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Some Aspects of the Applied Hemodynamics in Diagnostic Angiology

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Abstract

Sometimes physical principles of some technologies, which are used very effectively by the human, are so confused and nebulous that many year passes when people clearly realize laws and rules, which these technologies were based on.
Author - Ulyana B. Lushchyk, MD, PhD, DSc
Co-author - Novytskyy V. Viktor, Prof. D.Ph.&Math.Sc.
Sometimes physical principles of
some technologies, which are
used very effectively by the
human, are so confused and
nebulous that many year passes
when people clearly realize laws
and rules, which these
technologies were based on.
М. H. Maxon, М. Аlbert, F.Hedowry
Hemodynamics
(of Greek haima – blood, dynamis – force)
is a science, which appeared and is
developing on the crossroads of
hydromechanics and biology,
it studies blood movement in the closed
vascular system of the human organism taking
into account morphological structure of blood,
its physical-chemical characteristics, specific
features of vascular wall, dynamics of the live
system with applied adoption of the
hydrodynamic postulates. 
1. The gradient of the hydrostatic pressure in
various segments of the vascular system
that is formed due to the pumping function
of the myocardium.
2. Rheological properties of blood as the
dispersion of the forming elements with
properties of the non-Newton liquids.
3. Blood carrying vessels as the viscous-
elastic tubes, whose properties
(geometrical - size, branching and physical -
viscosity, elasticity, penetration) vary in
diameter and length.
HYDROMECHANICS
Theoretical Technical
hydromechanics hydromecanics
(hydraulics)
Hydrodynamics Rheology
Hydrostatics
Hemodynamics 
Ideal Newton liquids –
itisanabstractmodelthatisusedinordertosimplify
analyticalinvestigationsandischaracterisedwiththe
absolutelyunchangeablevolumeandcompleteabsence
ofviscositythat’sfrictionforcesundertheirmoving.
The profile of the velocity of movement of the ideal
Newton liquid
(viscosity = 0, F friction = 0)
Real Newton liquids
areallliquidsthatexistsinthenatureandcharacterised
by the viscosity - the force of the internal friction that
appearsinthemwhilethelayersaremoving.
Decreasing of their viscosity under increasing of the
temperature is the characteristic feature of the real
liquids (honey, tar, jam).
The profile of the velocity of
the real Newton
liquid’s movement
Non-Newton liquids
presentvariousmaterials,whoseonlycommonproperties
are their fluidity and deviation from the friction law of
Newton(marsh,emulsion,suspension,paint,blood).
The profile of velocity
of non-Newton liquids’ movement (viscous liquid)
As non-Newton liquids
increase their viscosity
under increasing of
temperature, patients under
hyperthermia and in the heat
require more careful
treatment.
The law of Hagen-Pausel
A loss of liquids is proportional to decreasing of
pressure per a unit of tube’s length and radius of the
tubeinthefourthpower.
Appliedessence:
is maintained with practically achieved velocities of
movementofliquidsinnarrowtubes.
This proportionality is not maintained for non-
Newton liquids - with decreasing of velocity of the
liquid’s movement the blood viscosity increases.
Москва, 2005
Hydrodynamic resistance with the pressure movement of real
liquids
1.Thevariantofthepressuremovementoftheidealliquid.
2.Thevariantofthepressuremovementoftherealliquid.
3.Thevariantofdecreasingofthepressuremovementofthe
real liquid in the conditions of the increased friction of the
wall.
Parameters In hydrodynamics In hemodynamics
Tube'swall unchangeablehard elastic,pulsating
Porosityofthetube'swall absent
thereareeffectsofpenetrationof
theliquidthroughthevacularwall
insmallvessels
Thetube'scontent
constantdensityofthereal
liquid
variabledensityonnon-Newton
liquids
apump
constantparametersofthe
pumpfunctioning
pumpingfunctionofthe
myocardiumisthevariablequantity
Segmentsofawatersupply
system
intakeandoutletmainlines thirdlinkapppears-capillarybed
Parameters In hydrodynamics In hemodynamics
Autoregulatingmechanisms
absentorarecontrolled
outside
present
characterofmovement pressure
isnotapressureoneinthe
classicalunderestanding,itdiffers
bythepossibilityofformationofa
blooddepotduetostretchingof
vascularwalls
Dempfers almostabsent present
Dynamicsystem absent present
corespondingtothe
gravitationforces
constant
constantlyvariabledueto
variationsofbodypositions
Москва, 2005
The section that
corresponds to
the capillary net
has the largest
area
Москва, 2005
According to the
condition of the
stream’s continuity in
case of increasing of
the system’s cross
section area the
velocity of blood flow
decreases in the
corresponding areas
Hemodynamics Laws
1. The law of continuous movement
Stream of liquid can be continuous under condition
of laminar stream and constant volumetric velocity
(multiplication of velocity and cross section is the
constant value): Sv = const
Volumetric velocity of blood flow is constant in any
section of the cardio-vascular system.
2. Bernoulli’s equation (1738) –
itisacorrelationforconstantmovingoftubeofflowof
idealincompressibleliquid.
Aproductofgeometric,piezometricandvelocityheight
remains constant on the whole distance of the given
flowoftheliquidstream:
z+p/γ+v2/2g=const,
γ= ρg
( γ specific gravity of the liquid )
“energetic”presentationoftheequation:
zpg + p +
ρ
v2 / 2 = const,
Zpg hydraulic pressure,
p – static pressure,
ρ
v2/2 – velocity (kinetic) pressure, that’s kinetic energy
of the mass unit of the moving liquid.
A sum of three pressures -
hydraulic, static and
velocity (kinetic) - makes
up complete pressure of
the moving liquid and it is
constant
That’s why separate kinds of mechanic
energy can vary, but their sum remains
the constant value - it is the law of the
energy conservation of moving liquid,
which is fundamental for the whole
hydromechanics.
Applying the Bernoulli’s equation to
real liquid they take into account
friction force too, which arises under
liquids’ moving.
3. The Puasel’s formula
A magnitude of the volumetric
velocity of liquid stream Q
depends on the radius of the
vessel r and is proportional to
r4 under condition of the
relative stability of difference
between pressure and length of
the vessel.
Amount of blood that flow through a blood
carrying bed per time unit is determined by the
presence of two factors:
1) pressure gradient in the circulation system;
2) resistance of the blood carrying bed that
depends on a degree of variance of the lumen
of vessels and character of their branching.
All methods of the life-time investigation of the
vascular system can be conditionally divided
into the following directions:
1. Assessment of the heart’s and vessels’
structures
2. Assessment of the functional activity of the
heart as a pump
3. Assessment of functions of vessels
4. Assessment of perfusion in organs and
tissues
5. Assessment of the pressure in the vascular
system
6. Assessment of the rheological features of
blood flow
It is necessary to observe in order to realize
and to realize in order to operate.
Roman Rollan
Assessment of the venous channel and signs of the intracranial
hypertension
ASTd
ASTs
VJIs
VJId
ACCs
ACCd
AVd=s
ACMd=s
ACPd
ACPs
ACId=s
AB
Hemodynamic efficiency of revascularization
VJId
VJIs ACCs
VSTd
ASTs
VVd
VVs
ACIs
ACId
AB
Assessment of elastic- tonic features of vessels
Assessment of the hemodynamic importance
ACCd ACCd after operation
ASTd
ASTs
ASTd after operation
ACCs after operation
ACCs
Integrated approach to assessment of functioning of
the hemodynamic system
Screening of ischemization of the myocardium with the
correction of hemodynamics in the organism
control
group
DE I DE II DE III
1. Predominating caliber of cerebral arteries
Мicrocaliber 2 18,5 24 32
Middlecaliber 72 74,5 68 48
Macrocaliber 26 7 8 20
2. Type of angioarchitectonics
Magistral 74 68 54 46
Diffused 26 32 46 54
3. Tortuosity of cerebral arteries
ofoneartery 2 4 14 38
oftwoarteries 4 4 14 34
4. Type of division
Dichotomic 94 55,6 34 34
Pathologicalatypical 6 44,4 66 66
Mathematical Modeling of Possible Tracts of Revascularization
Present level of non-invasive investigation of the vascular bed
requires  profound knowledge of basics of hemodynamics and
potential of the ultrasound devices not only from physicians, USD
functional diagnostics, but also from vascular surgeons and
neurosurgeons
Calculation of the size of the hydraulic stroke
Calculation of the required caliber of a vessel
Correction of the arteriovenous-liquor balance
An angle of incline of an artery in case of transposition
Theoptimumangleup
to60°
2 approaches:
macrolevel of
blood circulation;
microcirculation
... Such attitude toward angiology and angiotherapy may be explained by deliberate distraction from understanding of the cardiovascular pathology, as there is a large gap between the information about cardiovascular system studied at medical institutions and the real state that can be explored using current medical technologies. They just need deep understanding of these processes of adequate blood supply in the organism, which actually holds the livelihoods of all living organisms [8,[44][45][46][47][48][49][50][51][52][53][54][55]. ...
... Perhaps in this regard, doctors have formed a certain stereotype that the metabolism is primary and vascularization is secondary. Although, the pathogenetic view is well known that the cardiovascular system provides blood supply to organs and systems and the arterial bloodstream delivers oxygen and nutrients to tissue and cellular metabolism, while the venous link takes out carbon dioxide and metabolic products [7,55]. ...
... And practitioners ignore how fast arterial blood moving in a reservoir, the signs of venous stasis and how it may be reflected on the velocity and quality of tissue oxygenation and metabolism [7,21,[55][56][57]. ...
Article
Full-text available
Review: Problems of effective correction and radical solving of cardiovascular disorders are not new. However, the statistic indexes of cardiovascular pathology are growing and they are considerably younger [1-6]; this testifies to lack of effective management strategy and tactics in fight against these diseases [7-13]. Today we can make a real estimation of achieved results: for the last 20-30 years many technologies are created for research of vascular system - USD of vessels, МRТ in angiomode; devices for correction of cardiac disorders are widely used - from numerous technologies for estimation of the heart structure to coronarography and coronarshunting; new fields of radical medicine are successfully implemented, such as cardiac surgery, angiosurgery, phlebology [14-16]. And at the same time, regardless of the most up-to-date technologies for vascular diagnostics and angiosurgery cardiovascular diseases gets top ranking regarding morbidity and death rate [6,9,17,18]. It can be explained by the fact that development and introduction in medical practice of modern vascular technologies are behind a steady tendency to progress and cardiovascular diseases strike younger people. This dissonance testifies to insufficient knowledge and analysis at the application of new technological potential of visualization of the cardiovascular system at structural (in vitro and in vivo) and functional level - in vivo [7,9,10,12,17]. Our 20-year-old experience of research of vascular disorders and successful attempts of their correction [19] has shown that 1) There is a huge layer of unexplored hemodynamic parameters, which are important in the personalized treatment processes. However, long neglecting biomechanics in medicine [20] resulted into excessive emphasis on endothelial dysfunction and cellular metamorphosis beneficial for promoting pharmacological business. As a result, doctors are not ready to think logically with categories of circulation mechanics and applied hydro- and hemodynamics [21]. 2) Physicians and medical staff don't have enough knowledge in angiology, hemodynamics, hydrodynamics, analytical angiocorrection, angiotherapy, treatment management on evidential basis. Without understanding the depth of hemodynamic laws and logics of pathological and sanogenic transformations in blood supply for organs and regional reservoirs as closed system of vascular tubes - vascular blood flow, it is impossible to perform personalized adequate treatment and predict positive outcomes [8,10]. 3) There is an urgent need in development of vascular monitoring technologies based on principles of evidential medicine [2,7,8,10]. Monitoring dynamic changes in any medical process management, doctors may correct on time the decline from sanogenic blood restoration in a particular regional reservoir and logic of blood redistribution in different vascular reservoirs in a patient's body. Keywords: Personalized treatment, Hemodynamics, Cardiovascular diseases, Angiocorrection, Hydrodynamic conflicts, Brain edema, Biomarkers, Angiomarkers, Intracranial hypertension, Vascular screening, Angiotherapy
... During 2010-2017, the methodology of USDG of major arteries and veins gradually developed into Angiomarker technology with the possibility of analysis of about 50 hemodynamic parameters that proved to be significant pathohemodynamic indicators of vascular blood flow disorders, in contrast to structural changes at the macro level [52,53,54,55,56,57,58]. ...
Book
Full-text available
This monograph is devoted to a topical issue - applied angiology, the place of different diagnostic methods in the verification and objectification of vascular structural and functional disorders based on deep knowledge of authors - experts in applied hemodynamics, angiology, angiotherapy - Academician of the Ukrainian Academy of Technological Sciences, Professor, Doctor of Medical Science Ulyana Lushchyk and Professor, Doctor of Physical and Mathematical Sciences Viktor Novytsky and the team of scientists headed by them. Methods of objectification of the cardiovascular system, their advantages and limitations for certain segments of the cardiovascular system, their application in the visualization and monitoring of vascular changes at the macro- and microvascular levels are described in detail.
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