Cardiovascular Engineering and Technology最新文献

{"title":"Computational Comparison of the Mechanical Behavior of Aortic Stent-Grafts Derived from Auxetic Unit Cells","authors":"Rahul Vellaparambil, Woo-Suck Han, Pierluigi Di Giovanni, Stéphane Avril","doi":"10.1007/s13239-023-00706-x","DOIUrl":"https://doi.org/10.1007/s13239-023-00706-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>Inappropriate stent-graft (SG) flexibility has been frequently associated with endovascular aortic repair (EVAR) complications such as endoleaks, kinks, and SG migration, especially in tortuous arteries. Stents derived from auxetic unit cells have shown some potential to address these issues as they offer an optimum trade-off between radial stiffness and bending flexibility.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this study, we utilized an established finite element (FE)-based approach to replicate the mechanical response of a SG iliac limb derived from auxetic unit cells in a virtual tortuous iliac aneurysm using a combination of a 180° U-bend and intraluminal pressurization. This study aimed to compare the mechanical performance (flexibility and durability) of SG limbs derived from auxetic unit cells and two commercial SG limbs (Z-stented SG and circular-stented SG models) in a virtual tortuous iliac aneurysm. Maximal graft strain and maximum stress in stents were employed as criteria to estimate the durability of SGs, whereas the maximal luminal reduction rate and the bending stiffness were used to assess the flexibility of the SGs.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>SG limbs derived from auxetic unit cells demonstrated low luminal reduction (range 4–12%) with no kink, in contrast to Z-stented SG, which had a kink in its central area alongside a high luminal reduction (44%).</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>SG limbs derived from auxetic unit cells show great promise for EVAR applications even at high angulations such as 180°, with acceptable levels of durability and flexibility.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"2 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical Proof-of-Concept of a Minimally Invasive Direct Cardiac Compression Device for Pediatric Heart Support","authors":"Erica C. Hord, Melanie P. Hager, Christina M. Bolch, Katherine Bonugli, Lee-Jae Guo, Egemen Tuzun, John C. Criscione","doi":"10.1007/s13239-023-00703-0","DOIUrl":"https://doi.org/10.1007/s13239-023-00703-0","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Purpose</h3><p>For pediatric patients, extracorporeal membrane oxygenation (ECMO) remains the predominant mechanical circulatory support (MCS) modality for heart failure (HF) although survival to discharge rates remain between 50 and 60% for these patients. The device-blood interface and disruption of physiologic hemodynamics are significant contributors to poor outcomes.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>In this study, we evaluate the preclinical feasibility of a minimally invasive, non-blood-contacting pediatric DCC prototype for temporary MCS. Proof-of-concept is demonstrated in vivo in an animal model of HF. Hemodynamic pressures and flows were examined.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Minimally invasive deployment on the beating heart was successful without cardiopulmonary bypass or anticoagulation. During HF, device operation resulted in an immediate 43% increase in cardiac output while maintaining pulsatile hemodynamics. Compared to the pre-HF baseline, the device recovered up to 95% of ventricular stroke volume. At the conclusion of the study, the device was easily removed from the beating heart.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>This preclinical proof-of-concept study demonstrated the feasibility of a DCC device on a pediatric scale that is minimally invasive and non-blood contacting, with promising hemodynamic support and durability for the initial intended duration of use. The ability of DCC to maintain pulsatile MCS without blood contact represents an opportunity to mitigate the mortality and morbidity observed in non-pulsatile, blood-contacting MCS.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"236 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138742989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proximal Clipping and Distal High-Flow Bypass in the Treatment of Giant/Complex Intracranial Aneurysm: An Opportunity or a Risk from a Fluid-Structural Interaction Analysis","authors":"Shifu Li, Zheng Huang, Hua Chen, Fenghua Chen","doi":"10.1007/s13239-023-00704-z","DOIUrl":"https://doi.org/10.1007/s13239-023-00704-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Objectives</h3><p>Conventional clipping and endovascular treatment are difficult to apply for some giant intracranial aneurysms (GIAs), and sometimes extracranial-to-intracranial (EC-IC) bypass becomes the optional choice. However, not all GIA patients can benefit from it. This study aims to recognize the underlying problems.</p><h3 data-test=\"abstract-sub-heading\">Methods</h3><p>We included eligible patients in our care. Then, we researched from three levels: a retrospective review of clinical data, fluid-structural analysis from two representative patient-specific models, and fluid-structural interaction analysis for idealized models to investigate the hemodynamic and biomechanical mechanisms.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>In this article, we report nine patients with GIA who underwent EC-IC surgery. Of them, three experienced dangerous postoperative hemorrhage, and one patient died. Among these three patients, two lacked the A1 segment of the anterior cerebral artery (ACA). The numerical simulation showed that after surgery, for the patient with an unruptured aneurysm and existence of ACA, the wall deformation, wall stress, pressure, and area of the oscillatory shear index (OSI) &gt; 0.2 were decreased by 43%, 39%, 33%, and 13%, while the patient without A1 segment having postoperative hemorrhage showed 36%, 45%, 13%, and 55% increased, respectively. Thus, we postulated a dangerous “stump phenomenon” in such conditions and further demonstrated it from idealized models with different sizes of ACA. Finally, we found a larger anastomosis angle and smaller diameter of the graft can alleviate this effect.</p><h3 data-test=\"abstract-sub-heading\">Conclusions</h3><p>Neurosurgeon should cautiously evaluate the opportunity and risk for such patients who have aplasia of the A1 segment of ACA when making clinical decisions.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":"77 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2023-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138632206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Peripheral Perfusion Dynamics Indices for Detecting and Grading Arterial Stenosis.","authors":"Tomer Joshua Heitner, Amit Livneh, Amir Landesberg","doi":"10.1007/s13239-023-00686-y","DOIUrl":"10.1007/s13239-023-00686-y","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral artery disease causes severe morbidity, especially in diabetics and the elderly. There is a need for accurate noninvasive detection of peripheral arterial stenosis. The study has tested the hypothesis that arterial stenosis and the associated adaptation of the downstream circulation yield characteristic changes in the leg perfusion dynamics that enable early diagnosis, utilizing impedance plethysmography.</p><p><strong>Methods: </strong>The arterial perfusion dynamic was derived from impedance plethysmography (IPG). Two degrees of arterial stenosis were emulated by inflating a blood-pressure cuff around the thigh to 45 and 90 mmHg, in healthy volunteers (n = 30). IPG signals were acquired continuously throughout the experiment. Ankle and brachial blood pressures were measured at the beginning of each experiment and at the end of each emulated stenosis phase.</p><p><strong>Results: </strong>Thigh compressions did not affect the pulse-transit time, but prolonged the time to the peak perfusion wave. Segmentation of the perfusion upstroke into two phases, at the time point of maximum acceleration (MAT), revealed that arterial compression prolonged only the initial slow phase duration (SPd). The MAT and SPd were proportional to the emulated stenosis severity and detected the arterial stenosis with high sensitivity (> 93%) and specificity (100%). The SPd increased from 46.4 ± 21.2 ms at baseline to 75.4 ± 38.5 ms and 145 ± 39 ms under 45 mmHg and 90 mmHg compressions (p < 0.001), without affecting the pulse-transit time.</p><p><strong>Conclusions: </strong>The novel method and indices can identify and grade the emulated arterial stenosis with high accuracy and may assist in differentiating between focal arterial stenosis and widespread arterial hardening.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"774-785"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138177980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"4D Flow Patterns and Relative Pressure Distribution in a Left Ventricle Model by Shake-the-Box and Proper Orthogonal Decomposition Analysis.","authors":"Xiaolin Wu, Hicham Saaid, Jason Voorneveld, Tom Claessens, Jos J M Westenberg, Nico de Jong, Johan G Bosch, Saša Kenjereš","doi":"10.1007/s13239-023-00684-0","DOIUrl":"10.1007/s13239-023-00684-0","url":null,"abstract":"<p><strong>Purpose: </strong>Intraventricular blood flow dynamics are associated with cardiac function. Accurate, noninvasive, and easy assessments of hemodynamic quantities (such as velocity, vortex, and pressure) could be an important addition to the clinical diagnosis and treatment of heart diseases. However, the complex time-varying flow brings many challenges to the existing noninvasive image-based hemodynamic assessments. The development of reliable techniques and analysis tools is essential for the application of hemodynamic biomarkers in clinical practice.</p><p><strong>Methods: </strong>In this study, a time-resolved particle tracking method, Shake-the-Box, was applied to reconstruct the flow in a realistic left ventricle (LV) silicone model with biological valves. Based on the obtained velocity, 4D pressure field was calculated using a Poisson equation-based pressure solver. Furthermore, flow analysis by proper orthogonal decomposition (POD) of the 4D velocity field has been performed.</p><p><strong>Results: </strong>As a result of the Shake-the-Box algorithm, we have extracted: (i) particle positions, (ii) particle tracks, and finally, (iii) 4D velocity fields. From the latter, the temporal evolution of the 3D pressure field during the full cardiac cycle was obtained. The obtained maximal pressure difference extracted along the base-to-apex was about 2.7 mmHg, which is in good agreement with those reported in vivo. The POD analysis results showed a clear picture of different scale of vortices in the pulsatile LV flow, together with their time-varying information and corresponding kinetic energy content. To reconstruct 95% of the kinetic energy of the LV flow, only the first six POD modes would be required, leading to significant data reduction.</p><p><strong>Conclusions: </strong>This work demonstrated Shake-the-Box is a promising technique to accurately reconstruct the left ventricle flow field in vitro. The good spatial and temporal resolutions of the velocity measurements enabled a 4D reconstruction of the pressure field in the left ventricle. The application of POD analysis showed its potential in reducing the complexity of the high-resolution left ventricle flow measurements. For future work, image analysis, multi-modality flow assessments, and the development of new flow-derived biomarkers can benefit from fast and data-reducing POD analysis.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"743-754"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10739257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Vivo Material Properties of Human Common Carotid Arteries: Trends and Sex Differences.","authors":"Marija Smoljkić, Jos Vander Sloten, Patrick Segers, Nele Famaey","doi":"10.1007/s13239-023-00691-1","DOIUrl":"10.1007/s13239-023-00691-1","url":null,"abstract":"<p><strong>Introduction: </strong>In vivo estimation of material properties of arterial tissue can provide essential insights into the development and progression of cardiovascular diseases. Furthermore, these properties can be used as an input to finite element simulations of potential medical treatments.</p><p><strong>Materials and methods: </strong>This study uses non-invasively measured pressure, diameter and wall thickness of human common carotid arteries (CCAs) acquired in 103 healthy subjects. A non-linear optimization was performed to estimate material parameters of two different constitutive models: a phenomenological, isotropic model and a structural, anisotropic model. The effect of age, sex, body mass index and blood pressure on the parameters was investigated.</p><p><strong>Results and conclusion: </strong>Although both material models were able to model in vivo arterial behaviour, the structural model provided more realistic results in the supra-physiological domain. The phenomenological model predicted very high deformations for pressures above the systolic level. However, the phenomenological model has fewer parameters that were shown to be more robust. This is an advantage when only the physiological domain is of interest. The effect of stiffening with age, BMI and blood pressure was present for women, but not always for men. In general, sex had the biggest effect on the mechanical properties of CCAs. Stiffening trends with age, BMI and blood pressure were present but not very strong. The intersubject variability was high. Therefore, it can be concluded that finding a representative set of parameters for a certain age or BMI group would be very challenging. Instead, for purposes of patient-specific modelling of surgical procedures, we currently advise the use of patient-specific parameters.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"840-852"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Analysis of PTFE Monocusp Leaflet Design in a Patient-Based 3D in-Vitro Model of Tetralogy of Fallot.","authors":"Xiaoya Zhang, Shannen B Kizilski, Dominic P Recco, Martha D Chaillo Lizarraga, Nicholas E Kneier, Noah E Schulz, Christopher W Baird, Peter E Hammer, David M Hoganson","doi":"10.1007/s13239-023-00690-2","DOIUrl":"10.1007/s13239-023-00690-2","url":null,"abstract":"<p><strong>Purpose: </strong>Pulmonary valve (PV) monocusp reconstruction in transannular patch (TAP) right ventricular outflow tract (RVOT) repair for Tetralogy of Fallot has variable clinical outcomes across different surgical approaches. The study purpose was to systematically evaluate how monocusp leaflet design parameters affect valve function in-vitro.</p><p><strong>Methods: </strong>A 3D-printed, disease-specific RVOT model was tested under three infant physiological conditions. Monocusps were sewn into models with the native main pulmonary artery (MPA) forming backwalls that constituted 40% and 50% of the reconstructed circumference for z-score zero PV annulus and MPA diameters (native PV z-score - 3.52 and - 2.99 for BSA 0.32m²). Various leaflet free edge lengths (FEL) (relative to backwall), positions (relative to PV STJ), and scallop depths were investigated across both models. Pressure gradient, regurgitation, and coaptation were analyzed with descriptive statistics and regression models.</p><p><strong>Results: </strong>Increasing FEL beyond 100% of the MPA backwall decreased gradient but mildly increased regurgitation to a peak of 25%. Positioning the free edge 2 mm past the STJ mildly increased gradient for each FEL without significantly changing regurgitation compared to STJ placement. Scalloping leaflets trivially affected performance. Pre-folding leaflets improved mobility and slightly reduced gradient.</p><p><strong>Conclusions: </strong>Balancing gradient, regurgitation, and oversizing for growth, a set of leaflet designs have been selected for pre-clinical evaluation. Designs with leaflet widths 140-160% in the 40% backwall model (110-120% in the 50% backwall), positioned at or 2 mm past the STJ, demonstrated the best results. The next stage of ex-vivo testing will additionally consider native RVOT distensibility, native leaflet interactions, and TAP characteristics.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"827-839"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Investigation of Bio-impedance Analysis at a Wrist Phantom with Two Pulsatile Arteries.","authors":"Yang Yu, Andrew Lowe, Gautam Anand, Anubha Kalra, Huiyang Zhang","doi":"10.1007/s13239-023-00689-9","DOIUrl":"10.1007/s13239-023-00689-9","url":null,"abstract":"<p><strong>Purpose: </strong>Bio-impedance analysis (BIA) has been widely investigated for hemodynamic monitoring. However, previous works rarely modelled two synchronously pulsatile arteries (representing the radial and ulnar arteries) in the wrist/forearm model. This work aims to clarify and quantify the influences of two pulsatile arteries on BIA.</p><p><strong>Methods: </strong>First, two blood-filled arteries were structured in a 3D wrist segment using the finite element method (FEM). Afterwards, an easy-to-produce two-arteries artificial wrist was fabricated with two components: gelatine-based surrounding tissue phantom and saline blood phantom. A syringe driver was utilised to constrict the arteries, and the impedance signals were measured using a Multi-frequency Impedance Analyser (MFIA).</p><p><strong>Results: </strong>Both simulation and experimental results demonstrated the non-negligible influences of the ulnar artery on the overall BIA, inducing unwanted resistance changes to the acquired signals from the radial artery. The phantom experiments revealed the summation of the individual resistance changes caused by a single pulsatile artery was approximately equal to the measured resistance change caused by two synchronously pulsatile arteries, confirming the measured impedance signal at the wrist contains the pulsatile information from both arteries.</p><p><strong>Conclusion: </strong>This work is the first simulation and phantom investigation into two synchronously pulsatile arteries under BIA in the distal forearm, providing a better insight and understanding in the morphology of measured impedance signals. Future research can accordingly select either a small spacing 4-spot electrode configuration for a single artery sensing or a band electrode configuration for overall pulsatile arteries sensing. A more accurate estimation of blood volume change and pulse wave analysis (PWA) could help to develop cuffless blood pressure measurement (BPM).</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"810-826"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Measurement of Bovine Pericardium Density and Its Implications on Leaflet Stress Distribution in Bioprosthetic Heart Valves.","authors":"Masod Sadipour, Ali N Azadani","doi":"10.1007/s13239-023-00692-0","DOIUrl":"10.1007/s13239-023-00692-0","url":null,"abstract":"<p><strong>Purpose: </strong>Bioprosthetic Heart Valves (BHVs) are widely used in clinical practice, showing promising outcomes. Computational modeling offers a valuable tool for quantitatively characterizing BHVs. To ensure the accuracy of computational models, it is crucial to consider precise leaflet properties, including mechanical properties and density. Bovine pericardium (BP) serves as a common material for BHV leaflets. Previous computational studies often assume BP density to approximate that of water or blood. Given that BP leaflets undergo various treatments, such as tissue fixation and anti-calcification, this study aims to measure the density of BP used in BHVs and assess its impact on leaflet stress distribution.</p><p><strong>Methods: </strong>Eight square BP samples were laser cut from Edwards BP patches and their density was determined. Specimen weight was measured using an A&D Analytical Balance, while volume was assessed through high-resolution imaging. Additionally, finite element models resembling a BHV, like the Carpentier-Edwards PERIMOUNT Magna, were constructed in ABAQUS.</p><p><strong>Results: </strong>The average density of the BP samples was found to be 1,410 kg/m³. During the acceleration phase of a cardiac cycle, the maximum stress reached 1.89 MPa for a density of 1,410 kg/m³ and 2.47 MPa for a density of 1,000 kg/m³ (a 30.7% difference). In the deceleration phase, the maximum stress reached 713 kPa and 669 kPa, respectively.</p><p><strong>Conclusion: </strong>Leaflet stress distribution and motion in BHVs are influenced by density variations. Establishing an accurate density value for BHV leaflets is imperative for enhancing the computational models, which can ultimately contribute to improved BHV design and outcomes.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"853-861"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Skeletal Muscle-Pump on Blood Pressure and Postural Control in Parkinson's Disease.","authors":"Rabie Fadil, Asenath X A Huether, Farshid Sadeghian, Ajay K Verma, Andrew P Blaber, Jau-Shin Lou, Kouhyar Tavakolian","doi":"10.1007/s13239-023-00685-z","DOIUrl":"10.1007/s13239-023-00685-z","url":null,"abstract":"<p><strong>Purpose: </strong>Activation of the calf (gastrocnemius and soleus) and tibialis anterior muscles play an important role in blood pressure regulation (via muscle-pump mechanism) and postural control. Parkinson's disease is associated with calf (and tibialis anterior muscles weakness and stiffness, which contribute to postural instability and associated falls. In this work, we studied the role of the medial and lateral gastrocnemius, tibialis anterior, and soleus muscle contractions in maintaining blood pressure and postural stability in Parkinson's patients and healthy controls during standing. In addition, we investigated whether the activation of the calf and tibialis anterior muscles is baroreflex dependent or postural-mediated.</p><p><strong>Methods: </strong>We recorded electrocardiogram, blood pressure, center of pressure as a measure of postural sway, and muscle activity from the medial and lateral gastrocnemius, tibialis anterior, and soleus muscles from twenty-six Parkinson's patients and eighteen sex and age-matched healthy controls during standing and with eyes open. The interaction and bidirectional causalities between the cardiovascular, musculoskeletal, and postural variables were studied using wavelet transform coherence and convergent cross-mapping techniques, respectively.</p><p><strong>Results: </strong>Parkinson's patients experienced a higher postural sway and demonstrated mechanical muscle-pump dysfunction of all individual leg muscles, all of which contribute to postural instability. Moreover, our results showed that coupling between the cardiovascular, musculoskeletal, and postural variables is affected by Parkinson's disease while the contribution of the calf and tibialis anterior muscles is greater for blood pressure regulation than postural sway.</p><p><strong>Conclusion: </strong>The outcomes of this study could assist in the development of appropriate physical exercise programs that target lower limb muscles to improve the muscle-pump function and reduce postural instability in Parkinson's disease.</p>","PeriodicalId":54322,"journal":{"name":"Cardiovascular Engineering and Technology","volume":" ","pages":"755-773"},"PeriodicalIF":1.8,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41174844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}