have important consequences for right ventricular function.
Patchy Deletion of Bmpr1a Potentiates Proximal Pulmonary Artery Remodeling in Mice Exposed to Chronic Hypoxia
Reduced vascular expression of bone morphogenetic protein type IA receptor (Bmpr1a) has been found in patients with pulmonary arterial hypertension. Our previous studies in mice with patchy deletion of Bmpr1a in vascular smooth muscle cells and cardiac myocytes showed decreased distal vascular remodeling despite a similar severity of hypoxic pulmonary hypertension (HPH). We speculate increased stiffness from ectopic deposition of collagen in proximal pulmonary arteries might account for HPH. Pulsatile pressure-flow relationships were measured in isolated, ventilated, perfused lungs of SM22α;TRE-Cre;R26R;Bmpr1a ( flox/flox ) (KO) mice and wild-type littermates, following 21 days (hypoxia) and 0 days (control) of chronic hypoxia. Pulmonary vascular impedance, which yields insight into proximal and distal arterial remodeling, was calculated. Reduced Bmpr1a expression had no effect on input impedance Z (0) (P = 0.52) or characteristic impedance Z (C) (P = 0.18) under control conditions; it also had no effect on the decrease in Z (0) via acute rho kinase inhibition. However, following chronic hypoxia, reduced Bmpr1a expression increased Z (C) (P < 0.001) without affecting Z (0) (P = 0.72). These results demonstrate that Bmpr1a deficiency does not significantly alter the hemodynamic function of the distal vasculature or its response to chronic hypoxia but larger, more proximal arteries are affected. In particular, reduced Bmpr1a expression likely decreased dilatation and increased stiffening in response to hypoxia, probably by collagen accumulation. Increased PA stiffness can have a significant impact on right ventricular function. This study illustrates for the first time how proximal pulmonary artery changes in the absence of distal pulmonary artery changes contribute to pulmonary arterial hypertension.
Role of Collagen Content and Cross-linking in Large Pulmonary Arterial Stiffening After Chronic Hypoxia
Chronic hypoxic pulmonary hypertension (HPH) is associated with large pulmonary artery (PA) stiffening, which is correlated with collagen accumulation. However, the mechanisms by which collagen contributes to PA stiffening remain largely unexplored. Moreover, HPH may alter mechanical properties other than stiffness, such as pulse damping capacity, which also affects ventricular workload but is rarely quantified. We hypothesized that collagen content and cross-linking differentially regulate the stiffness and damping capacity of large PAs during HPH progression. The hypothesis was tested with transgenic mice that synthesize collagen type I resistant to collagenase degradation (Col1a1(R/R)). These mice and littermate controls (Col1a1(+/+)) were exposed to hypoxia for 10 days; some were treated with β-aminopropionitrile (BAPN), which prevents new cross-link formation. Isolated PA dynamic mechanical tests were performed, and collagen content and cross-linking were measured. In Col1a1(+/+) mice, HPH increased both collagen content and cross-linking, and BAPN treatment prevented these increases. Similar trends were observed in Col1a1(R/R) mice except that collagen content further increased with BAPN treatment. Mechanical tests showed that in Col1a1(+/+) mice, HPH increased PA stiffness and damping capacity, and these increases were impeded by BAPN treatment. In Col1a1(R/R) mice, HPH led to a smaller but significant increase in PA stiffness and a decrease in damping capacity. These mechanical changes were not affected by BAPN treatment. Vessel-specific correlations for each strain showed that the stiffness and damping capacity were correlated with the total content rather than cross-linking of collagen. Our results suggest that collagen total content is critical to extralobar PA stiffening during HPH.
