1
|
Whittle RS, Diaz-Artiles A. Gravitational effects on carotid and jugular characteristics in graded head-up and head-down tilt. J Appl Physiol (1985) 2023; 134:217-229. [PMID: 36476158 PMCID: PMC9870583 DOI: 10.1152/japplphysiol.00248.2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Altered gravity affects hemodynamics and blood flow in the neck. At least one incidence of jugular venous thrombosis has been reported in an astronaut on the International Space Station. This investigation explores the impact of changes in the direction of the gravitational vector on the characteristics of the neck arteries and veins. Twelve subjects underwent graded tilt from 45° head-up to 45° head-down in 15° increments in both supine and prone positions. At each angle, the cross-sectional area of the left and right common carotid arteries (ACCA) and internal jugular veins (AIJV) were measured by ultrasound. Internal jugular venous pressure (IJVP) was also measured by compression sonography. Gravitational dose-response curves were generated from experimental data. ACCA did not show any gravitational dependence. Conversely, both AIJV and IJVP increased in a nonlinear fashion with head-down tilt. AIJV was significantly larger on the right side than the left side at all tilt angles. In addition, IJVP was significantly elevated in the prone position compared with the supine position, most likely because of raised intrathoracic pressure while prone. Dose-response curves were compared with existing experimental data from parabolic flight and spaceflight studies, showing good agreement on an acute timescale. The quantification of jugular hemodynamics as a function of changes in the gravitational vector presented here provides a terrestrial model to reference spaceflight-induced changes, contributes to the assessment of the pathogenesis of spaceflight venous thromboembolism events, and informs the development of countermeasures.NEW & NOTEWORTHY Flow stasis and thrombosis have been identified in the jugular vein during spaceflight. We measured the area and pressure of the internal jugular vein and the area of the common carotid artery in graded head-up and head-down tilt. Experimental data are used to generate gravitational dose-response curves for the measured variables, demonstrating that jugular vein area and pressure exhibit a nonlinear response to altered gravity. Gravitational dose-response curves show good agreement with spaceflight and parabolic flight studies.
Collapse
Affiliation(s)
- Richard S Whittle
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
| | - Ana Diaz-Artiles
- Department of Aerospace Engineering, Texas A&M University, College Station, Texas
- Department of Kinesiology & Sport Management, Texas A&M University, College Station, Texas
| |
Collapse
|
2
|
Simka M, Latacz P. Numerical modeling of blood flow in the internal jugular vein with the use of computational fluid mechanics software. Phlebology 2021; 36:541-548. [PMID: 33611976 DOI: 10.1177/0268355521996087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the site and nature of altered hemodynamics in pathological internal jugular veins. METHOD With the use of computational fluid mechanics software we simulated blood flow in 3 D models of the internal jugular veins that exhibited different morphologies, including nozzle-like strictures in their upper parts and valves in the lower parts. RESULTS In a majority of models with nozzle-like strictures, especially those positioned asymmetrically, abnormal flow pattern was revealed, with significant flow separation and regions with reversed flow. Abnormal valves had no significant impact on flow in a case of already altered flow evoked by stricture in upper part of the vein. CONCLUSIONS In our jugular model, cranially-located stenoses, which in clinical practice are primarily caused by external compression, cause more significant outflow impact respect to endoluminal defects and pathological valves located more caudally.
Collapse
Affiliation(s)
- Marian Simka
- Department of Anatomy, Institute of Medicine, University of Opole, Opole, Poland
| | - Paweł Latacz
- Department of Neurology, University Hospital, Jagiellonian University Medical College, Kraków, Poland
| |
Collapse
|
3
|
Cheng D, Zhuang Y, Kou Q, Zhang M, Zhao Y, Han C, Li J, Wang Y, Xu K, Mo F, Zhang J. Numerical simulation of hemodynamics in membranous obstruction of the suprahepatic inferior vena cava based on a subject-specific Budd-Chiari syndrome model. Clin Biomech (Bristol, Avon) 2018; 52:20-24. [PMID: 29316476 DOI: 10.1016/j.clinbiomech.2017.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 12/26/2017] [Accepted: 12/29/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND This study was performed to determine the hemodynamic changes of Budd-Chiari syndrome when the inferior vena vein membrane is developing. METHODS A patient-specific Budd-Chiari syndrome vascular model was reconstructed based on magnetic resonance images using Mimics software and different degrees (16%, 37%, and 54%) of idealized membrane were built based on the Budd-Chiari syndrome vascular model using Geomagic software. Three membrane obstruction Budd-Chiari syndrome vascular models were established successfully and fluent software was used to simulate hemodynamic parameters, including blood velocity and wall shear stress. FINDINGS The simulation results showed that there is low velocity and a low wall shear stress region at the junction of the inferior vena cava and the branches of the hepatic veins, and swirl may occur in this area. As the membrane develops, the size of the low velocity and low wall shear stress regions enlarged and the wall shear stress was increased at the membrane region. There was a significant difference in the mean values of wall shear stress between the different obstruction membrane models (P<0.05). INTERPRETATION Hemodynamic parameters play an important role in vascular disease and there may be a correlation between inferior vena cava wall shear force changes and the slow development process of the inferior vena cava membrane.
Collapse
Affiliation(s)
- Deqiang Cheng
- School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - Yinping Zhuang
- School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China; School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China.
| | - Qiqi Kou
- School of Information and Control Engineering, China University of Mining and Technology, Xuzhou 221116, China
| | - Min Zhang
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Yinghong Zhao
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Cuiping Han
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Jingjing Li
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Yong Wang
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Kai Xu
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Fei Mo
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| | - Jiawei Zhang
- School of Medical Imaging, Xuzhou Medical University, 84West Huai-hai Road, Xuzhou 221004, China
| |
Collapse
|
4
|
Ciccone MM, Scicchitano P, Gesualdo M, Cortese F, Zito A, Manca F, Boninfante B, Recchia P, Leogrande D, Viola D, Damiani M, Gambacorta V, Piccolo A, De Ceglie V, Quaranta N. Idiopathic sudden sensorineural hearing loss and ménière syndrome: The role of cerebral venous drainage. Clin Otolaryngol 2017; 43:230-239. [PMID: 28744995 DOI: 10.1111/coa.12947] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To evaluate the influence of cerebral venous drainage on the pathogenesis of idiopathic sudden sensorineural hearing loss (ISSHL) and Ménière syndrome (MD). DESIGN Observational, prospective, cohort study. SETTING ENT and Cardiology Departments (University of Bari, Policlinico Hospital, Bari, Italy). PARTICIPANTS We enrolled 59 consecutive patients (32 males, mean age 53.05 + 15.37 years): 40 ISSHL and 19 MD. MAIN OUTCOME MEASURE All patients underwent physical examination, biochemical evaluation (glycemic and lipid profile, viral serology, C reactive protein, etc), audiometric (tonal, vocal, vestibular evoked myogenic potentials and auditory brainstem response test) and impedentiometric examination. The pure tone average (PTA) was calculated for the following frequencies: 250, 500, 1000, 2000, 3000, 4000, 8000. An echo-color Doppler evaluation of the venous cerebral veins, internal jugular (IJV) and vertebral veins (VV) at supine and 90° position was performed. RESULTS No morphological alterations were found both in patients and controls. There were no signs of stenosis, blocked flow, membranes, etc. We found lower minimum, mean and maximum velocities in distal IJVs (P = .019; P = .013; P = .022; respectively) and left VVs (P = .027; P = .008; P = .001; respectively) in supine (0°) position in both MD and ISSHL patients as compared to controls. The same was for orthostatic position (90°). We found negative correlations between the velocities in extracranial veins and PTA values: therefore, the worst the audiometric performance of the subjects, the lower the velocities in the venous cerebral drainage. CONCLUSIONS Idiopathic sudden sensorineural hearing loss and Ménière syndrome patients showed altered venous flow in IJVs and VVs as compared to controls, independently from posture. This different behavior of venous tone control can influence the ear performance and may have a role in the pathogenesis of both diseases.
Collapse
Affiliation(s)
- M M Ciccone
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - P Scicchitano
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - M Gesualdo
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - F Cortese
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - A Zito
- Section of Cardiovascular Diseases, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - F Manca
- Department of Science of Educational, Psicology and Communication, University of Bari, Bari, Italy
| | - B Boninfante
- P.J.D. of Statistical- Department of Medical Statistics, University of Bari, Bari, Italy
| | - P Recchia
- Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy
| | - D Leogrande
- Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy
| | - D Viola
- Dipartimento di studi aziendali e giusprivatistici, University "A. Moro" of Bari, Bari, Italy
| | - M Damiani
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - V Gambacorta
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - A Piccolo
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - V De Ceglie
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| | - N Quaranta
- Section of Otolaryngology, Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari, Bari, Italy
| |
Collapse
|
5
|
Miraucourt O, Salmon S, Szopos M, Thiriet M. Blood flow in the cerebral venous system: modeling and simulation. Comput Methods Biomech Biomed Engin 2016; 20:471-482. [PMID: 27802781 DOI: 10.1080/10255842.2016.1247833] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The development of a software platform incorporating all aspects, from medical imaging data, through three-dimensional reconstruction and suitable meshing, up to simulation of blood flow in patient-specific geometries, is a crucial challenge in biomedical engineering. In the present study, a fully three-dimensional blood flow simulation is carried out through a complete rigid macrovascular circuit, namely the intracranial venous network, instead of a reduced order simulation and partial vascular network. The biomechanical modeling step is carefully analyzed and leads to the description of the flow governed by the dimensionless Navier-Stokes equations for an incompressible viscous fluid. The equations are then numerically solved with a free finite element software using five meshes of a realistic geometry obtained from medical images to prove the feasibility of the pipeline. Some features of the intracranial venous circuit in the supine position such as asymmetric behavior in merging regions are discussed.
Collapse
Affiliation(s)
- Olivia Miraucourt
- a Laboratoire de Mathématiques, EA 4535 FR CNRS ARC 3399 , Université de Reims Champagne-Ardenne, UFR Sciences Exactes et Naturelles , Reims Cedex 2 , France
| | - Stéphanie Salmon
- a Laboratoire de Mathématiques, EA 4535 FR CNRS ARC 3399 , Université de Reims Champagne-Ardenne, UFR Sciences Exactes et Naturelles , Reims Cedex 2 , France
| | - Marcela Szopos
- b Université de Strasbourg , CNRS, IRMA UMR 7501 , F-67000 Strasbourg , France
| | - Marc Thiriet
- c Laboratoire J.-L. Lions , UMR 7598 CNRS/Université Pierre et Marie Curie-Paris 6 , Paris , France .,d INRIA, Equipe-projet REO , Le Chesnay , France
| |
Collapse
|
6
|
Marcotti S, Marchetti L, Cecconi P, Votta E, Fiore GB, Barberio A, Viotti S, Redaelli A, Laganà MM. An anatomy-based lumped parameter model of cerebrospinal venous circulation: can an extracranial anatomical change impact intracranial hemodynamics? BMC Neurol 2015; 15:95. [PMID: 26099795 PMCID: PMC4476203 DOI: 10.1186/s12883-015-0352-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 06/10/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The relationship between extracranial venous system abnormalities and central nervous system disorders has been recently theorized. In this paper we delve into this hypothesis by modeling the venous drainage in brain and spinal column areas and simulating the intracranial flow changes due to extracranial morphological stenoses. METHODS A lumped parameter model of the cerebro-spinal venous drainage was created based on anatomical knowledge and vessels diameters and lengths taken from literature. Each vein was modeled as a hydraulic resistance, calculated through Poiseuille's law. The inputs of the model were arterial flow rates of the intracranial, vertebral and lumbar districts. The effects of the obstruction of the main venous outflows were simulated. A database comprising 112 Multiple Sclerosis patients (Male/Female = 42/70; median age ± standard deviation = 43.7 ± 10.5 years) was retrospectively analyzed. RESULTS The flow rate of the main veins estimated with the model was similar to the measures of 21 healthy controls (Male/Female = 10/11; mean age ± standard deviation = 31 ± 11 years), obtained with a 1.5 T Magnetic Resonance scanner. The intracranial reflux topography predicted with the model in cases of internal jugular vein diameter reduction was similar to those observed in the patients with internal jugular vein obstacles. CONCLUSIONS The proposed model can predict physiological and pathological behaviors with good fidelity. Despite the simplifications introduced in cerebrospinal venous circulation modeling, the key anatomical feature of the lumped parameter model allowed for a detailed analysis of the consequences of extracranial venous impairments on intracranial pressure and hemodynamics.
Collapse
Affiliation(s)
- Stefania Marcotti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Lara Marchetti
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Pietro Cecconi
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Gianfranco Beniamino Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Antonello Barberio
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Stefano Viotti
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo Da Vinci, 32, 20133, Milan, Italy.
| | - Maria Marcella Laganà
- Magnetic Resonance Laboratory, Fondazione Don Carlo Gnocchi ONLUS, IRCCS Santa Maria Nascente, Via Capecelatro 66, 20148, Milan, Italy.
| |
Collapse
|
7
|
Müller LO, Toro EF, Haacke EM, Utriainen D. Impact of CCSVI on cerebral haemodynamics: a mathematical study using MRI angiographic and flow data. Phlebology 2015; 31:305-24. [DOI: 10.1177/0268355515586526] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background The presence of abnormal anatomy and flow in neck veins has been recently linked to neurological diseases. The precise impact of extra-cranial abnormalities such as stenoses remains unexplored. Methods Pressure and velocity fields in the full cardiovascular system are computed by means of a global mathematical model that accounts for the relationship between pulsating cerebral blood flow and intracranial pressure. Results Our model predicts that extra-cranial strictures cause increased pressure in the cerebral venous system. Specifically, there is a predicted pressure increase of about 10% in patients with a 90% stenoses. Pressure increases are related to significant flow redistribution with flow reduction of up to 70% in stenosed vessels and consequent flow increase in collateral pathways. Conclusions Extra-cranial venous strictures can lead to pressure increases in intra-cranial veins of up to 1.3 mmHg, despite the shielding role of the Starling resistor. The long-term clinical implications of the predicted pressure changes are unclear.
Collapse
Affiliation(s)
- LO Müller
- Computer Science Department, National Laboratory for Scientific Computing, LNCC/MCTI, Petrópolis, RJ, Brazil
- Laboratory of Applied Mathematics, Department of Civil, Environmental and Mechanical Engineering, University of Trento, Trento, Italy
| | - EF Toro
- Laboratory of Applied Mathematics, Department of Civil, Environmental and Mechanical Engineering, University of Trento, Trento, Italy
| | - EM Haacke
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
- Magnetic Resonance Innovations, Inc. Detroit, MI, USA
| | - D Utriainen
- Magnetic Resonance Innovations, Inc. Detroit, MI, USA
| |
Collapse
|